Despite a growing arsenal of targeted therapies for hidradenitis suppurativa (HS), experts say surgery shouldn't be sidelined. A small retrospective study found that outpatient CO2 laser excision in seven patients with severe HS led to low recurrence rates, minimal pain, and no major complications — offering faster relief than waiting months for medications to kick in.
Even as new biologics and targeted therapies have transformed the treatment landscape for hidradenitis suppurativa (HS), experts are pushing back on the idea that surgery is a last resort. Dr. Amit Garg of Northwell Health argues that for patients with severe, draining lesions, waiting months through multiple medication trials is simply too burdensome — and that outpatient surgery can offer faster, meaningful relief.
A small retrospective study presented at two dermatology conferences lends support to this view. Seven patients with Hurley stage III (severe) HS underwent CO2 laser excision with marsupialization on an outpatient basis — no hospital stays required. Results were encouraging: most treated sites showed no active disease at follow-up, postoperative pain was minimal, and there were no major complications or wound-related adverse events.
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Why it matters: HS carries a heavy quality-of-life burden, and pharmacologic control doesn't always translate to rapid symptom relief. Ambulatory CO2 laser excision could fill a critical gap, offering patients faster resolution of debilitating lesions without the cost or recovery time of hospitalization. Prospective trials are needed to solidify best practices.
