Hidradenitis Suppurativa Center · Beverly Hills
We treat HS in the regions most clinicians avoid — perianal, perineal, gluteal, and inguinal — with a two-laser model: 1064 nm Nd:YAG follicle-directed therapy for active disease and 1470 nm intralesional laser tunnel closure for established sinus tracts. Our work is procedural, anatomic, and honest about what surgery can and cannot do.
Hidradenitis suppurativa is a chronic inflammatory condition. Our protocol is designed for durable control — fewer flares, fewer tunnels, less drainage, less pain — not cure. We will tell you what we believe we can change, what we cannot, and where the evidence is still thin. If a different specialty is a better fit for your stage of disease, we will say so.
The model
HS is not one disease at one moment. The right intervention depends on whether the tissue is still inflammatory or has already organized into tunnels. We use different tools for each.
A long-pulsed Nd:YAG laser targets the hair follicles that drive HS inflammation. Delivered as a series of sessions, the goal is to quiet active disease, reduce flare frequency, and slow progression toward tunnel formation. Best suited to Hurley I and selected Hurley II patients.
How follicle therapy works →Anatomic focus
Most HS programs concentrate on axillary disease. We concentrate on the perianal, perineal, gluteal, and inguinal regions — where exposure, function, and continence are at stake, and where conservative tissue handling matters most.
Disease around the anus and perineum is functionally unforgiving. Tunnels involve the gluteal cleft, the natal area, and sometimes the sphincter complex. Our colorectal training is the reason this region is the center of our practice.
Learn more →Tunnels in the buttocks and natal cleft are often mistaken for pilonidal disease. We distinguish the two, and treat HS in this region with 1470 nm intralesional tunnel closure — the same in-office, closed-wound technique used in our pilonidal SiLaC program.
Learn more →Inguinal HS sits in a region with dense lymphatics and high mechanical stress. We approach it conservatively — follicle therapy first when active disease dominates, targeted closure when tunnels have organized.
Learn more →Why a colorectal surgeon
The anatomy that makes perianal, perineal, and gluteal HS difficult — the sphincter complex, the natal cleft, the perineal body, the ischiorectal fossa — is the anatomy colorectal surgeons train in for years.
Dermatologic and plastic surgical approaches to HS are necessary and valuable for many regions of the body. For disease that involves the anal canal, the perineum, or threatens continence, the operating surgeon should be someone whose daily work is this region.
Dr. Kamrava is board-certified in colorectal surgery and has built a focused HS practice around this anatomic overlap.
Candidacy
We would rather decline a case than take one we are not the right team for. A short preview below; the full candidacy criteria live on the candidacy page.
What the evidence supports
We will not tell you HS has a cure, or that laser therapy works for everyone. We will tell you the following.
Multiple controlled trials have shown reductions in lesion count and Hurley stage progression with long-pulsed 1064 nm Nd:YAG therapy of affected follicles in HS.
The 1470 nm intralesional radial-fiber technique is the same approach used in the pilonidal SiLaC program — making this one of the most experienced laser sinus tract closure practices in the United States, now applied to HS.
Disease that involves the sphincter complex or perineal body has outcomes that depend on the operating surgeon's familiarity with this anatomy — independent of which laser is used.
What to expect
Step 01
We review your photographs, history, and prior treatment. We stage the disease and tell you whether we are the right team.
Step 02
Where tunnels are present, we map them. Where active inflammation dominates, we plan a follicle therapy course. Many patients receive both.
Step 03
Both procedures are in-office. Follicle laser sessions take 20–45 minutes. The 1470 nm intralesional tunnel closure is performed under local anesthesia in our procedure suite — walk in, walk out the same day.
Step 04
Most patients return to desk work the day after tunnel closure. We follow recovery in person and by video, and continue medical co-management with your dermatologist.
The patient we usually meet
“I had been to four doctors before I found this practice. Two of them did not know what HS was. One offered a wide excision I was terrified of. I wanted someone who actually worked in this part of the body and would tell me the truth.”
Most patients reaching this page have been managed for years by clinicians who know HS exists but do not operate on it. They have tried antibiotics, biologics, and incision-and-drainage cycles, and they are tired. Our job is to be honest about what surgery can change, to use the smallest intervention that does the job, and to keep your dermatologist or rheumatologist in the loop the entire time.
Next step
Consultations in Beverly Hills or virtual for patients traveling from outside Southern California.
Typical response within one business day. We will never share your information.
