Table of ContentsView AllTable of ContentsTreatmentPreventionCopingFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Treatment
Prevention
Coping
Frequently Asked Questions
The chronic inflammatory skin diseasehidradenitis suppurativa(HS) can create scars. While the exact cause of HS is unknown, hormones, genetics, and environmental factors play key roles in developing the disease.
HS causes sudden eruptions ofabscesses(boils) and nodules on the skin nearhair follicles. These are intensely sore and result in abnormal pigmentation and scars. The abscesses most commonly occur around skin folds in the armpits, groin, abdomen, and breast areas. This can make movement and basic activities very difficult.
While there is no cure for HS, there aretreatments to slow progressionand help minimize flare-ups (times when symptoms worsen). During a flare-up, multiple abscesses may form. These can erupt and cause pain. Scarring and sinus tracts (small tunnels under the skin) can occur as the abscesses heal.
In this article, you will learn ways to prevent, minimize, and help heal your hidradenitis suppurativa scars.
leventince / Getty Images
Treating Hidradenitis Suppurativa Scars
HS scars can be treated to minimize their appearance. A healthcare provider can help you determine which treatment is best for your unique situation and type of scar.
There are six types of HS scars:
Each type of scar requires a different type of treatment.
Dermabrasion or Microdermabrasion
While dermabrasion and microdermabrasionare effective at producing significant improvements in skin appearance, it often takes several treatments over a period of time to see results. Though the treatments work well on superficial scars they are less effective on deep scars.
Microneedling
Microneedlinguses a barrel of tiny needles that is rolled over the skin to cause thousands of micropunctures. These tiny punctures initiate a healing process that producescollagen(a protein in the skin). Collagen helps replace the skin of the scar and lessen its appearance.
There are several advantages to this treatment. It is cheaper, requires less recovery time (two to three days), allows for treated and untreated skin to blend together, and is less likely to cause changes in pigmentation. Results can usually be seen at about six weeks but could take three months.
Laser Resurfacing
Though studies onlaser resurfacingfor HS scars are limited, there is promise.Laser resurfacing has been used on traumatic scars from other causes (such as cuts) quite effectively.
Treatment can be done without anesthesia and downtime is minimal. However, those with darker skin may need to be treated with more caution as the risk of abnormal pigmentation is higher.
Surgical Removal of HS Scars
Some HS scars, especially those that occur in later stages of the disease, may cover large areas or include sinus tracts under the skin. This can cause disfiguring scarring that may require surgery.
For best results, surgery should be done when your HS is in its least inflammatory state. Having surgery during a flare-up may put you at risk for less optimal results and more scarring.
Surgery for HS scars can include:
Scar Creams and Lighteners
Topical creams that can be used for HS scars include:
If you are considering a topical cream, talk to your healthcare provider as some creams such as Bio-Oil and Mederma should not be used on open wounds.
Scar Shrinking Injections
Birth Control Pills
While more research needs to be done into the link between hormones and HS flares, one study found that the use of birth control pills in females with HS helped them manage flares that would worsen throughout their menstrual cycle.
Preventing Hidradenitis Suppurativa Scars
Preventing scarring from HS starts with minimizing and preventing flare-ups, which cause the abscesses that create scarring. This can be done through lifestyle modifications and at-home treatments of the abscesses that occur with HS.
Hidradenitis suppurativa scars occur as the erupted abscesses of HS heal over time. In the early stages of HS, scarring may be superficial, affecting only on the top layers of skin. As the disease progresses, sinus tracts may form. There may also be more abscesses and scarring can become substantial.
Laser Hair Removal
Stop Smoking
Smoking is a known trigger for HS.Ceasing smoking can help prevent flare-ups and the scarring that may follow.
Weight Loss as Needed
Obesity is associated with increased incidences of HS. Being overweight not only makes you prone to flare-ups but it also causes skin irritation in areas of more folds.
Scar Massage
Massaging a scarcan help even out the skin, prevent scars from causing mobility problems, improve blood flow to promote healing, and decrease further scar tissue buildup.
To massage a scar, make sure that any scabbing has healed. Use an oil like vitamin E oil to apply smooth pressure along the scar tissue.
Scar Dressings
Properly caring for the wounds that occur when the abscesses burst can help minimize scarring. This includes cleaning the wound to avoid infection.
As the wound heals, a scar dressing can help minimize the appearance of the scar. In postoperative studies, people who kept the wound covered and moist with petroleum jelly for three weeks saw an improved scar. Anecdotally, vitamin E, Mederma, and cocoa butter also appear to help with scarring.
Cleansers
Sunscreen
Scar tissue is sensitive to the sun making it more susceptible to sun damage and abnormal pigmentation.Covering the scar with sunscreen can help. However, it is best to choose non-irritating sunscreens as chemical-laden products can irritate HS.
Moisturize
Certain products like Mederma contain dimethicone, a silicone-based polymer, which protects the skin and improves scar texture. Moisturizing with these topical moisturizers can help prevent scarring.
Over-the-Counter Cortisone Creams
Cortisone creamscan decrease inflammation and minimize the appearance of scars. Be sure to talk to your healthcare provider if using these creams as overuse can cause thinning of the skin.
Coping With HS Scars
Living with a condition that has no cure can be difficult, producing many different emotions. It is well known that having physical pain from HS scars or losing some of your mobility can affect your quality of life.Feeling self-conscious about HS scars is also a normal reaction.
Talk to your healthcare provider or qualified mental health professional if your HS scars are causing you to feel depressed or they are affecting your everyday activities. There are options to help.
Summary
While hidradenitis suppurativa scars are a typical complication of living with the condition, there are ways to minimize their appearance and the amount of scarring.
Treatment options include preventing flare-ups through methods like weight loss and quitting smoking, treating the scars with laser therapy or microneedling, and taking care of your skin with medicated cleansers and moisturizers.
A Word From Verywell
Taking a proactive approach to your care when living with HS can help give you a sense of control. Learning about your treatment options and discussing them with your healthcare provider can help you discover the best ways to cope with the disease.
Address your concerns with your healthcare provider. Connecting with others who live with the condition can also help you feel less alone.
Frequently Asked QuestionsWhile there is no cure for HS, you can experience periods of remission in which there are no lesions or abscesses.HS bumps typically erupt on their own. Popping the bumps on your own can put you at risk of infection.Hidradenitis does not have an odor, however, the bacteria that form inside an abscess can produce a foul smell.HS bumps typically drain on their own, A healthcare provider may surgically drain an abscess to relieve pain, but it should not be the only method of treatment.
While there is no cure for HS, you can experience periods of remission in which there are no lesions or abscesses.
HS bumps typically erupt on their own. Popping the bumps on your own can put you at risk of infection.
Hidradenitis does not have an odor, however, the bacteria that form inside an abscess can produce a foul smell.
HS bumps typically drain on their own, A healthcare provider may surgically drain an abscess to relieve pain, but it should not be the only method of treatment.
20 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Napolitano M, Megna M, Timoshchuk EA, et al.Hidradenitis suppurativa: from pathogenesis to diagnosis and treatment.Clin Cosmet Investig Dermatol. 2017;10:105-115. doi:10.2147/CCID.S111019
Chadwick S, Heath R, Shah M.Abnormal pigmentation within cutaneous scars: A complication of wound healing.Indian J Plast Surg. 2012;45(2):403-411. doi:10.4103/0970-0358.101328
Jfri A, O’Brien E, Alavi A, Goldberg SR.Association of hidradenitis suppurativa and keloid formation: A therapeutic challenge.JAAD Case Rep. 2019;5(8):675-678. doi:10.1016/j.jdcr.2019.06.001
Gill L, Williams M, Hamzavi I.Update on hidradenitis suppurativa: connecting the tracts.F1000Prime Rep. 2014;6:112. doi:10.12703/P6-112
American Society of Plastic Surgeons.Dermabrasion.
Gozali MV, Zhou B.Effective treatments of atrophic acne scars.J Clin Aesthet Dermatol. 2015;8(5):33-40.
Nicholson CL, Hamzavi I, Ozog DM.Rapid healing of chronic ulcerations and improvement in range of motion after fractional carbon dioxide (CO2) treatment after CO2 excision of hidradenitis suppurativa axillary lesions: A case report.JAAD Case Rep. 2016;2(1):4-6. doi:10.1016/j.jdcr.2015.11.001
Fu X, Dong J, Wang S, Yan M, Yao M.Advances in the treatment of traumatic scars with laser, intense pulsed light, radiofrequency, and ultrasound.Burns Trauma. 2019;7:1. doi:10.1186/s41038-018-0141-0
Vinkel C, Thomsen SF.Hidradenitis suppurativa: causes, features, and current treatments.J Clin Aesthet Dermatol. 2018;11(10):17-23.
HS Connect Organization.Hidradenitis suppurativa scarring.
Johns Hopkins Medicine.Scars.
Montero-Vilchez T, Valenzuela-Amigo A, Cuenca-Barrales C, Arias-Santiago S, Leyva-García A, Molina-Leyva A.The role of oral contraceptive pills in hidradenitis suppurativa: a cohort study.Life (Basel). 2021;11(7):697. doi:10.3390/life11070697
Aleem S, Majid I.Unconventional uses of laser hair removal: a review.J Cutan Aesthet Surg. 2019;12(1):8-16. doi:10.4103/JCAS.JCAS_97_18
Narla S, Lyons AB, Hamzavi IH.The most recent advances in understanding and managing hidradenitis suppurativa.F1000Res. 2020;9:F1000 Faculty Rev-1049. doi:10.12688/f1000research.26083.1
Seyed Jafari SM, Hunger RE, Schlapbach C.Hidradenitis suppurativa: current understanding of pathogenic mechanisms and suggestion for treatment algorithm.Front Med (Lausanne). 2020;7:68. doi:10.3389/fmed.2020.00068
Commander SJ, Chamata E, Cox J, Dickey RM, Lee EI.Update on postsurgical scar management.Semin Plast Surg. 2016;30(3):122-128. doi:10.1055/s-0036-1584824
Sidgwick GP, McGeorge D, Bayat A.A comprehensive evidence-based review on the role of topicals and dressings in the management of skin scarring.Arch Dermatol Res. 2015;307(6):461-477. doi:10.1007/s00403-015-1572-0
Scala E, Cacciapuoti S, Garzorz-Stark N, et al.Hidradenitis suppurativa: where we are and where we are going.Cells. 2021;10(8):2094. doi:10.3390/cells10082094
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
