Hidradenitis suppurativa (HS) is a chronic, debilitating inflammatory skin disease that significantly impacts quality of life through painful nodules, abscesses, and scarring in sensitive areas. This challenging condition affects an estimated 0.7-1.2% of the population, with women being three times more likely to develop HS than men. Dr. Zitelli provides comprehensive HS management throughout Cincinnati, combining medical therapies with surgical interventions to help patients achieve better disease control and improved quality of life.
Not only provides excellent care but truly cares.
Understanding Hidradenitis Suppurativa Presentations
HS manifests through several distinct patterns and severity levels, requiring individualized treatment approaches based on disease stage and location.
Mild HS (Hurley Stage I)
Single or multiple isolated abscesses without scarring or sinus tract formation, primarily affecting axillary and groin areas
Moderate HS (Hurley Stage II)
Recurrent abscesses with tract formation and scarring, involving single or multiple widely separated lesions across affected regions
Severe HS (Hurley Stage III)
Diffuse involvement with multiple interconnected tracts, extensive scarring, and chronic drainage across broad anatomical areas
Atypical Presentations
Unusual locations or patterns that may complicate diagnosis, including isolated lesions or involvement of non-traditional anatomical sites
Dr. Zitelli’s Comprehensive HS Management Philosophy
Effective HS management requires understanding the chronic, inflammatory nature of this complex disease. Dr. Zitelli’s approach emphasizes early intervention, comprehensive medical therapy, and surgical planning when appropriate to prevent disease progression and improve patient outcomes.
“Hidradenitis suppurativa is a challenging condition that requires patience, persistence, and a comprehensive treatment plan. Early intervention can make a significant difference in preventing complications and improving quality of life,” explains Dr. Zitelli.
Clinical Assessment and Staging
Accurate HS assessment involves evaluating disease severity, anatomical involvement, and impact on daily functioning. Dr. Zitelli utilizes standardized scoring systems to monitor treatment response and adjust therapeutic approaches based on individual patient needs.
Multidisciplinary Treatment Approach
HS management often requires coordination between dermatology, surgery, and pain management specialists. Dr. Zitelli works collaboratively to ensure patients receive comprehensive care addressing all aspects of this complex condition.
Evidence-Based Treatment Strategies
Modern HS management offers multiple therapeutic options ranging from topical treatments to advanced biologics, with treatment selection based on disease severity and patient factors.
Topical Therapies
Antimicrobial washes, antibiotic gels, and anti-inflammatory agents for mild disease and maintenance of remission following systemic treatment
Oral Antibiotics
Long-term antibiotic regimens including tetracyclines and combination therapies targeting both antimicrobial and anti-inflammatory effects on disease activity
Biologic Therapies
TNF-alpha inhibitors like adalimumab for moderate to severe disease, with emerging options including IL-17 and IL-23 inhibitors showing promise
Surgical Interventions
Ranging from incision and drainage for acute flares to wide local excision for severe, recalcitrant disease requiring definitive management
Advanced Treatment Options
Patients with moderate to severe HS may benefit from advanced therapeutic approaches when conventional treatments prove insufficient.
Biologic Therapy Management
Adalimumab represents the only FDA-approved biologic for HS, though other agents show promising results in clinical trials. Biologic therapy requires careful monitoring and patient selection to optimize outcomes while minimizing potential adverse effects.
Surgical Planning and Techniques
Surgical intervention becomes necessary when medical management fails to control disease progression. Options range from conservative drainage procedures to extensive excision with reconstruction, depending on disease extent and patient goals.
Lifestyle Modifications and Supportive Care
HS management extends beyond medical therapy to include comprehensive lifestyle modifications that can significantly impact disease activity and overall wellbeing.
Weight management, smoking cessation, and stress reduction all play important roles in HS control. Appropriate wound care, pain management, and psychological support help patients cope with this chronic condition’s daily challenges.
Frequently Asked Questions About Hidradenitis Suppurativa
HS results from a combination of genetic predisposition, hormonal factors, and environmental triggers including smoking and obesity, though the exact cause remains incompletely understood.
Currently, no cure exists for HS, but effective treatments can control symptoms, prevent complications, and significantly improve quality of life for most patients.
HS is a chronic condition requiring long-term management, though many patients see improvement within 3-6 months of starting appropriate therapy.
Biologic therapies are generally safe when used under proper medical supervision, with regular monitoring to detect and manage potential side effects.
Surgery is reserved for severe disease or areas that don’t respond to medical treatment, with many patients achieving good control through medication alone.
Board-Certified Dermatologist Serving Cincinnati, Ohio
Dr. Kristine Zitelli is a board-certified dermatologist serving the Cincinnati area, known for her expertise in treating a wide range of skin conditions. She completed her medical degree at Wright State University and dermatology residency at the University of Cincinnati, with additional advanced training at the UCSF Psoriasis and Skin Treatment Center. Her clinical focus includes thorough skin examinations, psoriasis, eczema, complex medical dermatology, surgical dermatology and cosmetic treatments using the latest technologies.
Dr. Zitelli has been named a “Top Doctor” in Cincinnati every year since 2016 as well as Cincinnati’s Top Dermatologist in 2020. She remains dedicated to educating the community about skin health and sun safety. Combining academic excellence, clinical research, and a compassionate approach, Dr. Zitelli delivers personalized, evidence-based care to every patient.
Transform Your HS Management in Cincinnati
Don’t let hidradenitis suppurativa control your life. Dr. Zitelli’s comprehensive approach to HS treatment combines the latest medical therapies with surgical expertise to help patients in Cincinnati and Montgomery achieve better disease control and improved quality of life. Schedule your hidradenitis suppurativa consultation today to begin your journey toward effective management.
