The nodules of hidradenitis suppurativa may need to be drained in the emergency department, particularly if they are very large, fluctuant, and painful. Antibiotics are indicated if cellulitis or fever is present, and you should get admitted if you have fever, etc.
Surgical consultation may be obtained for removal of sinus tracts, curettage, and exteriorization of the gland. Excision and skin grafting may be helpful for severe intractable cases. Also, surgery should be considered in early cases because the area to excise is smaller and less damaged from recurrences. The CO2 laser has been used to strip away glandular tissue.
Tetracycline and erythromycin may be helpful on a long-term basis, and cephalosporins often will help in acute cellulitis. On a short-term basis in the emergency department, dicloxacillin is considered a good choice. Topical products, such as benzoyl peroxide, may be helpful. Topical and intralesional injections of corticosteroids are sometimes helpful.
If the symptoms still persist, consult your skin specialist or dermatologist.
Let us know about how you are doing and if you have any other doubts.
I was diagnosed with HS about 1 year ago and have been through the ordeal of lancing a BIG DEEP boil on the bottom of my breast (which DOES NOT NUMB due to infection...OUCH!!) and recurring PAINFUL boils in my armpits. I haven't had any more breast issues (thank goodness!) but am still having the armpit problems. Mine seems to respond best to Doxycycline when it flares up. My flare ups seem to correspond with my PMS...it happens about 5 days before my period, so I also think it has to do with a hormone imbalance. Sometimes though, it just randomly happens mid-month. (maybe stress induced??) I put "udder balm" or "bag balm" on the boils and sometimes this will help soften the skin up so that they can drain. Yes, it is marked for veterinary use and is used to soften up cow udders (lol), but is available in your local drug store. It's cheap, seems to help and is totally safe for humans. It's very similar to "Boil Ease" and much less expensive. One tin of it will last FOREVER!!
The main reason that I am writing this note is because I am a classic yo-yo dieter and I noticed something VERY interesting during my two most recent weight loss attempts. I am 5'4' and 180 pounds at the moment and had a high weight of 198, so I am on the chunky side of the fence. I wear a size 17 in blue jeans and extra large tops.
I have tried many diets, but the only one that works for me is a high protein, VERY LOW carbohydrate ZERO SUGAR diet. (Atkins induction menu for one whole month instead of the suggested two weeks) I did this recently for one whole month (SHEER TORTURE...LOL) was very strict about it when I did it, and I kept the carbs below 15 grams a day. MEAT, EGGS, CHEESE AND LETTUCE ONLY!!! "YES" TO MAYO and ranch dressing, NO TO KETCHUP (it contains sugar) also...NOTHING WHITE...I allowed myself a very small portion of green beans or broccoli once a day. I also drank enough water to fill a lake. NOTHING TO DRINK BUT WATER...and an occasional unsweet tea with Splenda! NO DIET SODAS!! It takes the first three days to detoxify the body and then the weight loss begins! :0)
I recently managed to "stay on the wagon" for a month and lost 18 pounds without exercise. The thing that makes this relevant to this forum is that during the time that I was on that strict diet without sugar or carbs (which turn into sugars in the bloodstream) I didn't have ANY outbreaks of HS and the outbreak that I had when I started the diet faded away completely in about 7-8 days after I started the diet. My body was finally detoxified of all of the CRAP that I stuff into it every day.
I then "fell off of the wagon" after a month and returned to my normal everyday "idiot" diet of fast foods, highly processed foods and refined sugars. (and PEPSI, PEPSI, PEPSI, ALL OF THE TIME...FULL FLAVORED) What a bad girl I am!
It took about two to three weeks of the old habits to REtoxify my body before the armpit symptoms reappeared, just as bad as they were before. HMMMMMMM.......I just wonder if there's a connection......lol
I wonder how many HS sufferers there are who are carb and sugar intolerant like I am? I tend to gain weight in the middle and are an "apple" body type. I was told that I am prediabetic and have high insulin levels and high blood pressure. My blood sugars are normal.
Due to these strange reactions of my HS to the special diet, I would almost lay money on the fact that MANY cases of HS are caused by toxins in our bloodstream caused by bad diet habits and high insulin levels in the blood. Especially since some of the research I've done says that most HS sufferers are overweight.
I guess that when my pain and suffering in my armpits is worse than the sugar and carb cravings, I might actually break free from this HORRIBLE disease. I would love to see an experiment with about 100 people with HS on a diet like this one to see if my guess is correct.
Maybe someday I'll find the willpower to make the permanent diet/lifestyle change and test my theory over a longer period of time. :0)
I hope I help at least ONE person with this post! That would have to be someone with better willpower than I have, but I'm sure that they are out there somewhere...