Hidradenitis suppurativa clinical guideline

View the Academy’s latest guidelines on hidradenitis suppurativa below.

Guideline highlights

• Hidradenitis suppurativa is a chronic, inflammatory skin condition that affects up to an estimated 1% of the population globally and is characterized by painful, recurring nodules, abscesses, and tunnels that are most commonly located in the armpits, groin, and other skin-fold areas.

• The guidelines, which were developed jointly with the Hidradenitis Suppurativa Foundation, are the first in the AAD’s clinical guidelines portfolio that are specific to the management of HS and reflect the AAD’s staunch commitment to expanding evidence-based guidelines for serious conditions that significantly impact function and quality of life.

• The guidelines support individualized, patient-centered HS management and make 37 evidence-based recommendations in topics such as topical therapies, systemic antibiotics, hormone therapy, oral retinoids, biologics, systemic therapies, procedural interventions, supportive management, weight reduction, diet, and complementary and alternative medicines available in the United States.

• For moderate-to-severe HS — as well as for routine pain assessment as a good clinical practice standard — strong recommendations are made for four biologic therapies: adalimumab, bimekizumab, infliximab, and secukinumab.

• Conditional recommendations are made in favor of topical clindamycin, resorcinol, ruxolitinib, oral doxycycline, tetracycline, clindamycin, rifampin, ertapenem, spironolactone, short-term systemic steroids, upadacitinib, specific procedural interventions, tobacco cessation, supportive pain management, zinc supplementation, and vitamin D repletion.

View the AAD guidelines disclaimer.