Hidradenitis suppurativa Treatment in Lancaster
Hidradenitis suppurativa is a chronic inflammatory skin condition that causes painful lumps, drainage and scarring in skin folds. Our practice offers specialty medical care in Lancaster, CA, with a plan built around your symptoms and goals.
Understanding Hidradenitis suppurativa
Hidradenitis suppurativa (HS) is a long-lasting condition in which painful, inflamed lumps develop deep in the skin, most often in the armpits, groin, buttocks and under the breasts. The lumps can break open, drain fluid or pus, and heal with scarring. Estimates suggest it affects roughly 1 in 100 people, and it often begins after puberty, in the teens or twenties. Beyond physical pain, HS can affect sleep, clothing choices, intimacy, work and emotional well-being, and many people wait years before receiving a correct diagnosis.
The exact cause is not fully understood. HS begins when hair follicles become blocked and inflamed, and the immune system responds in an exaggerated way. Genetics play a role, and many people have a relative with the condition. Hormonal changes, smoking, excess body weight, and friction in skin folds are recognized risk factors or aggravators. It is not caused by poor hygiene and it is not contagious. It is also associated with other conditions, including metabolic syndrome, inflammatory bowel disease, and acne.
Professional treatment matters because HS tends to progress if left unmanaged. Early lumps can develop into tunnels under the skin and permanent scars that are harder to treat. Over-the-counter products and home remedies rarely control the underlying inflammation. A medical evaluation allows the disease to be staged, other conditions to be ruled out, and an appropriate plan to be started that reduces flares, relieves pain and helps protect your skin over time.
Signs & Symptoms of Hidradenitis suppurativa
- Painful, deep lumps. Tender, pea-sized or larger nodules form under the skin, often in areas where skin rubs together.
- Recurring boils. Lumps that seem to heal and then return in the same location are characteristic of the condition.
- Blackheads in pairs. Double-headed or "tombstone" blackheads often appear in affected skin folds.
- Drainage. Lesions may leak pus or fluid that can have an odor and stain clothing.
- Itching and burning. Skin may itch, burn or feel hot shortly before a lump appears.
- Common locations. The armpits, groin, inner thighs, buttocks and under the breasts are most often affected.
- Scarring. Repeated flares can leave thickened, ropelike or pitted scars.
- Daytime discomfort. Pain with movement, sitting, or clothing friction can interfere with daily activity.
What to Expect
- Thorough assessment of your history, flare pattern and affected skin
- Treatment matched to disease severity and your goals
- Regular follow-up with adjustments as symptoms change
- Realistic goals: fewer and milder flares, less pain, slower scarring
- Support for pain control and emotional well-being
How We Treat Hidradenitis suppurativa
Assessment
We review your history, flare pattern, previous treatments and the areas of skin involved. A physical examination helps stage the disease and identify tunnels, scars and active lesions. We also ask about related health factors and how the condition affects your daily life.
Treatment Plan
Your plan is matched to the severity of your disease and your goals. It may combine skin care, topical or oral medications, and discussion of advanced options when appropriate. We explain the benefits and limits of each choice so you can decide with confidence.
Ongoing Care
Hidradenitis suppurativa is chronic, so we plan regular follow-up to see how you are responding. Treatment is adjusted as symptoms change, and we coordinate with other clinicians when needed. The aim is fewer flares, less pain and better daily comfort.
Benefits
A personalized care plan
No two people experience this condition the same way. Your plan reflects your symptoms, your history and your priorities.
Unhurried time for questions
This condition can be sensitive to discuss. We make room for your questions so you understand every step.
Coordinated follow-up
We schedule check-ins to review progress and adjust care, so your treatment does not stall after the first visit.
Your Treatment Journey
First Evaluation (week 1)
We take a thorough history, examine affected areas and discuss how the condition affects you. You leave with an initial plan and clear next steps.
Treatment Begins (weeks 2-4)
You start the agreed measures, which may include skin care changes and medication. Early on, some lesions may still flare, as improvement is usually gradual.
Progress Review (month 2-3)
We assess how many flares you have had, pain levels and any side effects. If progress is limited, we adjust or add options.
Long-term Management
Because the condition is chronic, care focuses on keeping flares controlled and preventing scarring. Periodic visits keep your plan current.
Warning Signs That Need Prompt Care
Fever with a flare. A fever or feeling generally unwell alongside skin lesions may signal infection.
Spreading redness. Redness, warmth and swelling that expand quickly around a lesion need prompt evaluation.
Severe, uncontrolled pain. Pain that is not eased by usual measures should be assessed soon.
Tunnels under the skin. Connected channels (sinus tracts) that drain persistently suggest more advanced disease.
Limited movement. Scarring or pain that restricts walking or arm movement warrants attention.
Rapidly increasing lesions. A sudden rise in the number or size of lumps may call for a change in treatment.
Persistent open wounds. Wounds that do not close over several weeks need professional care.
Low mood or isolation. Distress, anxiety or withdrawal because of the condition deserves support as part of care.
If you recognize these signs, help is available. Early treatment leads to better outcomes.
Evidence-Based Treatment Options
Treatment follows established, evidence-based options and is chosen by disease severity. Mild HS is often managed with gentle cleansing, reducing friction, weight and smoking-cessation support where relevant, topical antibiotics such as clindamycin, and warm compresses. Moderate disease may add oral antibiotics such as doxycycline for their anti-inflammatory effect, or hormonal therapies and other agents in selected patients. For more severe or persistent disease, biologic medications that target inflammation, such as adalimumab, are approved options and may be discussed. Office procedures such as drainage of a painful abscess, steroid injection into an inflamed nodule, or surgical removal of recurring lesions and tunnels may also be considered. Pain control and emotional support are part of care.
Realistic Goals
HS rarely disappears completely. Realistic goals are fewer and milder flares, less pain and slower progression of scarring.
Common Questions About Hidradenitis suppurativa
How long does hidradenitis suppurativa treatment take?
It is a long-term condition, so treatment is usually ongoing rather than a short course. Many people notice some change within a few months, but the timeline varies with severity and the approach used.
Is medication required?
Not always. Mild disease may be managed with gentle skin care, avoiding triggers and topical products. Moderate or severe disease often benefits from oral medications or other therapies, which we would discuss with you.
Does insurance cover treatment?
Coverage depends on your plan and the specific treatment. Please call the office at (661) 579-6088 to ask about coverage before your visit.
What if the first treatment does not work?
This is common and does not mean you are out of options. We review what has and has not helped, then adjust the medication, add another approach or discuss more advanced treatments.
Is hidradenitis suppurativa contagious?
No. It is not an infection that spreads between people, and it is not caused by poor hygiene. The lumps arise from inflammation of hair follicles.
Where can I be seen for hidradenitis suppurativa in Lancaster?
You can contact Aldo Gamarra, MD at 1658 West Ave J., Lancaster, CA 93534, or call (661) 579-6088 to ask about an evaluation.
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