Diode Laser Therapy as an Adjunct to Minimally Invasive Therapy for Hidradenitis Suppurativa

Purpose This study aims to evaluate whether diode laser-assisted deroofing, integrated into Minimally Invasive Techniques for Hidradenitis Suppurativa (MITHS), can accelerate wound healing, reduce recurrence, and improve symptom resolution compared to conventional surgical approaches. Does diode laser therapy as part of MITHS enhance clinical outcomes in HS patients versus traditional surgical methods? Methods We conducted a retrospective single center, single surgeon study between January 2022 and January 2024 involving 55 HS patients (Hurley stages 2–3) who underwent MITHS with a 1470 nm diode laser ablation after excisional tunneling debridement with an ultrasonic instrument. Hidradenitis tracts were ablated intraoperatively using the lasers. Outcomes were assessed based on symptom resolution: full, partial, or unresolved which was self reported. Patient demographics, prior treatment history, lesion location, and adverse effects were also recorded. Results Among 55 patients, 62 MITHS procedures were performed. Initially, 60% (n = 27) achieved complete resolution and 40% (n = 18) partial resolution. After subsequent treatments, 58% (n = 36) were complete and 29% (n = 18) partial; 13% (n = 8) were lost to follow-up. No symptom worsening occurred. Adverse effects were minimal and transient, including two reversible upper extremity nerve palsies. All procedures were well-tolerated under local anesthesia. Conclusion Diode laser therapy as an adjunct to MITHS shows high efficacy, minimal morbidity, and rapid recovery, offering a less invasive alternative for HS management. It may achieve remission or cure in moderate-to-severe cases and addresses unmet therapeutic needs. Further prospective studies are needed to validate and optimize its role in multidisciplinary care.