Carbon Dioxide Laser Deroofing for Hidradenitis Suppurativa: Experience from an Asian Cohort

Hidradenitis suppurativa (HS) is a chronic inflammatory disorder of the pilosebaceous unit associated with recurrent flares which significantly impair quality of life. Carbon Dioxide (CO₂) laser deroofing is a tissue-sparing technique that may offer effective symptom control with low recurrence. Our study describes the clinical characteristics and outcomes of an Asian cohort who underwent CO₂ laser deroofing for HS. This retrospective study included patients who underwent clinic-based CO₂ laser deroofing for HS lesions between November 2017 and December 2024 at a single institution. A total of 43 procedures were performed on 30 patients (57% male; median age 22.0 years [IQR 17.0–33.8 years]). The cohort included mainly Chinese (53.3%) and Indian (33.3%) patients. At surgery, 51.2% had Hurley stage II, 25.6% stage III, and 23.3% stage I disease. Most patients (95.3%) were concurrently treated with tetracyclines. The axilla was the most treated site (63%). Recurrence occurred in 9.3% of procedures; for which one required abscess aspiration. Other complications included minor bleeding (23.3%), hypergranulation (7.0%) and infection (4.7%). CO₂ laser deroofing is a simple, effective, and minimally invasive treatment for HS lesions. It offers low recurrence and complication rates and is feasible in an outpatient setting for Asian populations.