116117 and HS: What Germany's Medical On-Call Number Is For — and What It Isn't

It is Saturday evening. A lesion in the groin has become noticeably more painful since the morning, the skin feels warmer than usual, and you are not sure whether this is still your ordinary flareFlare: A period of acute worsening in a chronic condition. In Acne Inversa, a flare may be triggered by stress, hormonal changes, friction, or other factors and can manifest as new nodules, abscesses, or increased pain.FlareA period of acute worsening in a chronic condition. In Acne Inversa, a flare may be triggered by stress, hormonal changes, friction, or other factors and can manifest as new nodules, abscesses, or increased pain.Read more in the glossary. Your dermatologyDermatology: The medical specialty concerned with diagnosing and treating skin conditions. Acne Inversa is often managed by dermatologists, although surgery and other specialties may also be involved.DermatologyThe medical specialty concerned with diagnosing and treating skin conditions. Acne Inversa is often managed by dermatologists, although surgery and other specialties may also be involved.Read more in the glossary practice does not open until Monday. What now?

Germany has a number for exactly this gap — too urgent to wait, not an emergency: 116117. Many people living with hidradenitis suppurativa (HS, acne inversa) have never heard of it. This article explains what sits behind the number, what it is for, and — just as importantly — what it is not for.

Note: This article explains how the care system is organised. It cannot assess your symptoms and does not replace medical judgement.

What 116117 actually is

116117 is a nationwide number run by the Associations of Statutory Health Insurance Physicians. It works without an area code, is staffed around the clock, and is free for the caller — from a landline and from a mobile.

The key thing to understand: there are two different services behind the number, and they are frequently confused.

1. The medical on-call service

This is the part most people mean. The medical on-call service — known in German as the ärztlicher Bereitschaftsdienst, and regionally as the Notdienst or Bereitschaftspraxis — takes over when practices are closed: evenings, nights, weekends and public holidays.

It is intended for people who are not life-threateningly ill but whose problem cannot wait until the next regular consultation. On the phone, you discuss what the sensible next step is. Depending on the situation and the region, that can mean advice by phone, a pointer to an on-call practice nearby that is open, or a home visit.

2. The appointment service

The second part has nothing to do with acute situations. The appointment service helps people with statutory health insurance find routine appointments with doctors and psychotherapists, by phone or online. That is the route for “I finally need a dermatology appointment”, not for “I feel terrible tonight”.

The distinction is worth remembering. Calling at night does not land you in appointment booking, and looking for a specialist appointment does not get you treated by the on-call service.

Why this matters particularly with HS

HS has a feature that makes the decision harder than for most conditions: the disease already looks alarming on its own. Painful lumps, inflammation, draining lesions and odour are part of the ordinary course for many people.

Someone with another condition who suddenly notices pus or swelling recognises it as unusual. With HS, it is the familiar state. That produces two opposite errors:

• Some people go to an emergency department for an ordinary flare, because nobody ever explained the difference.
• Others wait far too long when something genuinely deteriorates, because they have learned to dismiss pain and drainage as “normal”.

116117 sits precisely in the gap between those two errors: somewhere to ask outside practice hours without having to use an emergency department.

One point stays important throughout: drainage or pus alone does not tell you whether a lesion is bacterially infected. HS is an inflammatory disease rather than an infection — but secondary infectionSecondary Bacterial Infection: A bacterial infection that develops in skin already affected or damaged by another condition. Open or draining HS lesions can sometimes become secondarily infected. This is a possible complication of HS, not the underlying cause of the disease.Secondary Bacterial InfectionA bacterial infection that develops in skin already affected or damaged by another condition. Open or draining HS lesions can sometimes become secondarily infected. This is a possible complication of HS, not the underlying cause of the disease.Read more in the glossary can occur. Whether it has cannot be decided over the phone, and not from any single feature.

When calling 116117 can make sense

The on-call service is for situations where you would ordinarily see a practice, the practices are closed, and the matter cannot wait until they reopen. With HS, that might be:

• Symptoms change noticeably over the weekend and your usual self-management is no longer coping.
• You feel unwell in yourself on top of the skin symptoms — with fever or chills, for example.
• An area of inflammation is spreading visibly fast, or is becoming increasingly hot and swollen.
• After a procedure, a wound changes in a way your surgical team told you to report — and the team cannot be reached right now.
• Pain has become suddenly much more severe than usual and you do not know how to get through the night.

You do not need to be sure that “something serious” is going on. Working that out is exactly what the service is for.

When 116117 is not the right route

The other direction matters just as much.

For potentially life-threatening situations the number is 112, not 116117. That covers general emergency signs such as severe breathing difficulty, loss of consciousness or severely impaired consciousness, a severe allergic reaction, or extremely severe acute pain. If you are unsure whether a situation is life-threatening, call the emergency number — that rule is stated explicitly in the official German emergency guidance and applies regardless of anyone’s underlying condition.

116117 is also not the place for ongoing HS management. The on-call service bridges a gap; it does not take over longer-term treatment planning, does not adjust long-term medication, and does not replace being connected to dermatology. Questions like “is my current treatment working?” or “should we change the plan?” belong in a regular consultation.

And anything that can be planned belongs in practice hours. A prescription that has been due for two weeks, a referral, or a certificate are not cases for the on-call service.

What to have ready before you call

A call is considerably more useful if you have a few things at hand. With HS, one of them matters more than the rest: the comparison with your own usual pattern.

• Your diagnosis in plain words: “I have acne inversa, also called hidradenitis suppurativa.” Clinicians outside dermatology do not see the condition often.
• What is different today compared with an ordinary flare — and since when.
• Whether you have a fever or feel unwell overall.
• Which areas are affected, and whether you have had a procedure recently.
• Your current medicines, including anything bought without a prescription.
• Your insurance card and, if you have them, records from dermatology.

If you already document your symptoms, a quick look at your notes before calling is usually faster than reconstructing it from memory mid-conversation.

The three routes at a glance

For everyday life with HS in Germany, three routes are worth keeping apart:

1. Routine review — your dermatology or general practice. For pain that interferes with daily activities, repeated flares, several affected areas, or a treatment that is not working as expected.
2. 116117 — outside practice hours, when something is urgent but not life-threatening and cannot wait until practices reopen.
3. 112 — when a situation appears life-threatening or serious permanent harm may be at risk.

This split does not make any decision for you and says nothing about what is causing your symptoms. It only means that, in an already difficult moment, you do not also have to work out who to call.

Which HS changes belong to which of the three routes is described in more detail on its own page: When should I get medical help with HS?