Hi @Muffinmam I also have HS, in fact I’m currently on treatment for an episode.
Have you tried anti-biotic treatment? This normally clears it up for me, not every time but mostly. The most effective one I found for it was Flucloxacillin (a penicillin based anti-b). However after many years I developed a reaction to it and had to discontinue. I’m now on non-penicillin based anti-b’s.
In response to your query about surgery, I did have to go down this route for 3x excisions, out of the 3 only one was successful and still resulted in a fairly deep cavity wound that required daily nurse dressing, with cleaning, packing wound and re-dressing. This was back when they had NHS walk in centres, does anyone remember those? It took a long time to heal. The following surgical removals were not good, one was incredibly painful and left me with a big, awful seeping wound that took an age to heal. The second v similar but I got a nasty infection to boot, which burst the stitches and again was very tricky wound management. I think this can be common with surgical removal, which is why they don’t necessarily always recommend it. My preference the last 15 years is to quickly knock it out with antibiotics before the infection gets too deep/ problematic.
Also the problem with surgery that a consultant told me, was they can remove that infected follicle/ sweat gland and tissue (basically do surgery for that episode) but more crop up in a different area/s so surgery is not an effective preventative due to the nature of the disease.
Speak to your Dr about antibiotics though, I never got anywhere with the compresses or topical treatments either. It is thought to be hormone related. All the v best with it, it is tough.