Lancing and I & Ds

Updated: Jun 30

Should you get your abscesses lanced, drained or get an I & D (incision & drainage)? Only if absolutely necessary and unfortunately, pain does not qualify as necessary!

Please keep in mind when “giving your opinion, suggestions, promoting, urging, or encouraging" others to do this, you have no idea what their situation is.

- Are they new to this disease?

- What is the status of their abscess?

- Do they have any other medical conditions?

If you choose to have your abscesses lanced or have I & Ds, regardless of the risks, this is your prerogative, however, please do not encourage others in this same risky behavior. Those new to HS may be inquiring about this practice as they’ve seen this mentioned in groups, please do not encourage this form of disease management.

There are times when an abscess is infected and this procedure is required or if you have a large abscess that has been going on too long and the pain is completely unbearable. Lancing and I & Ds should not be used as regular maintenance for hidradenitis and specialists are now realizing this. These procedures are very risky, even in a sterile environment and done by professionals. Self lancing or using a needle is never advised.

The impact of an I & D happens over time; every time you lance in the same area or close to the area the scar tissue starts to build up. The more scar tissue that builds up causes tunneling to occur. If you are at stage 1 or a mild stage 2, for example, with no scar tissue/tunneling or minimal scar tissue/tunneling, you have now set the stage for abscesses to form in other areas and the surrounding areas. This means you are putting yourself at risk of advancing the severity of your disease and your HS stage. Another common issue that develops as the result of lancing or an I & D is the development of a continuously draining abscess which can be very hard to heal. These types of issues don’t require multiple I & Ds, this can happen after only one lancing.

In addition to the above, you are tripling your chances of developing fistulas (A fistula is an abnormal connection or passageway that connects two organs or vessels that do not usually connect). Lancing or I & D of a perianal abscess (anal areas) can result in a chronic anal fistula and may require a fistulectomy by a surgeon. I & Ds should be avoided in this area at all costs.

Lancing and I & Ds are one of the worst things you can do for hidradenitis, which is why so many doctors and hospitals will not do it. We’re told by our dermatologist or the hospital that it is best to let the abscesses drain naturally. Any physician who knows this disease typically uses these methods as a last resort or know when it’s appropriate.

This is an awareness article for educational purposes only and is not intended to replace the advice of your doctor or other health care provider.

Written by Denise Panter-Fixsen

Edited by Brindley Kons

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