information regarding doctors

HS – Doctors

HS patients see many different types of doctors. Here the most common are listed out and described, including the abbreviation commonly used in chat.

1. Endocrinologist (Endo): specializes in hormone disorders and the endocrine system. Endocrinology is the science and medical specialty concerned with the internal or hormonal secretions and their physiologic and pathologic relations.

2. Radiation Oncologist (RO): specializes in radiation therapy. RO is the branch of medicine in which radioactive rays are used to cure or palliate cancers. The objective is to deliver a therapeutic dose of radiation to malignant tissue, leaving healthy, surrounding tissues unharmed. Radiation therapy is used to treat many cancers, including cancers of the bone, brain, breast, cervix, lymphoid tissues, and uterus.

3. General Practitioner (GP): your general “family” doctor, probably used the most by board members but not the most effective.

4. Dermatologists (Derm): Many with HS have success with derms, although that is ironic since HS is not a skin disease. Dermatology is the branch of medicine concerned with the study of the skin, diseases of the skin, and the relationship of cutaneous lesions to systemic disease.

5. Infectious Disease Doctors: Many patients have gone to these doctors before they realized they had HS. However, you must remember that HS is not an infections nor is it contagious. An infectious disease is any disease caused by growth of pathogenic microorganisms in the body. Diagnosis and treatment of infectious disorders such as sexually transmitted diseases, tuberculosis, hepatitis B and conditions acquired while traveling. The mainstay of treatment is the use of antibiotic and other antimicrobial drugs, which must be carefully selected in order to be effective. Infectious disease is a subspecialty of internal medicine.

6. Internist: Internal medicine is the branch of medicine that treats diseases of the internal organs by other than surgical means. In effect, internal medicine is based on experimental work in physiology and physiochemistry and the implication that investigators and practitioners in the specialty have special training, knowledge, and skills. The internist uses the tools of history taking, physical examination, and diagnostic testing to diagnose and prevent disease. Patient education, lifestyle modification, psychological counseling, use of medications, inpatient medical care, and referral to other specialists are responsibilities of the internist. Therefore, they are good to go to for blood tests when you cannot see another doctor.

7. Pain Management specialist: the supervision and control of pain due to a physical or medical condition.

8. Physician Assistant (P.A.) - a person who is trained, certified and licensed to perform history taking, physician examination, diagnosis and treatment of commonly encountered medical problems, and certain technical skills, under the supervision of a licensed physician, and who thereby extends the physician’s capacity to provide medical care.

9. Surgeon: Surgery is a branch of medicine concerned with the treatment of disease, injury, and deformity by operation or manipulation. A variety of operations on almost all parts of the body. Surgery may be done to diagnose illness, remove or repair tissue, repair injuries, or correct malfunctioning parts. HS patients usually have one of three procedures:

a. Incision & Drainage (I&D): the surgeon will cut a small slit (1/4” to ½”) to open the wound, squeeze it to drain as much pus as possible (and sometimes to get pus to culture), then place a bit of gauze, cloth, or string inside the hole to keep the hole from closing. The open hole allows the pus to drain enough that the inflamed gland can shrink.

b. Excision: If the wound is not infected or has already been drained, the surgeon will cut a larger slit in the skin (½” to 1” or more) and cut out the entire inflamed gland. If he does this, make sure he does a pathology report! Also, the recovery period usually is done by secondary intent, which heals the wound from the inside out, keeping the hole open until the inside heals. It usually takes one to two weeks to heal.

c. Radical Surgery: This involved a large incision to the skin and the removal (scraping) of all hair follicles and/or sweat glands. Many times a skin graft is required. Recovery is usually between two weeks to two months.

10. Plastic Surgeon: Suggested by HS patients, as this type of surgeon will produce the best looking scars.

11. Cosmetic Surgeon: Not suggested by HS patients.

HS - Medical Treatments

1. Laser Surgery

a. Tanning beds

b. UV Light Therapy (some docs will do, or some HS patients just stand in front of a UV light bulb 10-20 mins per

c. Electrolysis

2. Radiation Therapy

3. Surgery (see above)

4. Prescription drug use (long or short-term antibiotics, anti-androgens, birth control pills, painkillers, anti-inflammatories) – NOTE: Antibiotics have only been proven to help HS symptoms when there is a secondary infection present. Long-term use of antibiotics seems to make symptoms worse when the antibiotics are finished.

a. Spironalactone (diuretic and anti-androgen)

b. Glucophage and Metformin (insulin sensitizers)

c. Birth Control: Diane-35 (dianette), minicette, yasmine (all anti-androgens)

d. Remicade

e. Clobetasol – topical corticosteroid

f. Topical cortosteroids

g. Prednisone – oral steroid

h. Accutane (Please be aware of the severe side effects of this drug before you use it)

i. Retin A

j. Dapsone

k. Flucloxacillin

l. calvapen

m. tetracyclines

n. metronidazole

o. Retinoids; avoid like the plague can severely dry out your skin, can cause liver and kidney damage and increase feelings of depression if in some people if you are that way disposed.

5. Intralesional cortisone injections - steroid injections via a needle. The derm will inject the solution into the center of the HS cyst. This works for many people right away, but you also must be careful how often you have injections because they do have their downsides, like discolored skin.