A more precise approach to hidradenitis suppurativa (HS), combining clinical assessment with high-frequency ultrasound mapping and targeted procedural treatment when appropriate.
Assessment beyond the surface
Clinical examination, high-frequency ultrasound mapping and targeted procedural options—selected according to the anatomy of each lesion.
Hidradenitis suppurativa is a chronic inflammatory skin disease that can cause recurrent painful nodules, abscesses, draining tunnels and scarring. It most often affects areas where skin rubs together, including the underarms, groin, buttocks, inner thighs and under the breasts.
HS is not simply an infection or a hygiene problem. Disease can extend beneath the visible skin, which is why examination alone may not show the full extent of an active tunnel or inflammatory collection.
Parkwood Skin Clinic’s approach: define what is happening beneath the skin, identify which lesions are active or structurally established, and match each area to the least invasive effective option available.
High-frequency ultrasound can add structural information to the clinical examination, helping identify fluid, inflammation and tunnels beneath the skin and helping define the treatment field.
HS can form inflammatory collections and interconnected tunnels beneath the skin. Ultrasound can complement examination by showing subsurface anatomy and helping define the area that actually needs treatment.
For selected lesions, the same real-time imaging can also be used to guide an intralesional injection to the intended target.
Ultrasound can help identify the depth, direction and connections of selected HS tunnels and collections, including changes that may be difficult to appreciate by touch alone.
Mapping can help distinguish an acute inflamed lesion from more established structural disease and support decisions around injection, CO₂ laser, deroofing, excision or referral.
For selected lesions, ultrasound guidance can help position an intralesional anti-inflammatory injection within the intended target rather than relying on surface landmarks alone.
When useful, ultrasound findings can be documented so future assessment is based on more than appearance alone.
HS often needs multimodal treatment. Medical therapy may be required to control the underlying inflammatory disease, while procedural treatment addresses individual persistent lesions, tunnels or scarred areas.
The aim is to separate active inflammation from permanent structural change, then choose the right treatment for each problem.