A variety of procedures may be employed for hidradenitis suppurativa, a chronic cutaneous condition that causes abscesses, nodules, and tunnels in skinfold areas. Intralesional steroid or incision and drainage are preferred for acutely inflamed discrete lesions, while deroofing or excision may be pursued for persistent or recurrent areas. Excision and deroofing may target individual lesions or complete regions that are more widely affected. Reconstructions may be considered after excisions based on operator and patient preference. Other procedures such as botulinum toxin injection, cryoinsufflation, and electrosurgical and laser-based modifications to deroofing and excisions have also been used successfully.