something like creams or other surface-therapy doesnt help, if its really hidradenitis supporativa (or better to say: "inverted acne" - the inflammation is going inwards) can be treated with antibiotica. hidradenitis supporativa often develops a fistula. i got such an anal fistula and the end was a surgery. my fistula was quite near the anus. i was wearing 24/7 about 2 years at this time and my hygienic behaviour was always OK, i think. IMPORTANT TIPP: if you ever need a surgery because of a fistula >>> only with laser!!! - this method is new, not all doctors are knowing about it, the older version is like be treated by a butcher and your healing process would be about 1/2 year.