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Here’s what you may expect from HS tunnel procedures, including the most common choices, complications, and recovery tips.

For individuals suffering from hidradenitis suppurativa (HS), a skin illness in which abscesses grow beneath the skin, managing discomfort, sores, and other symptoms is a top priority. According to the American Academy of Dermatology, HS frequently results in the formation of “tunnels” that connect these lumps beneath the skin, producing even more pain and the likelihood of complications.

“These tunnels are more common in patients with severe, long-standing HS.” “They can be painful and sometimes drain fluid or pus,” explains Dr. Adil Moulanchikkal, Lead Ayurvedic Skin Specialist at EliteAyurveda Clinics. Tunnels arise as a result of repeated inflammation of hair follicles, as well as the production of abscesses and scarring, according to researchers.

There are, thankfully, therapies for HS, including surgery. We’ll go over all you need to know about the several surgical treatments available, from how they operate to aftercare instructions.

Options for HS Surgery from an Allopathic Perspective

The goal of HS treatment, according to Dr. Adil, is to disrupt the cycle of inflammation so that your skin can heal. Your allopathic doctor may prescribe antibiotics, hormone therapy, or biologic drugs. These therapies can assist with symptoms like discomfort and redness, but they can’t make tunnels disappear (which become more common as your HS worsens and lasts longer).

To eliminate tunnels and provide you with relief, your doctor may choose one of the following surgical techniques:

• Incision and drainage. This procedure, also called as lancing, can help relieve pain from a flaring tunnel. It’s typically utilised as a first step in treating larger abscesses to help reduce the wound area before deroofing. Before making a skin cut to remove the pus from the tunnel, your doctor will numb the area. “The problem with incision and drainage is that the lining remains, so the lesions almost always reappear and cause additional problems.” “Because deroofing only requires a couple more steps and has a much higher cure rate, it’s recommended that providers treating HS use deroofing instead of incision and drainage.”

• Roof replacement surgery. As the name implies, a deroofing surgery removes the skin that forms the top of the tunnel to allow the skin below to heal. “After numbing the tunnel or tunnels, the tunnel roof is removed with a scalpel or laser.” “The lining is then scraped away, and the tunnels are left open to heal,” explains the author. Following that, you should only have a small scar with no tunnel beneath it. “There is a risk that the tunnel will reopen, but it is very low, occurring only between zero and 14% of the time,” he says.

• Excision entails removing the skin all the way around the tube, down to the layer of fat beneath. “It’s critical to discuss with the person performing your surgery where you both believe the tunnel may extend to ensure that the entire area is numbed up before anything begins.” These procedures can be conducted in the office while you are awake or while you are sedated, with the latter being more likely if your tunnel spans a larger area. Wounds are typically left open to heal as well as possible when excision is used, such as when deroofing. “Sometimes, doctors will use skin grafts, skin flaps, or stitches to close the open skin after tunnel excision, but this raises the risk that they will reappear,” says Dr. These operations may result in a quicker healing period and additional scars, depending on the type of repair.

• Cryoinsufflation is a type of cryoinsufflation.According to Dr. Daveluy, while this is the newest surgical therapy for HS, many doctors may not offer it because additional research is needed to back up its usefulness. According to Dr. Adil, “it usually doesn’t require any analgesia or numbing because it’s only a little uncomfortable.” Several treatments are usually required.” While some small trials have shown efficacy, it is unknown how consistently useful this treatment is.

Complications from Surgery

When medicine alone does not relieve the painful or unpleasant symptoms of HS tunnels, surgery is usually the next step and the recommended treatment for tunnels, with the ultimate goal of permanently healing them. However, there is a potential that tunnels will form again even after surgery. 

The level of risk varies according on the surgical procedure. Which is the higher risk? Because HS is a systemic disease, treating one area of skin will not stop the disease from spreading to another. New tunnels will commonly form outside of the treated area. 

A recent study found a 35% recurrence rate among HS patients who had surgery.

There are always risks connected with any medical practise. All skin surgeries, for example, include a risk of bleeding or infection, according to Dr. Adil. “Scarring will also result from these procedures, and the appearance of that scarring will vary greatly,” she explains.

If you have sutures from your operation, there is also a potential that they will pop. “Excisions where the skin is sewn up at the end have a high risk of the stitches falling apart and the wound opening up, especially if the HS disease and inflammation are not well-controlled at the time of surgery,” Dr. Adil adds.

Post-operative pain is another potential complication of surgery, albeit it may be less severe than normal HS discomfort. “Many patients report that the pain following surgery is actually less intense than the pain of HS before surgery,” Dr. Adil explains. 

Finally, contractures are an option with HS. Contractures are scars that impede range of motion because they have healed too firmly. According to Dr. Adil, this effect is most common in the armpits or groyne areas, which are frequently affected by HS: “For example, an armpit contracture may prevent you from raising your arm above your head.” 

Ayurvedic Approach to HS Treatment 

According to Ayurveda, Hydradenitis Suppurativa is a cause of Kapha and Pitta dosha. When the digestive fire (Agni), or Pitta, is out of balance, the Kapha Dosha becomes vitiated, slowing metabolism. Because of the disruption of fat molecules, they begin to gather in muscles and impede physiological routes, resulting in painful, swelling sores in the groyne, buttocks, thighs, and armpits.

Affected people may have pain in their armpits, buttocks, breasts, groyne, or inner thighs. In addition, a foul-smelling fluid that can suddenly leak may fill the painful HS lesions.

Second, in addition to surgery, these below are known HS therapies.

• Topical therapy may help to clear out the affected area, reduce inflammation, and speed up lesion healing. Antiseptic creams and acne medications are examples of topical therapy for HS. Although they do not directly address the underlying cause of the condition, they can assist to alleviate some of its symptoms.

• Corticosteroids are drugs that reduce swelling, inflammation, and pain. They can be administered orally or intravenously. Oral corticosteroids can cause high blood pressure, weight gain, and mood disturbances. Long-term use can also cause osteoporosis, hyperglycemia, and skin thinning.

• One hormone that may have an effect on HS is androgen. Additionally, hormonal swings throughout the menstrual cycle, pregnancy, and other times may aggravate HS symptoms. For mild to moderate HS, oral hormone therapy (monotherapy) is an option, and it may be combined with other medicines for severe HS. If administered during pregnancy, hormone medication for women may cause blood clots as a side effect. Men may also have decreased libido and ejaculatory issues.

• Retinoids – Vitamin A is the source of retinoids, which are drugs. They act by reducing inflammation and suppressing skin cell multiplication. Pregnant women should avoid using oral retinoids since they increase the risk of congenital defects. Chapped lips, dry skin, and transient hair loss are also possible adverse effects.

• Biologics are modified versions of natural proteins generated from human cells. By focusing on immune system components that cause inflammation, biologics may assist your body in developing a resistance against HS.

Biologic medications can raise your risk of infection because they target your immune system. These medications may also raise the risk of cancer, but this has yet to be confirmed.

Nausea, headaches, and back discomfort are possible side effects of biologics. Heart failure and autoimmune nerve issues are among the worst side effects. Biologics may also increase your risk of infection and lymphoma. Always discuss the advantages and disadvantages of this treatment with your doctor.

Biologics, antibiotics, and hormone therapy for HS each have their own set of adverse effects, such as affecting the immune system balance (Biologics), affecting the microbiome balance (Antibiotics), or causing hormonal imbalance (Hormone Therapy).

Finally, how might Ayurvedic treatment from a trained professional aid in the reversal of HS?

Ayurveda emphasises detoxification (Shodhana treatment) and calls it kushtha yoga. Panchakarma, which ensures that the disease does not return, is the emphasis of Ayurvedic treatment. It will also increase the doshas’ ability to govern everything in the body.

Some therapy options for hidradenitis suppurativa include:

1. Detoxification: Ama is removed from the body with the use of detoxifying herbal medications.

2. Internal drugs: These are given to balance all doshas based on physiological processes. The drugs could include Varanadi Kashayam, Triphala Guggulu, Gandhaka Rasayana, and others. Repeated detoxifications help the body remove excess ama.

3. External applications include massaging herbal oils and preparations into scarred regions.

We prescribe a Vedic diet and exercise in addition to the primary course of treatment for Hidradenitis suppurativa. This aids in the restoration of a poorly controlled metabolism and the balancing of the doshas in the body.

All of these are beneficial in treating and avoiding the disease’s recurrence.

Ayurvedic treatment for hidradenitis suppurativa The goal of treatment is to restore the body’s natural balance by detoxifying it with powerful herbal remedies. 

Elite Ayurveda’s treatment for Hidradenitis Suppurativa includes balancing the Kapha and Pitta doshas as well as restoring metabolism harmony. Body detoxification, internal medications to balance doshas, and exterior applications to repair wounds are all part of the treatment.

The treatment consists of herbal mixtures generated based on individual Prakruti and Vikruti analyses. To learn more, please visit our website.

From My Perspective

• The best treatment for you should improve your overall health rather than impose additional negative effects.
• Within a reasonable time following treatment beginning, the treatment under consideration should provide benefits and improve general well-being.
• The recurrence rate or remission duration should be as short as possible.
• Treatment should not be prohibitively expensive in total.
• The treatment should address not just the symptoms of the illness, but also the underlying cause of the problem.
• By adopting a comprehensive approach to restoring the body and mind to its natural state, the appropriate treatment will assist you in discovering true health.

I can personally attest to the efficacy of our Ayurvedic treatment because thousands of people around the world are now disease-free.

Connect with me to acquire our patient testimonials and to speak directly with our patients about their experience with us and Ayurveda in general.

Dr. Adil Moulanchikkal, Lead Ayurveda Specialist at EliteAyurveda Clinics, reviewed the medical records. With over 15 years of experience in Neurological, Skin, and Autoimmune Disease treatment.

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