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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18759
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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Is there any cure for hidredenitis? My stepdaughter has been

Resolved Question:

Is there any cure for hidredenitis? My stepdaughter has been diagnosed with it and it seems that the GP can't do anything for her.
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. D. Love replied 3 years ago.
It will help if you could provide some further information:
Does she have any other chronic medical problems?
Is she taking any chronic medicines?

Customer: replied 3 years ago.

She doesn't have any other problems. She was first diagnosed (over two years ago) with a fistula in the vulval area - there were two lumps on either side and it was painful to sit at times. She had an operation to deal with one side, as the lump on the other side had at that time subsided. After the op the doctor told her that it was hidredenitis, not a fistula. The side operated on is now OK, but the other side has grown. Sometimes a hard tip appears (like a boil) and a quantity of pus is discharged. There is a constant slight show of pus. She has been on a variety of antibiotics, which don't have any effect.

Expert:  Dr. D. Love replied 3 years ago.
Thank you for the additional information.

There is no permanent cure for hidradenitis, but there are many possible interventions that can be used to help control the disease process.

Interventions can be either medical or surgical. Typically, when a particular area is more severe, such as forming abscesses, fistulas, or sinus tracts, it is better to consider surgical options, as was apparently done on one side. If the other side is now forming a boil/abscess, then it may be necessary to consider surgery on the opposite side.

From a medical perspective, there are several medicines that can be used. Certainly, antibiotics are the usual first-line medicine, but if antibiotics are not sufficient, then the next steps would be to use medicines to control inflammation, such as steroids, which may be injected into local areas where the disease is more severe or given orally if there is more diffuse disease, or immune suppressing medicines, such as infliximab (Remicade). There also is evidence that retinoids can help, such as isotretinoin. Medicines that suppress androgens (male hormones, but which are present in small amounts in females) also may help. There is an antibiotic that also has some anti-androgen activity, tetracycline, that may be considered, if not already used. There also has been some recent evidence that a medicine that is used for diabetes, metformin, may help hidradenitis. Metformin has also been shown to help women with polycystic ovary syndrome, which is another condition in which there is excessive androgens. Metformin has been used for these conditions, even if there is no diabetes present, but I did ask about other medical conditions because it is commonly already used for diabetes.

This conditon can be very stubborn to treat, and it may require consultation with a Dermatologist to try some of these other options.

If you have any further questions or need clarification, please let me know.

Customer: replied 3 years ago.

Many thanks for your very informative reply. I'll pass it on to her.

Expert:  Dr. D. Love replied 3 years ago.
You're welcome. I hope that she can get control of the condition soon.

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