INFLAMMATORY CONDITIONS (HIDRADENTIS)

Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition affecting areas of the body where skin rubs together and contains a higher concentration of sweat glands, most commonly the underarms, groin, buttocks, and under the breasts. It causes recurrent, painful lumps, abscesses, and, in more advanced cases, interconnected tunnels beneath the skin (sinus tracts). HS can have a significant impact on quality of life, and while there is no single cure, a combination of medical and surgical management can meaningfully improve symptoms and reduce flare frequency.

At LIFEXCLINICS, hidradenitis suppurativa is managed by Dr Robert George, a Specialist Soft Tissue Surgeon (MBBS MS FRACS), who works with patients to develop a long-term management plan suited to the severity and stage of their condition.

Signs and symptoms:

Common signs of hidradenitis suppurativa include:

• Recurrent, painful lumps in the underarms, groin, buttocks, or under the breasts
• Abscesses that recur in the same areas over time
• Persistent discharge or drainage from affected areas
• Sinus tracts — interconnected tunnels beneath the skin, seen in more advanced disease
• Scarring in previously affected areas
• Flares that worsen with friction, heat, or hormonal changes

Stages of hidradenitis suppurativa:

HS is typically classified according to severity:

• Stage I — isolated abscesses without sinus tracts or significant scarring
• Stage II — recurrent abscesses with sinus tract formation and scarring in one or more areas, with lesions still separated by areas of normal skin
• Stage III — widespread, interconnected sinus tracts and abscesses across an entire area, with diffuse involvement

Our approach to management:

Because HS varies significantly in severity, management is typically approached in stages, and may include:

• Medical management — for milder or early-stage disease, referral for prescription-based treatment may be recommended to help control inflammation and reduce flare frequency
• Incision and drainage — used to manage acute, painful abscesses, providing short-term relief
• Surgical excision — for more established or recurrent disease, surgical removal of affected tissue and sinus tracts is often the most effective way to achieve longer-term control
• Lifestyle and trigger management — guidance on factors that can influence flare frequency, including friction, weight, and smoking cessation, which is strongly associated with improved outcomes

Your consultation:

Every HS management plan begins with a thorough consultation, where the severity, distribution, and history of your condition are assessed. Dr George will explain the recommended approach, whether medical, surgical, or a combination of both, along with expected outcomes and potential risks, so you feel fully informed about your options.

A personalised approach:

Hidradenitis suppurativa affects every patient differently, and management is rarely a single treatment but an ongoing, tailored approach. Dr Robert George works closely with each patient to manage both flares and long-term disease progression, supported by our clinical team, throughout your journey.