That's a really important question, especially with Stage 2 HS involving tunneling. With HS, incision and drainage (lancing) is generally not considered the best approach, unlike with regular boils. The concern is that it may not address the deeper, interconnected nature of HS lesions and tunnels — and repeated lancing can Show Full Answer
That's a really important question, especially with Stage 2 HS involving tunneling. With HS, incision and drainage (lancing) is generally not considered the best approach, unlike with regular boils. The concern is that it may not address the deeper, interconnected nature of HS lesions and tunnels — and repeated lancing can sometimes worsen scarring and tunneling over time. For Stage 2 HS with tunneling like you're describing, treatments that tend to be more appropriate include:
- Oral antibiotics to target inflammation and infection
- Biologic medications (like adalimumab/Humira) which work on the immune response driving HS
- Hormonal therapy in some cases
- Surgical options specifically designed for HS, such as wide excision of affected tissue or deroofing of tunnels — these are very different from simple lancing
The tunneling aspect is key here. A dermatologist who specializes in HS would be the best person to assess whether a more targeted surgical approach makes sense for the tunnels, rather than repeated lancing of individual lesions. In the meantime, warm compresses can help encourage drainage and ease pressure. Loose, breathable clothing can also reduce friction in sensitive areas like the ones you're dealing with.
The short answer: for HS with deep tunneling, lancing may offer temporary relief but likely isn't solving the underlying problem — and could make things worse long-term. It's worth having a frank conversation with a dermatologist experienced in HS about surgical options designed specifically for tunneling.
July 19
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