I. Introduction

Multidisciplinary care is when different types of health care professionals work together as a team to provide coordinated and comprehensive care for a patient. The health care providers who may treat people with HS include dermatologists, wound care specialists, pain management specialists, mental health professionals, surgeons, and nutritionists (Table 13.1). Not every person with HS will need to see different types of health care professionals. This need depends on your disease severity and other medical conditions. Where you live may also determine which types of heath care professionals are available in your area.

II. HS Care Team Specialists

The dermatologist is the main provider in charge of treating HS. Dermatologists see all conditions concerning the hair, skin, and nails. There are different types of dermatologists.

General dermatologists may see all conditions, including HS. Their office may be in a teaching hospital or a private doctor’s office. Some dermatologists only see patients for surgery or cosmetic treatment, so you should check the dermatologist’s website or call their office to find out if the dermatologist is a general dermatologist.

Dermatologists treat HS in different ways based on how severe your HS is and the part(s) of the body affected by HS. They may prescribe medications and tell you ways to have fewer HS flares. They may also inject painful boils with a steroid medication, or perform laser treatments and surgeries to areas that are not getting better with other medications. If needed, dermatologists will also help plan care with other healthcare professionals, such as plastic surgeons, nutritionists, and pain management health care providers.

A primary care provider (PCP) is a healthcare professional who treats common medical conditions. Every person should have a PCP. Your PCP may be a family medicine doctor, internal medicine doctor, nurse practitioner, or physician assistant. PCPs may be the first providers to diagnose a person with HS and work together with dermatologists to treat the disease. Your PCP can help check for other medical conditions that are associated with HS, such as diabetes and high blood pressure, and manage these conditions if they are present. Additionally, your PCP may also play an important role in setting up care with other providers.

Dermatologic surgeons, plastic surgeons, and general surgeons are different types of surgeons that may treat HS by removing skin affected by HS. Finding a surgeon who feels comfortable treating HS is important. If surgery is potentially a good option for your HS, you can meet with a surgeon to have your HS examined and to formulate a surgical plan. After the discussion with your surgeon, you can decide if you would like to move forward and schedule a surgery. If you opt to have surgery, a follow-up visit (called a postoperative or post-op visit) will also be scheduled to make sure the surgical site is healing well. After seeing the surgeon, you should continue following up with your dermatologist.

Wound care teams involve doctors and nurses who take care of hard-to-heal wounds. They may recommend special bandages to improve healing that help decrease odor, drainage, and pain. When wound care centers are far away or are not covered by insurance, your dermatologist may help with wound care. Please see Chapter 15 for further information on wound care.

Rheumatologists, doctors that take care of joints, can also be part of the care team for a patient with HS who experiences joint pain in addition to skin lesions. Let your health care professional know if you have joint pain, and they can help make an appointment with a rheumatologist to ensure your joints are examined and treated.

Mental health professionals can help people deal with the stress of living with HS. Feelings of worry, anxiety, or depression are mental health conditions suffered by many people with HS. These feelings can affect health and quality of life, and can be treated with the help of mental health professionals, such as psychiatrists, psychologists, therapists, and counselors.

A nutritionist teaches patients about different types of foods, and how they can improve overall health through diet. Some people with HS notice that some foods worsen their HS. A nutritionist may help you find foods that do not worsen your HS. If you know which foods improve your HS, a nutritionist can provide advice and recommend similar foods. Nutritionists may also help with weight loss if needed, and this can be helpful for some people with HS.

Pain management providers help to manage chronic pain, which is pain due to long-term conditions. Primary care providers, dermatologists, and other healthcare providers may help to manage pain during short flares, but ongoing pain may require a pain management specialist to help safely combine different medications and pain relief methods.