Medical dermatology
Hidradenitis Suppurativa
Biologics and targeted therapies for painful bumps and tunnels in the armpits, groin, and under the breasts — beyond antibiotics alone.
What HS looks like
Recurrent painful bumps, draining tunnels, and scars in the armpits, groin, buttocks, or under the breasts. It is not caused by poor hygiene — it is an immune-mediated condition.
Treatment ladder
- Topical clindamycin and benzoyl peroxide washes
- Oral antibiotics (doxycycline, clindamycin + rifampin)
- Hormonal and metabolic agents (spironolactone, metformin)
- Biologics for moderate-to-severe disease
- Surgical excision of persistent tunnels when needed
Frequently asked questions
Does insurance cover HS biologics?
Most insurance plans cover medical dermatology procedures. Contact us to verify your benefits.
Trusted sources
This page is educational. Specific treatment decisions are made during your visit with Dr. Puyana.
Related procedures
Skin Cancer Screening
A head-to-toe full-body skin exam with a board-certified dermatologist — the single best thing you can do for skin cancer prevention in South Florida.
Learn more
Acne Treatment
A personalized acne plan from a dermatologist — not a generic over-the-counter routine. Clearer skin in 8–12 weeks for most patients.
Learn more
Eczema (Atopic Dermatitis)
Modern eczema care goes far beyond steroid creams — biologics and JAK inhibitors mean most patients can finally have calm skin year-round.
Learn moreBefore & After
Real patient results from Miami Skin Center.
Book a consultation
Choose a time that works for you. Online scheduling is through our practice calendar — same Coral Gables office, bilingual care.