LAUSR

monopolar coagulation mode (maXium, KLS Martin Group, Freiburg, Germany). This burnt the hair bulbs, which were easily extracted. Change in the angle of needles marks the collapse of perifollicular sheath. This along with easy extractability of the burnt hair follicle are markers of adequate burning (see Supplemental Digital Content 1, Video, http://links.lww.com/DSS/B81). More than 90% of axillary hairs were removed in a single session. Hidradenitis suppurativa lesions healed in a month after the procedure. There was no recurrence in the operated area until the follow-up of 4 months without any requirement of antibiotics in the axilla (Figure 1). This was in contrast with her course during the previous year when she had required oral antibiotics for 4 months with only partial control in pain and discharge when on antibiotics. The Sartorius score for axilla decreased from 23 to 0. The hair density decreased from 23/cm to 4/cm, amounting to 83% reduction. There was mild hyperpigmentation, but no extensive scarring or restriction in range of motion. The patient kept developing lesions at the unoperated perineal site and required topical antibiotics for the same. Compared with acupuncture needles, using epilation electrodes is time-consuming because it requires insertion in 1 hair at a time and involves high wear-and-tear. Recurring cost of pricey electrodes is another limiting factor of conventional epilation electrodes. Epilation electrodes are customized to specific machines, whereas acupuncture needles are cheap and universal. Multiple surgeons can insert needles at different sites simultaneously, making it even faster. Some hyperpigmentation and follicular scarring are not likely to be a concern in patients with HS, and minor hyperpigmentation did not bother our patient. Lasers are faster but have partial and temporary results which require maintenance treatment. They lead to hair reduction rather than permanent hair removal. Laser machines are costly, whereas basic radiofrequency machines are relatively cheaper and available in low-resource settings. Radiofrequency epilation is a minimally damaging surgery that can decrease the total number of lesions, severity, and frequency of flares and ultimately the disease burden in HS by reducing the volume of diseased tissue. This easy-to-learn, economical, and fast procedure can be easily adopted in lowresource settings.