To all, Thanks for all input. I have had hidradenitis supprativia for 33 years. My dermatologist in Beaumont has seen these and say they are sebaceous or inclusive cysts. I had one dermatologist in Houston do about 4 steroid shots, but they have only got worse since that time. The Houston doc said she didn't want to do anymore shots, but put me on Cosentyx. They are on the outside of vulva and two inside, one on the left and one on right side. Most of them are down low enough for my local dermatologist to inject cortisteroid shots in but the one on the vulva and the two inside it are going to be a problem. I am considering calling Women's hospital in Houston to try to get a maybe a gynecologist (mine retired 2 years ago) to at least rule out vulva related diseases or maybe recommend surgery. I had a hysterectomy years ago. I am so against biologics only because the one I took gave me another skin condition in PPPP which is hand and feet psoriasis which I know have on the palms and soles of. My h.s. is not doing badly. I take doxycycline once a day and use Hibiclens scrub. These cysts are definitely a different thing.

Honestly a dermatologist will recommend a surgeon, however a surgeon and someone who is into wound care and cosmetic surgery because their better with reconstruction if needed

Definitely make sure the doctor is qualified in derm or plastic surgery. I have had 16+ surgeries. My first one was single on thigh until my first pregnancy. I had 12 on each side of my groin. Because there was no dermatologist available anywhere near, a general surgeon performed the removal of the groin cysts. I am still having issues 30 years later with the scar tissue, draining and ingrown hairs in that area. I have had one removed on my left cheek by a plastic surgeon and never saw it again, no scar. I had skin cancer removed by a dermatologist surgeon on that same cheek and 42 stitches later, you can see a scar from my ear across my cheek and to my chin. Leaving a bump at the end where it was knotted. In the process of that healing, 2 more cysts formed in that skin tissue. ( Which is common with scar tissue) It is your body, you have the right to ask questions until you are comfortable with the situation. I have only learned to be my own advocate in the past 6 years after 38 years of being diagnosed with HS. Alot of doubt in myself and thinking doctors always knows more...supposedly and not aware of resources (keep in mind goggle did not exist in my beginning). I hope this helps and feel free to ask me any questions.
If I can make this journey with HS any easier for someone, it makes the experience worth having.

In my late 20's I went to a surgeon for numerous cyst and fibroid tumor operations. He said he would get rid of my sebaceus cysts in my groin and I shouldn't have any problems. He did each my right groin then my left groin. My groin was stapled closed after each removal and I had to use crutches to walk and not wear any under garments. I really didn't have any trouble after that: but, at the age of 72 I got HS!
I agree with seeing a dermatologist who may or may not send you to a surgeon. Best of luck to you. If you have any other questions I could help you with please do not hesitate to ask.