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Laser therapy has been proposed as a potential cure for hidradenitis suppurativa. Here, we will put that claim to the test and examine the theory and effectiveness of various types of laser and light therapy that you should consider for treatment.

Hidradenitis suppurativa (HS) represents a medical challenge not only for the patients affected but also for the doctors trying to treat the disease. Hidradenitis suppurativa is a chronic skin disease characterized by recurrent inflammatory nodules, fistulas, abscesses, and scarring in the hair follicles and apocrine glands normally located around a patient's underarms, perianal area and anywhere under excessive skin folds such in overweight patients. As we have seen in previous articles, hidradenitis suppurativa treatment is something entirely necessary to prevent from long-term consequences occurring [1]. It is entirely dependent on the symptoms and the recurrence patterns of the disease. A definitive therapy that can provide long-term relief would be hidradenitis suppurativa treatment with surgery. Unfortunately, patients still have a risk of recurrence even with an invasive surgical procedure so newer therapies are being explored to determine if patients could have a better outcome. One theory is that hidradenitis suppurativa treatment with lasers could be an option to help patients. Here, we will explore if the scientific data supports this claim and if it is an option worthwhile for you to consider if you suffer from HS. 

The theory and effectiveness of carbon dioxide laser therapy 

To potentially burst your bubble right off the start, if you are reluctant to have surgery, laser therapy is something that would be considered to be an adjuvant to traditional surgical options so patients would still need to have the operation. 

The idea behind why laser therapy would work is because these lasers target and destroy hair follicles, sebaceous glands and bacterial colonies found in the apocrine glands so the surgeries would not have to as extensive. 

Because the physician can pinpoint where exactly he will direct the laser beam to destroy tissue, the results should be better because the problematic area is being removed. [2

Another potential benefit of this line of therapy is patients will not require the same deep surgical incisions that may have been required compared to the more severe versions of the disease. Scars will be flatter so cosmetic results are also more attractive to patients considering this procedure. 

Carbon dioxide laser therapy is touted to be a very worthwhile consideration of therapy for HS, but results have been controversial and inconsistent. 

One investigation determined that a total of 61 patients suffering from HS and having CO2 laser therapy had recurrence rates of HS in only 1.1 percent of cases after 20 years [3]. Another similar investigation, however, determined that patients suffering from HS with an underlying metabolic disorder known as Hurley disease had relapse rates of HS closer to 11 percent in the same sites of where the laser was administered. This study also observed that new lesions appeared in over 36 percent of patients [4]. Hurley disease is commonly associated with HS, being seen in over 86 percent of cases so it is something that cannot be overlooked [5]. 

All things considered, this is still a good result for a disease previously thought to have no cure. When patients were asked how they felt after the laser procedure, over 95 percent reported that they were satisfied with the therapy. Ultimately, nearly 30 percent of these patients eventually had a relapse of the symptoms along the borders of where they had the laser therapy. For this reason, CO2 laser therapy for hidradenitis suppurativa it is not necessarily wholly reliable. [6]

Could the Nd: YAG laser therapy or light pulse therapy be a better option? 

Similar to CO2 laser surgery, another option for Hidradenitis Suppurativa treatment that patients may benefit from would be using another type of laser therapy referred to as neodymium-doped yttrium aluminum garnet (Nd:YAG) laser therapy (catchy, I know). This procedure requires three total visits spaced over three months to be effective. At the conclusion of the study, it researchers determined that after a 3-month therapy, patients reported a reduction of 66 percent of all lesions across the body. [7] This is an impressive result, but no long-term follow-up was part of this study, so relapse rates are not available at this time. 

Another alternative therapy that could be beneficial does not include hidradenitis suppurativa treatment with lasers at all. It uses intense pulse light therapy to produce an effect similar to traditional laser approaches but is much cheaper. Research determined that in a small trial of 18 patients suffering from HS, intense pulse light could make a difference. Patients were given pulsed light biweekly for a period of 1 month with only half of their body receiving therapy. Even after one year after treatment, there was a statistically significant difference between the symptoms and number of lesions found on the treated side compared to the untreated side. Because this is the same patient, it proves that the light therapy did make the difference. [8]

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