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Understanding Hidradenitis Suppurativa Drainage : Procedure, Benefits, and Alternatives

  1. Introduction

    Hidradenitis suppurativa is a chronic inflammatory condition that is characterized by the formation of painful, recurrent nodules, abscesses, and tunnels in areas where the skin frequently rubs together. It includes the area of the armpits, buttocks, groin, and the underside of the breasts.

    The condition starts with small tender bumps that progress into painful lumps or boils. The condition may further advance to the development of interconnected tunnels beneath the skin, causing drainage of pus and fluids. Chronic drainage is known to be a characteristic feature of hidradenitis suppurativa.(1)

    Hidradenitis suppurativa is not a contagious condition but its occurrence involves a combination of factors including genetics, immune system dysfunction, and inflammation around hair follicles.

    The severity of hidradenitis suppurativa varies from person to person. Some individuals might experience mild symptoms while some might have severe and widespread involvement.

    The article provides insight into the hidradenitis suppurativa drainage procedure, along with its associated benefits and critical considerations.

    Hidradenitis suppurativa drainage is a medical intervention aimed at managing the painful and recurrent symptoms of this condition. It provides relief from pain, reduces inflammation, and promotes healing.(2)

  2. Hidradenitis Suppurativa Drainage Procedure

    The hidradenitis suppurativa drainage procedure aims to provide relief from discomfort, reduce inflammation and promote healing by draining pus and fluid from the affected areas.

    The healthcare professional evaluates the severity and location of the lesion. They take note of the medical history, current medications, and any existing medical condition.

    To begin with the procedure, local anesthesia is given to numb the area. This is to ensure that the procedure is painless. A small incision is made in the affected area, typically over the nodule of the abscess. This allows access to the accumulated pus and fluid.

    Gentle pressure is then applied to the area, allowing the discharge of pus and fluid from the lesion. This allows relief from pain, reduces swelling, and facilitates the body’s healing process.

    The incised area is then covered with a sterile dressing to protect it from external contamination and to aid the healing process. These dressings need to be changed periodically according to the healthcare professional’s instructions.

    Guidelines are provided to the patient for post-procedure care, including proper wound care, hygiene practices, and potential signs of infection.

    For patients with multiple or recurrent hidradenitis suppurativa, multiple drainage procedures may be necessary over time.

    Hidradenitis suppurativa drainage may provide immediate relief but does not offer a permanent solution. A 2022 narrative review suggested that incision and drainage are very successful in reducing pain and discomfort in Hidradenitis suppurativa inflammation.(3) Recurrence is possible, which is why, drainage is often integrated into the comprehensive treatment plan along with medical management, lifestyle adjustment, and other interventions. A study found that the symptoms recurred in 35% of people who had wide excision or limited local excision surgical treatment.(4)

    Those opting for drainage should have an open discussion with the healthcare provider about the potential benefits and risks. This is to ensure they have a clear understanding of the role of the procedure in the hidradenitis suppurativa management strategy.

  3. Benefits of Hidradenitis Suppurativa Drainage Procedure

    The hidradenitis suppurativa drainage procedure is beneficial in the following ways:

    1. Lesions from Hidradenitis suppurativa can be intensely painful. This is due to the accumulation of pus and inflammation. Hidradenitis suppurativa drainage removes the build-up of fluids and reduces pressure on the sensitive nerve endings.
    2. The procedure helps in reducing inflammation and promotes healing.
    3. It facilitates the natural healing process of the body by removing infection and inflammation. The body gets more efficient in repairing damaged tissue, leading to faster recovery.
    4. Untreated lesions lead to complications such as abscess rupture, spread of infection, and formation of interconnected tunnels under the skin.
    5. Early intervention allows an individual to resume daily activities with more comfort and confidence.
    6. Proper drainage reduces the extent of scarring that would result from improperly managed hidradenitis suppurativa lesions.
    7. The symptoms of hidradenitis suppurativa can have significant impact on mental health. Drainage provides relief from symptoms and improves psychological well-being and self-esteem.
    8. Drainage can help in facilitating other treatment strategies. It can create a more favorable environment for medications, antibiotics, or other therapeutic measures to work efficiently.

    The effectiveness of hidradenitis suppurativa drainage may vary based on individual condition, the severity of hidradenitis suppurativa, and how well integrated is the comprehensive treatment approach.

  4. Alternative Treatment Approaches for Hidradenitis Suppurativa

    Along with hidradenitis suppurativa drainage, there are several treatment options that can be helpful in managing hidradenitis suppurativa.

    • Medical Management: Oral or topical antibiotics are given to control bacterial infection and reduce inflammation. Non-steroidal anti-inflammatories and corticosteroids can be helpful in managing pain and inflammation. Medications that suppress the immune system manage the immune response that triggers hidradenitis suppurativa inflammation.
    • Biologic Therapies: Biologic medications, like tumor necrosis factor inhibitors, act by blocking the tumor necrosis factor, a protein involved in the inflammatory process. Interleukin inhibitors target specific interleukins such as IL-17 and IL-23 to reduce inflammation.
    • Lifestyle Changes: Maintaining a healthy weight can be helpful in reducing friction and irritation in the area prone to hidradenitis suppurativa lesions. Also, quitting smoking can have a positive impact on symptoms and overall health. Regular cleansing and maintaining hygiene can be helpful in minimizing flare-ups.
    • Warm Compresses: Warm compresses can be helpful in alleviating pain and reducing inflammation.
    • Topical Treatment: Topical antiseptics prevent infection and promote healing. Topical retinoids reduce inflammation and prevent the formation of new lesions.
    • Surgical Interventions: Laser treatment can be given to the affected area to reduce inflammation. Surgical removal of severe recurring lesions can be considered in certain cases.
    • Dietary Modifications: Some individuals report symptom improvement by avoiding foods high in dairy and with a high glycemic index.
    • Photodynamic Therapy: It involves applying photosensitizing agent to the skin and then exposing it to light. This can be helpful in reducing inflammation and bacteria.
  5. How to Stop Hidradenitis Suppurativa Discharge?

    According to the American Academy of Dermatology, the following steps can be taken to minimize symptoms and prevent infection:(5)

    • It is important to keep the affected area clean to prevent infection and reduce discharge. The affected area should be washed regularly with mild antibacterial soap and pat dry.
    • Loose-fitting and breathable clothes should be worn to minimize friction and irritation in the affected areas.
    • If someone is overweight, losing weight can prove to be helpful.
    • Smoking worsens the symptoms of hidradenitis suppurativa. Therefore, quitting smoking can be beneficial.
    • Cuts or damages to the skin from shaving can lead to flare-ups and infection.
    • People with hidradenitis suppurativa should avoid sweating and being overheated.

    These measures can be helpful for a patient to manage and reduce discharge, complete resolution might not be possible in all the cases.


Understanding hidradenitis suppurativa drainage is crucial for anyone aiming to effectively manage this persistent skin ailment. This procedure not only offers immediate relief from the distress caused by painful nodules, abscesses, and tunnels but also focuses on alleviating pain, curtailing inflammation, and fostering healing. As a result, patients not only find solace from pain but also witness a notable reduction in inflammation, potentially halting the condition’s progression. Moreover, expedited healing can thwart complications and enhance the overall well-being of those grappling with hidradenitis suppurativa. Should the symptoms of hidradenitis suppurativa intensify, it’s imperative to consult a healthcare expert. While surgical drainage is an oft-recommended solution, it’s worth noting that lesions might recur post-procedure. Nonetheless, many consider it a potent method, especially for alleviating pain from extensive lesions.

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Team PainAssist
Team PainAssist
Written, Edited or Reviewed By: Team PainAssist, Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:August 22, 2023

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