Hidradenitis suppurativa treatment, in London.

Start with your GP. Hidradenitis suppurativa is a medical condition, and your GP is the person who can confirm the diagnosis, start treatment, and refer you to a dermatologist where the disease is more severe or is not settling. Dermatology leads specialist care, and NICE has appraised systemic treatments for moderate to severe disease, which sits entirely within that specialist pathway. A private aesthetic clinic is not the right first appointment and cannot substitute for either. Melatone does not diagnose hidradenitis suppurativa and does not prescribe for it. Where we can help is narrower and comes later: laser hair reduction as an adjunct, once a diagnosis is confirmed and alongside the treatment your GP or dermatologist has prescribed.

Hidradenitis suppurativa begins at the hair follicle. The current understanding is that the follicular unit becomes blocked and inflamed in skin folds where hair, friction and sweat glands coincide, most often the armpits, groin, under the breasts and the buttocks. That inflammation can rupture into the surrounding tissue, which is what produces the painful deep lumps, the tunnels under the skin and the scarring that follow. It is not caused by poor hygiene and it is not an infection you picked up, although individual lesions can become secondarily infected. Smoking and obesity are recognised as factors that worsen it, and there is a genetic component in some families. Because hair follicles are central to the mechanism, reducing the hair in an affected area has been studied as a treatment.

No. Hidradenitis suppurativa is a long-term condition that is managed rather than cured, and any clinic implying otherwise is overstating what is known. What is achievable for many people is meaningful control: fewer flares, less pain, and slower progression of scarring. Treatment is usually a combination rather than a single thing, led by your GP and, where the disease warrants it, a dermatologist. Where laser hair reduction is used it is one part of that combination, never the whole of it, and it does not change the underlying condition.

Hidradenitis suppurativa itself is not generally a fatal condition, and it is not a cancer. It is, however, a serious inflammatory disease that can cause significant pain, scarring and disability when it is not managed, and it is associated with other health conditions that your GP will want to keep an eye on. Individual lesions can become seriously infected. If you develop spreading redness, a fever, feel generally unwell, or an area becomes rapidly more painful and hot, that needs urgent medical attention through your GP, NHS 111, or A&E if you are very unwell. Do not wait for a cosmetic appointment for that.

No. Hidradenitis suppurativa is not contagious. It cannot be caught from another person, passed on through contact, or spread through shared towels, clothing or swimming pools. It is an inflammatory condition of your own hair follicles and skin, not an infection that transmits. This matters because the visible lesions and discharge lead people to assume otherwise, and that assumption causes a great deal of unnecessary shame.

Partly, in some people. A proportion of those with hidradenitis suppurativa have a family history of it, which points to an inherited component, but most cases do not follow a simple inheritance pattern and having a relative with it does not mean you will develop it. Other recognised contributing factors include smoking and excess weight, and hormonal influences are reported. Your GP is the right person to talk through your own risk factors, because which of them apply to you affects what is worth doing.

It is usually a long-term, relapsing condition rather than one that resolves and stays gone. Many people have periods of relative quiet and then flares. The realistic goal is control rather than disappearance: fewer and less severe flares, less pain, and limiting the permanent scarring and tunnelling that repeated inflammation causes. That is why getting into the medical pathway early, through your GP, matters more than any single treatment.

There is reasonable published evidence that it may help, used as an adjunct. A 2024 systematic review and meta-analysis of ten studies covering 227 patients, six of them randomised controlled trials, found that laser hair removal was associated with significant improvement in hidradenitis suppurativa disease severity across the laser types studied, with adverse effects reported as primarily mild pain and erythema. The long-pulsed 1064 nm Nd:YAG was the most studied device. An earlier randomised within-patient controlled trial of 22 patients found 72.7 per cent improvement on the laser-treated side against 22.9 per cent on the control side over four monthly sessions. In that trial the laser was added to a prescribed topical regimen and compared against that regimen alone, which is exactly how it should be used: alongside medical treatment, never instead of it. It is not suitable during an active flare, on an infected area, or where the disease is advanced. Individual results vary.

It may be suitable if you already have a confirmed hidradenitis suppurativa diagnosis from a GP or dermatologist, your disease is early and stable rather than advanced, the area we would treat is quiet at the time of treatment, and you are continuing the treatment your doctor has prescribed. It is not suitable if you have not yet been assessed medically, if there is active infection, an abscess or a draining tunnel in the area, if you are in a flare, or if the disease is advanced with extensive scarring and interconnected tunnels. In those situations the honest answer is your GP, and we will say so. Assessment is with Arman Zaki, GMC-registered Physician Associate (Ref A8131967); laser is delivered by Catia Zaki, VTCT Level 4 Laser and IPL lead, after a patch test.