There are a handful of medications now available to treat hidradenitis suppurativa (HS) and a full pipeline, but surgical deroofing still play a key role in treating draining tunnels and persistent lesions. Steve Daveluy, MD, a Dermatologist at Wayne State University in Dearborn, MI, shares practical tips on how, when, and why to perform deroofing in HS. He gave a talk on this topic at the 2025 ODAC Dermatology Conference in Orlando, FL.