Hidradenitis suppurativa, also known as acne inversa, is a chronic inflammatory disease affecting the skin in the hair roots around the sweat glands. It is estimated to affect between one and four percent of the population.
Acne inversa is characterized by chronically recurring painful nodules that may form abscesses. The infection underneath the skin can lead to pus discharge from the infected area.
The underlying inflammation leads to scar formation and distortion of the skin. If left unchecked, this repetitive cycle of inflammation and infection can cause tunnels under the skin. This can result in sinus tracts that connect the various affected areas. The overlying skin ultimately becomes thickened.
Hidradenitis suppurativa commonly occurs in creases or folds of the skin, and it develops most often in the groin and armpits.
The preferred treatment for hidradenitis suppurativa is complete excision of the affected areas. Surgeons with less experience often do not remove the affected tissues entirely, resulting in recurring infections. Because of this, it’s imperative to choose a board-certified plastic surgeon with experience performing this procedure.
If you suffer from hidradenitis suppurativa, you may find that the infected nodules leak pus. This pus drainage from the skin may result in odor and frequent stains on your clothes. This can be a source of embarrassment.
Surgical excision can remove the infected nodules and stop pus from leaking out from your skin.
Hidradenitis suppurativa can be painful, especially if the lumps form in areas that have constant or periodic pressure on them.
Treatment for hidradenitis suppurativa removes the infected tissue and painful lumps so you can live without the itchiness, pain, and discomfort caused by this condition.
Acne inversa is a persistent infection. If left untreated, it can cause scars on the affected area of skin. Patients with severe hidradenitis suppurativa may end up with scarring over an entire area of their body.
By treating acne inversa with surgical excision, patients can avoid the thickening and extensive scarring of their skin.
The first step for treating acne inversa is a consultation with Dr. Hadeed. He will evaluate your condition and recommend a treatment plan to provide you with optimal results.
Dr. Hadeed is a double board-certified plastic surgeon with expertise in reconstructive procedures. He is highly experienced at treating concerns plaguing those who suffer from hidradenitis suppurativa.
Treatment for hidradenitis suppurativa is usually performed under general anesthesia. It may be performed as an outpatient surgical procedure, or it can be inpatient, especially if the procedure needed is more extensive.
Patients do not feel pain while the infected tissue is removed.
Dr. Hadeed treats the affected area(s) through a unique combination of advanced plastic surgery techniques.
To achieve the best possible results and minimize the chance of the infection recurring, Dr. Hadeed will widely excise the affected area. The excision process will remove the infected tissue. Dr. Hadeed will preserve the surrounding tissue to the degree possible.
This technique offers the best chance of providing effective long-term results.
Since broad excision will leave a large open area, Dr. Hadeed uses advanced plastic surgical techniques to close the wound. The options for closure of the areas include either skin grafts or flap closure.
Flap closure involves folding healthy skin over the wound and suturing it in place. This is used when the excised area is narrow with healthy skin on either side.
The advantage of this process is that it is fast and effective, and it requires no added complexity. The disadvantage is that it can only treat some wounds and may pull your skin tight for a time.
Skin grafts involve taking a healthy section of skin from another area of the body and grafting it over the wound. This is highly effective but more complex and has a higher chance of complications. For this reason, Dr. Hadeed will perform a skin graft only when necessary.
The advantage of a skin graft is that any size wound can be treated. The disadvantage is that a skin graft requires additional incisions in other areas of your body.
You may have surgical drains in place for one to three weeks after your operation. These drains help prevent swelling and speed your recovery. Most people can return to work once these drains are removed. You may resume most normal activities within two to three weeks after surgery.
You should refrain from exercise or vigorous activities until complete healing has occurred. This usually takes four to six weeks, though recovery times will vary depending on the amount of tissue removed.
Surgical excision will result in scarring in the places where the infected tissue is removed. However, these areas tend to already be scarred due to the nature of the infection. Dr. Hadeed will make the incisions and resulting scars as inconspicuous as possible.
If skin grafts are used, there will be additional scarring at the donor site. These scars can be significant, but most patients believe scars are worth the beneficial results. All scars fade over time.
After your operation, you should see immediate results, as the painful nodules will be gone. You should continue to monitor the treated area to ensure that the infection and associated symptoms do not return.
My experience with Dr. Hadeed exceeded my expectations! Not only am I incredibly happy and satisfied with my surgery results, I was very impressed by his warmth, expertise, and professionalism…
There is no one specific factor that causes hidradenitis suppurativa. Contributing factors in some individuals may include obesity, smoking, genetic factors, and possibly diets high in dairy products. Hidradenitis suppurativa occurs sporadically in most individuals.
Acne inversa is not a contagious disease. It is thought to be an inflammatory disease involving follicular structures. There is a family history of the condition in approximately 30 percent of individuals.
The cost of your hidradenitis suppurativa excision will vary based on the size of the infected area that needs treatment and the technique used. Dr. Hadeed will inform you of all necessary price information during your consultation.
Hidradenitis suppurativa can leave scars with or without surgery because the nodules open and scar repeatedly. These scars can also form under the skin, leading to more persistent infections by trapping sweat and bacteria under the skin. Surgical excision can remove these scars and the underlying infected tissues.
Wide excision of the affected area followed by reconstruction can effectively manage the symptoms of acne inversa. Generally speaking, acne inversa is a persistent condition that lasts for many years. Because of this, there is no guarantee that it will not recur, but some patients experience permanent results.
As with any surgical procedure, there are risks associated with surgically treating hidradenitis suppurativa.
These risks may include:
Before and After Photos - individual results may vary – Some images may be models