What to expect when you come to see us about HS.

Before the visit

Four things to send ahead.

None of these are required to schedule — they just make the visit more useful. Our intake team will send a secure link after booking.

A brief written history

Approximate age at onset, regions affected, family history, prior diagnoses (often labeled abscess, pilonidal, or fistula), and prior procedures or biologics. A few sentences is plenty — we ask the rest in person.

Photographs of active or recent disease

If you have them. Phone photos are fine. They help us plan and they spare you from having to re-show flares that may have settled since you booked. Upload through the secure intake link we send after scheduling.

A medication list

Current dermatologic, surgical, and systemic medications — including any biologic (adalimumab, secukinumab, infliximab, others), antibiotics, hormonal therapy, and pain medication.

Insurance and ID, if applicable

Bring a photo ID and your insurance card if you have one. Most of our care is structured as cash-pay with written estimates and superbills; details are on the pricing page.

In-person visit

How the visit flows.

1. 01

   Check-in (5 minutes)

   Forms confirmed, photo ID and any insurance verified, intake reviewed with our medical assistant.

2. 02

   Clinical history (10–15 minutes)

   We walk through your history together — what flares look like, where they occur, what makes them worse, what's been tried, and what your goals are. This conversation usually surfaces details that change the plan.

3. 03

   Physical exam (10–20 minutes)

   A focused examination of affected regions in a private, draped setting. We palpate tunnels, identify active and quiet disease, and map the anatomy. A chaperone is offered for every sensitive exam — no exceptions.

4. 04

   Hurley staging and disease mapping

   We assign a working Hurley stage by region (you can be different stages in different areas), photograph for the chart with your consent, and outline what we found.

5. 05

   Plan discussion (15–25 minutes)

   What we'd recommend, what we wouldn't, the realistic outcome range, the recovery you should plan for, and what it costs. Questions are expected — bring a list.

Virtual visit

If you're coming from out of town.

A virtual consultation gets you a real plan without a flight. It cannot replace the in-person evaluation required before any procedure, but it can tell you whether the trip is worth taking.

Same intake, different setting

Virtual consultations are available for patients outside Southern California or internationally. We use the same intake, the same history conversation, and the same plan discussion. The physical exam component is replaced by a structured review of photographs.

What we can decide remotely

Working stage assessment, candidacy in broad terms, what the plan would likely look like, an estimated procedure range, and recovery and travel planning.

What still requires an in-person visit

Final operative mapping and any procedure. An in-person evaluation is required before any treatment. For out-of-area patients we typically combine pre-op evaluation and procedure into one trip to Los Angeles.

How it's delivered

Video over a HIPAA-compliant platform. You'll receive a link the day before. A quiet, well-lit space and a stable connection are the only requirements.

The exam

Privacy, chaperone, and consent.

Examining perianal, perineal, gluteal, and inguinal anatomy requires trust. We treat that trust as the responsibility it is.

• A trained chaperone is offered for every exam involving sensitive regions and is always present on request.
• You decide the pace. You can pause or stop at any point, ask for a moment, or ask the chaperone to step closer.
• Photographs are taken only with your written consent, stored in your protected record, and used for your care planning. Any educational or publication use requires a separate, specific consent — never assumed.
• Patients who have had years of dismissive exams elsewhere should expect this one to feel different. That is intentional.

The discussion

What we cover before you leave.

What we'd recommend, and what we wouldn't

If follicle laser alone is right, we'll say so. If you'd be better served by a referral to dermatology, a plastic surgery colleague for staged reconstruction, or a different center entirely, we'll say that too.

Realistic outcomes

What the published data and our experience say is likely, what's possible, and what's not. No promises of cure — that is not what current medicine can deliver for HS.

What the recovery looks like for your case

Concrete timelines for work, exercise, travel, and daily life — for the specific procedure and the specific region we'd treat.

Cost and logistics

A written estimate, the payment options available, how insurance interacts with the plan, and what scheduling would look like.

What you leave with

A consultation has a written deliverable.

• A written summary of findings and the proposed plan, sent through the patient portal within 24 hours.
• A written estimate covering consultation, procedure, anesthesia setting if applicable, and expected follow-up.
• Educational links specific to your case — the relevant procedure and anatomy pages on this site.
• A direct contact path to the practice for follow-up questions, scheduling, and pre-procedure logistics.

After the consultation

Three reasonable next steps.

If you decide to proceed

Our team schedules the procedure, sends pre-operative instructions specific to the anesthesia setting, coordinates with your dermatologist or primary care if needed, and arranges any preoperative labs or clearances. Out-of-area patients receive a travel and lodging guide.

If you want time to think

Take it. We do not pressure patients into scheduling at the consultation. The written summary and estimate are good for 90 days; we re-evaluate at that point if anything has changed.

If you decide this isn't for you

That's a valid outcome. If we know of a colleague better suited to your case, we'll make the introduction. A consultation is not a commitment.

Common questions

Asked at almost every consultation.

How long is the consultation?

Plan for 60 to 90 minutes for the visit itself, plus 10 to 15 minutes for check-in. Out-of-area patients sometimes combine the consultation and a same-day or next-day procedural visit; we'll tell you in advance if that's appropriate.

Who will I see?

Dr. Kamrava personally conducts every HS consultation. Our medical assistant supports the visit and serves as a chaperone for sensitive exams.

Will I have to undress?

For the regions we focus on — perianal, perineal, gluteal, and inguinal — yes, for the brief examination portion. You are draped, the room is private, and a chaperone is offered.

Can a family member or partner come in with me?

Yes, for any part of the visit you'd like. Many patients prefer to have someone in the room for the history and plan discussion and to step out briefly for the exam. Your choice.

Will you tell me the price before I commit?

Yes. A written estimate is part of every consultation. We do not give meaningful pricing by phone before a clinician has reviewed your case because the right number depends on what you actually have.

More on the full FAQ page.