What are the best treatments for Hidradenitis Suppurativa?

Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that affects the sweat glands. It is characterized by painful, recurrent nodules, abscesses, and sinus tracts in the affected areas. HS can significantly impact a person's quality of life, causing physical discomfort and emotional distress. While there is no cure for HS, there are several treatment options available to manage the symptoms and improve the overall well-being of individuals with this condition.

Treatment Options for Hidradenitis Suppurativa

1. Topical Treatments: Mild cases of HS can often be managed with topical treatments. These include:

• Antiseptic Washes: Regularly washing the affected areas with antiseptic cleansers can help reduce bacterial colonization and prevent infection.


• Topical Antibiotics: Applying antibiotic creams or ointments can help control bacterial growth and reduce inflammation.


• Topical Steroids: Corticosteroid creams or ointments can help alleviate inflammation and provide temporary relief from pain and itching.

2. Systemic Medications: For moderate to severe cases of HS, systemic medications may be prescribed. These medications are taken orally or by injection and work throughout the body to target the underlying inflammation. Some commonly used systemic medications for HS include:

• Antibiotics: Oral antibiotics, such as tetracycline or clindamycin, are often prescribed to control bacterial growth and reduce inflammation.


• Immunosuppressants: Medications like methotrexate or cyclosporine may be used to suppress the immune system and reduce inflammation.


• Biologics: Biologic drugs, such as adalimumab or infliximab, specifically target certain molecules involved in the inflammatory process and can be effective in managing HS.

3. Intralesional Injections: In some cases, healthcare providers may administer intralesional injections directly into the HS lesions. These injections often contain corticosteroids or other medications to reduce inflammation and promote healing.

4. Surgical Interventions: Surgery may be considered for severe or persistent HS that does not respond to other treatments. Surgical options include:

• Incision and Drainage: Large abscesses or painful nodules can be surgically drained to provide relief.


• Wide Local Excision: This procedure involves removing the affected skin and underlying tissue to prevent recurrent lesions. It may be recommended for localized HS in specific areas.


• Laser Hair Removal: Since HS is often associated with hair follicles, laser hair removal can be used to destroy the hair follicles and reduce the occurrence of new lesions.

5. Lifestyle Modifications: Making certain lifestyle changes can also help manage HS symptoms and prevent flare-ups. These include:

• Maintaining Good Hygiene: Keeping the affected areas clean and dry can help prevent bacterial growth and reduce the risk of infection.


• Weight Management: Losing weight, if overweight or obese, can help reduce friction and sweating in the affected areas, potentially decreasing the severity of HS.


• Avoiding Tight Clothing: Wearing loose-fitting clothing made of breathable fabrics can minimize irritation and promote airflow to the affected areas.


• Stress Management: Stress can trigger HS flare-ups, so finding effective stress management techniques, such as meditation or exercise, can be beneficial.

It is important for individuals with HS to work closely with their healthcare providers to develop a personalized treatment plan. The effectiveness of treatments may vary from person to person, and a combination of approaches may be necessary to achieve optimal results. Regular follow-ups and open communication with healthcare providers are crucial for monitoring progress and adjusting the treatment plan as needed.