Sweat Gland Removal for Hidradenitis Suppurativa: Does It Help? | myHSteam

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Sweat Gland Removal for Hidradenitis Suppurativa: Does It Help?

Medically reviewed by Steven Devos, M.D., Ph.D.
Written by Emily Wagner, M.S.
Posted on July 27, 2023

Are you struggling to manage your hidradenitis suppurativa (HS), even with treatments recommended by your dermatologist? Maybe you’ve recently done some research or have heard someone on TV talking about how a surgery like sweat gland removal helped treat their HS.

Members of myHSteam have turned to others for information on this surgery. “Has anyone heard of sweat glands being removed for an HS cure? I was watching Real Housewives of Salt Lake City. Mary mentioned she suffered from HS and had all of her sweat glands removed. Does anyone know if this could help?”

While some people may benefit from it, sweat gland removal isn’t a recommended procedure for treating HS, also called acne inversa. In this article, we’ll cover why this is the case and other surgical options your dermatologist may recommend instead. We’ll also discuss when sweat gland removal is used and how some myHSteam members have found it helpful.

What Are Sweat Glands?

Sweat is your body’s natural way of cooling down. There are two main types of sweat glands — eccrine and apocrine. Eccrine sweat glands are found in most areas of your body and are responsible for bringing sweat to your skin’s surface. They’re responsible for causing hyperhidrosis (excessive sweating).

On the other hand, apocrine sweat glands open up into your hair follicles rather than the surface of your skin. They’re commonly found in the skin covering your underarms, scalp, breasts, groin, and genitals.

Sweat Glands and Their Role in HS

HS is a skin condition that develops when your hair follicles become clogged with a type of protein called keratin, found in skin, hair, and nails. Sweat tries to flow out from the apocrine sweat glands into the clogged follicle, but it gets trapped. This creates a perfect breeding ground for bacteria, which causes inflammation and discomfort.

Eventually, the hair follicle bursts and creates large nodules (lumps) or abscesses filled with pus from infections. If more hair follicles become clogged, the abscesses can eventually connect and form large sinus tracts or tunnels underneath your skin.

What Is Sweat Gland Removal?

Sweat gland removal is typically used to stop excessive sweating and treat hyperhidrosis. There are a few different techniques dermatologists and surgeons use to remove sweat glands in affected areas of skin:

  • Excision — Cutting out the sweat glands
  • Curettage — Scraping out the sweat glands with a special tool
  • Liposuction — Removing the sweat glands with suction
  • Laser surgery — Using heat to destroy the sweat glands

Is Sweat Gland Removal Surgery Recommended for HS?

Some myHSteam members have wondered whether removing apocrine sweat glands can help treat HS. “I was wondering if anybody has asked their dermatologist if HS is caused by apocrine sweat glands. Would removal of those help or eliminate symptoms? Are apocrine sweat glands necessary for survival or can they be safely removed?”

While sweat gland removal is a useful procedure for treating other skin conditions, health experts don’t recommend the surgery for treating HS. Even if a surgeon removes the apocrine sweat glands near the affected hair follicles, there’s still a chance that you’ll develop HS in other areas nearby. It’s also possible that a surgeon will miss some sweat glands during the surgery, meaning your HS symptoms could come back later.

Originally, doctors and researchers thought that HS was caused by an inflammatory malfunction of the apocrine sweat glands because it develops in areas of skin where they’re more concentrated. However, we now know that HS is caused by clogged hair follicles that allow bacteria to grow. Studies show that HS is likely an immune-mediated disease. This means that it’s mainly caused by your immune system overreacting to the bacteria.

Your sweat glands don’t become clogged, so there’s little reason to remove them. However, there is a chance that when a clogged hair follicle bursts, it destroys the nearby apocrine sweat glands.

Other Treatments and Surgeries for HS

We know that apocrine sweat glands play a role in HS, but sweat gland removal surgery likely won’t help get to the root of the problem. Your dermatologist will recommend certain treatments depending on your symptoms and severity of HS (measured by the Hurley system).

Medications for HS

If you have mild HS, your dermatologist may prescribe a topical (applied to the skin) antibiotic to stop bacterial growth. If the condition is more widespread, they may prescribe an antibiotic, such as clindamycin (Cleocin). Corticosteroid injections can help treat inflammation to reduce swelling and discomfort. Hormonal birth control may also help regulate hormone levels to control sweat glands and prevent hair follicles from clogging.

In some cases of treatment-resistant HS, a doctor also may prescribe isotretinoin (Accutane) off-label, since it may help improve symptoms.

If you have moderate or severe HS, your dermatologist may prescribe you a biologic to help prevent your immune system from overreacting to your clogged hair follicles. Examples include infliximab (Remicade) and adalimumab (Humira).

Recommended Surgeries for HS

If you have large and painful nodules or sinus tracts, your dermatologist may recommend surgery to treat or remove them. Examples of surgeries for HS include:

  • Incision and drainage — Cutting into the nodule to drain pus, which typically provides only temporary relief
  • Unroofing — Removing the top layer of skin covering sinus tracts or tunnels
  • Punch debridement — Also called limited unroofing, involves using a punch tool to create a small hole in a nodule

Wide excision is a surgical technique used to remove HS lesions and some of the nearby skin. It’s likely that this skin has apocrine sweat glands that may have clogged hair follicles. Rather than specifically removing sweat glands, this surgery treats the entire area of affected skin.

Members of myHSteam Share Their Experiences With Sweat Gland Removal

Some myHSteam members have had sweat gland removal surgery and have shared their experiences. One member wrote, “I had my sweat glands in my left armpit removed, I don’t grow hair or sweat there anymore and it’s been completely free from boils since. I don’t even have to wear deodorant on it anymore because I don’t sweat.”

Another shared that they’ve had a similar experience, “I had two wide excision surgeries under both of my arms to get the sweat glands out. I haven’t worn deodorant in years! Neither have I had a boil under my arms.”

It’s important to note that every case of HS is different — treatments that work for one person may not work for everyone else.

Talk to Your Doctor About Surgery for HS

If you’re interested in learning more about sweat gland removal to help treat your HS, talk to your doctor or dermatologist. They know your health history and can make treatment recommendations in your best interest.

Your dermatologist will likely have you try other HS treatments before choosing surgery. They can also help you weigh the pros and cons of having surgery if you need it. As with any procedure, there are some risks associated with sweat gland removal.

One myHSteam member shared their experience, “My first surgery was under both arms and I had to do wet to dry bandages. The pain was intense.”

According to the American Academy of Dermatology Association, other side effects of sweat gland removal surgery include bruising and soreness, as well as permanent scarring and loss of sensation in the skin.

Talk With Others Who Understand

On myHSteam, the social network for people with hidradenitis suppurativa and their loved ones, more than 34,000 members come together to ask questions, give advice, and share their stories with others who understand life with HS.

Have you had sweat gland removal surgery to treat your hidradenitis suppurativa? Share your experience in the comments below, or start a conversation by posting on your Activities page.

Posted on July 27, 2023
All updates must be accompanied by text or a picture.

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Steven Devos, M.D., Ph.D. received his medical degree and completed residency training in dermatology at the University of Ghent, Belgium. Learn more about him here
Emily Wagner, M.S. holds a Master of Science in biomedical sciences with a focus in pharmacology. She is passionate about immunology, cancer biology, and molecular biology. Learn more about her here

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