Finding a Dermatologist for Hidradenitis Suppurativa

How to Find the Right Dermatologist to Help You Manage Your Hidradenitis Suppurativa

Whether you’re newly diagnosed or unhappy with your current hidradenitis suppurativa treatment, a dermatologist who listens is key to getting the care you need.

How to Find the Right Dermatologist to Help You Manage HS

Learn about hidradenitis suppurativa and the importance of early diagnosis and personalized dermatological care.
How to Find the Right Dermatologist to Help You Manage HS

Hidradenitis suppurativa (HS) is a chronic skin disease in which painful nodules form, typically in areas where your skin rubs together or folds. Without treatment, the nodules can progress to pus-filled abscesses, tunnels between abscesses, scarring, and restricted movement in areas where scarring develops.

HS often begins between adolescence and a person’s forties.

People with HS might not get a diagnosis for years because of factors ranging from embarrassment to a lack of awareness that its recurring symptoms can and should receive treatment.

Many people don’t see a doctor for HS until it starts to interfere significantly with their daily activities and reduces their quality of life.

Here’s what gets in the way of seeking care for hidradenitis suppurativa, and some tips for finding a dermatologist.

Black woman talking with a new doctor in exam room
If you have this chronic skin disease, a good working relationship with your doctor will improve your outcomes.
iStock

Barriers to Care for Hidradenitis Suppurativa

HS isn’t a rare disease, but in the past, some primary care physicians failed to recognize its signs and symptoms, according to Anna Kirkorian, MD, the chief of dermatology at Children’s National Hospital in Washington, DC. “Fortunately, this is no longer the case in some areas of the United States,” she says, citing the uptick in referrals she’s seen in recent years.

But Dr. Kirkorian says that doctors who don’t recognize HS may treat the symptoms as isolated occurrences, not realizing that the condition is chronic.

Lack of Awareness

“People also may not recognize their symptoms as being caused by a chronic disease. They may think, for example, ‘This is just a strange thing that happens to me,’” says Kirkorian, “or ‘Oh, I just get boils,’ when they have HS.”

According to Mayo Clinic, catching HS as early as possible increases the effectiveness of treatment. They recommend consulting a doctor about HS if symptoms involve the following:

  • Pain
  • Symptoms that don’t get better after a few weeks
  • Symptoms that come back within weeks of treatment
  • Symptoms in several areas of the body
  • Regular flares
  • Movement difficulties

Embarrassment

Other times, people may be reluctant to seek care because they’re embarrassed by their symptoms or aren’t comfortable with a doctor examining certain body parts.

“The most common locations for HS lesions are the armpits, under the breasts, the groin, genitals, and buttocks,” says Steven Daveluy, MD, an associate professor and a clinical educator in the Wayne State University department of dermatology in Detroit and a board-certified dermatologist.

“These are sensitive areas that we don't share with many people in our lives. While logically, we know that it's okay to show these areas to our doctor, that doesn't make it any less awkward when another human being is standing in front of you, and you have to take your clothes off.”

Still, Dr. Daveluy advises, “try to remember that they are medical professionals trained to provide expert care for sensitive areas of the body.”

He adds, “If you've had a bad experience with a healthcare provider, please don't give up. Keep looking for a provider who knows the facts about HS and can provide the care you need. The HS Foundation website has a clinic finder that can help you find an HS expert.”

How to Find a Dermatologist

Most dermatologists can treat your HS effectively if they’re a good fit for you. “I think communication is the heart of all healthcare,” says Kirkorian. “If you don’t feel like the communication is working well during the visit, then that could be a reason to consider switching doctors.”

If your area doesn’t have any dermatologists, Kirkorian recommends looking for a dermatology practice further afield that offers telehealth appointments.

While video visits don’t work for all skin conditions, “The diagnosis [of HS] is not usually that challenging,” Kirkorian says. “That means a dermatologist typically spends most of the appointment discussing symptoms and treatments. You can usually take photos of affected areas and send them to the doctor through a secure platform when necessary.”

“Whether you’re looking for a telehealth or in-person appointment with a dermatologist, asking your primary care provider for a referral can be a good place to start,” says Kirkorian. “You can also get recommendations from online support or discussion groups. Hope for HS offers virtual and in-person meetings in different states, and Facebook groups are also available to discuss the condition with others who live with its symptoms.”

In addition to the HS Foundation, HS Awareness has a directory of HS-experienced dermatologists.

People with health insurance can also check with their insurance provider about which dermatologists are included in their network.

If you have severe HS, Kirkorian recommends seeing a dermatologist at a hospital affiliated with a medical school or at a hidradenitis suppurativa specialty clinic.

Above all, “People shouldn’t delay seeking care,” says Kirkorian. “We don’t want to wait until there is scarring or disability from the disease. I’d rather see a patient early than wait until their HS is severe.”

How to Find the Right Treatment

Before a dermatologist consultation, list the symptoms you experience and details of any medications, vitamins, or supplements you use and at what doses.

 This can help you get ready for your appointment and may allow the dermatologist to target symptoms more effectively.

Because discussing all the facets of HS treatment takes time, your healthcare provider may book more time for appointments for particularly severe HS. It’s unrealistic to expect that every treatment will work. “Finding the right one can take some time, and you may need to try something else,” she says, which is another reason why seeing a dermatologist who listens to your concerns is vital.

Learn as much about HS as you can. Kirkorian recommends visiting the HS Foundation website, which offers information about the condition and in-depth discussions on treatments and research. She advises avoiding online information that doesn’t come from a trusted source.

Hidradenitis Suppurativa Treatment Options

“Treating HS isn’t like following an instruction manual,” says Kirkorian, “which makes it different from some other skin conditions.” Instead, she says, HS treatment typically requires several approaches simultaneously, tailored specifically to the individual. “Even in the best hands, it can be a difficult disease to control,” she notes.

A doctor may prescribe several types of HS medicines, including:

  • Antibiotic liquids or gels
  • Oral antibiotics for widespread HS symptoms, including doxycycline (Monodox), clindamycin (Cleocin), or rifampin (Rimactane)
  • Injections of a steroid called triamcinolone acetonide (Kenalog-10)
  • Hormonal therapy, such as estrogen therapy, to treat mild HS
  • Biologics like adalimumab (Humira), infliximab (Remicade), and bimekizumab (Bimzelx), which reduce immune activity and reduce the disease cycle to improve symptoms in a few weeks
  • Oral retinoids, although a dermatologist may not recommend these during treatment
  • Pain relief medications
They might also discuss the benefits and risks of the following surgical options with you, including:

  • Deroofing: This involves removing tissue and exposing tunnels under the skin for people with moderate to severe HS. A dermatologist may do this for a single swollen lesion, which is known as a limited unroofing.
  • Laser therapy: A dermatologist might use a carbon dioxide laser to remove HS sores. Laser hair removal might also make symptoms better for people with early HS.
  • Surgical skin removal: For severe symptoms that don’t respond to other treatments, doctors may need to remove full areas of skin and replace them with a skin graft. But HS may still develop in other areas of the body.

In addition to prescription medicines, “treatment for HS may involve addressing any excess body weight, adjustments to exercise routines, and sexual health,” Kirkorian says.

Dermatologists might suggest using warm compresses to relieve pain and using an antiseptic wash like benzoyl peroxide or chlorhexidine as part of your daily skin-care routine. Smoking cessation can also improve HS.

The Takeaway

  • People with hidradenitis suppurativa (HS) may not seek treatment at first, whether they confuse their symptoms for another condition or feel reservations about having sensitive areas examined.
  • Early treatment is crucial, and a referring physician, an HS nonprofit, or an insurer can point you toward an HS-experienced dermatologist who can prescribe medications or discuss surgery to treat HS.
  • You don’t need to feel shame or embarrassment about HS, and learning about the condition can connect you with treatment that prevents HS’s sometimes disabling complications.
Amy-Spizuoco-bio

Amy Spizuoco, DO

Medical Reviewer

Amy Spizuoco, DO, is a board-certified dermatologist and dermatopathologist. Dr. Spizuoco has been practicing medical, surgical, and cosmetic dermatology, as well as dermatopathology in New York City for 12 years.

She did her undergraduate training at Binghamton University, majoring in Italian and biology. She went to medical school at the New York Institute of Technology College of Osteopathic Medicine. After medical school, she completed her dermatology residency at Lake Erie College of Osteopathic Medicine–Alta Dermatology in Arizona. During that time she studied skin cancer surgery and pediatric dermatology at Phoenix Children’s Hospital and attended dermatology grand rounds at the Mayo Clinic in Scottsdale. After her residency, Spizuoco completed a dermatopathology fellowship at the Ackerman Academy of Dermatopathology.

She was previously an associate clinical instructor in the department of dermatology at the Icahn School of Medicine at Mount Sinai in New York City. She is on the editorial boards of Practical Dermatology and Dermatology Times.

Adam Felman

Author
Adam is a freelance writer and editor based in Sussex, England. He loves creating content that helps people and animals feel better. His credits include Medical News Today, Greatist, ZOE, MyLifeforce, and Rover, and he also spent a stint as senior updates editor for Screen Rant.

As a hearing aid user and hearing loss advocate, Adam greatly values content that illuminates invisible disabilities. (He's also a music producer and loves the opportunity to explore the junction at which hearing loss and music collide head-on.)

In his spare time, Adam enjoys running along Worthing seafront, hanging out with his rescue dog, Maggie, and performing loop artistry for disgruntled-looking rooms of 10 people or less.

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Ludmann P. Hidradenitis suppurativa: Overview. American Academy of Dermatology Association. May 3, 2022.
  2. Hidradenitis Suppurativa. Mayo Clinic. June 21, 2024.
  3. How to Select a Dermatologist. American Academy of Dermatology Association. October 10, 2022.
  4. Hidradenitis Suppurativa: Diagnosis and Treatment. Mayo Clinic. June 21, 2024.
  5. Hidradenitis suppurativa diagnosis and treatment. Mayo Clinic. June 21, 2024.