Telemedicine for Hidradenitis Suppurativa

Telemedicine can make it easier for those managing the chronic skin condition hidradenitis suppurativa (HS) to address flare-ups quickly and maintain routine follow-ups. Telemedicine has risen in popularity over the past few years, with a sharp uptick in response to COVID-19.

Although it’s sometimes necessary to see your doctor in person, there are several benefits to telemedicine visits, such as saving the time spent commuting to and from the doctor’s office or waiting around for your appointment to start.

Telemedicine helps manage costs and improves access to healthcare by enabling patients to speak with providers from the comfort of home. Rather than risking the spread of germs during an in-office visit, patients can schedule a doctor’s visit without hesitation. Here’s what to expect when seeking telehealth services for HS.

What is Hidradenitis Suppurativa?

HS is characterized by blocked hair follicles that trigger the immune system, producing inflammation. Skin itching and swelling result in pus and blood-filled lesions, usually located in areas where the skin rubs together (such as the armpits).

Doctors have yet to identify the specific cause of HS, but obesity and smoking appear to exacerbate symptoms. Because HS tends to run in families, a genetic component may also be at play.

HS symptoms range from mild to severe, with the worst cases involving widespread lesions and chronic pain. Symptoms typically start in adulthood, but misdiagnosis is common, especially in mild cases. Over time, repeated cycles of HS lead to scarring and sinus tracts (tunnels beneath the skin).

Telehealth visits are particularly helpful when the pain of HS makes mobility more challenging. Patients may feel self-conscious venturing out in public if visible skin lesions are inflamed.

Putting on a full outfit and traveling to the doctor’s office in-person can be uncomfortable. The convenience of remote doctor’s visits may improve the quality of life for patients dealing with HS.

Hidradenitis Suppurativa Treatment

Doctors use a combination of treatment strategies for HS management, depending on the severity of the condition and the suspected cause. In mild cases, a primary care doctor or dermatologist may prescribe topical antibiotics, corticosteroid injections, or anti-inflammatory medication.

For consistent flare-ups, you may be given oral retinoids or antibiotics to prevent HS symptoms. Severe cases may result in referrals to a surgeon or specialist to remove damaged areas and prescribe medications to block inflammation called TNF-alpha inhibitors.

Telemedicine Coverage Considerations

If you’re interested in telemedicine but haven’t tried it before, start by asking your doctor’s office if they offer the option for virtual appointments. Before scheduling, speak to your insurance provider for details on your telemedicine coverage. You may want to ask about getting preapproved for your appointment.

Every plan and state has its own regulations. However, coverage for telemedicine has improved along with the advances in technology which better serve the increased demand for virtual health services. Even if you don’t have coverage now, it’s possible that your options will expand in the future.

Furthermore, just because your primary care doctor is covered for telemedicine visits, doesn’t mean the same rules will apply for specialist appointments. People seeing specialists for HS (such as surgeons, endocrinologists, or dermatologists) should ask questions in advance to avoid unexpected costs.

Telemedicine enables patients to connect with providers from any location around the country (as long as the provider is licensed to practice in your state). It’s possible that your insurance company already has a program set up using their own network of physicians for you to speak with virtually.

While you may be able to do a preliminary visit through telemedicine, the doctor will refer you for an in-person appointment in some cases. Patients with a longstanding history of HS are more likely to be able to have their concerns addressed through telemedicine than those without a clear diagnosis.

For more invasive treatments, like an injection, biopsy, or surgery, an in-person visit is necessary.

Teledermatology

The American Academy of Dermatology supports the use of teledermatology as long as quality care is provided. Ideally, the appointment will include:

  • A high-resolution camera with at least 800 x 600 pixels (480,000)
  • Collection of the patient’s relevant medical history
  • Collaboration with the patient’s primary care doctor

Dermatologists are advised to use caution when prescribing medication, as some states require “face to face” appointments for prescriptions. When ideal teledermatology conditions cannot be met, exceptions may be made, especially for patients in rural areas with limited access to care.

Preparing For Your Telemedicine Visit

If you’ve never had a telemedicine visit before, you may be anxious about the process. Telemedicine visits can be as short as 15 minutes, so it’s crucial to avoid technical setbacks and delays.

Get clear instructions from your doctor’s office before your scheduled visit, and review them in advance so you’re prepared to log into their preferred system or application. If possible, sign in early to leave extra time if issues arise.

Connecting

You’ll need a reliable internet connection, along with a device that has a camera and speakers. If your wireless internet at home is spotty, consider using the data plan on your phone.

It never hurts to have a back-up device when possible. Keep your doctor’s number on hand for last-minute help in case you have trouble logging into your telemedicine appointment.

If you don’t have access to a smartphone, computer, or tablet, talk to your doctor’s office about doing a phone call instead. While not ideal, your doctor may be able to make an exception in some cases.

Minimizing Distractions

During your telemedicine appointment, young children or other distractions can make it difficult to successfully engage with your provider. Plan to have extra help with child care, or schedule your appointment during a quieter time of day so you can discuss your health concerns and get the most out of your visit.

Sharing Visuals

With HS, you’ll need to be able to show your doctor your skin. Ask about emailing photos to your provider if you don’t have video capability.

If privacy is a concern, consider having your appointment in the car or at another location where you feel most comfortable. To give your doctor the clearest picture of how your condition looks, wear loose clothing that you can easily remove and aim for good lighting.

Asking Questions

Just like regular doctor’s visits, telemedicine appointments can go by quickly. To prepare, write down a list of questions or concerns that you’d like to cover. Anticipate questions that your doctor may ask by having a list of your current medications (along with pre-requested information, like your body weight or temperature) ready.

A Word From Verywell

Managing a chronic condition like HS isn’t easy. Telemedicine can ease the burden of running into your doctor’s office every time you have a flare-up or need a prescription refill. However, sometimes telemedicine isn’t sufficient to provide optimal care. Explore your healthcare options to make sure you receive the best available treatment and support for HS.

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