Hidradenitis Suppurativa Treatment Guidelines

Hidradenitis Suppurativa is a chronic, debilitating, inflammatory disease, which affects up to 1% of the U.S. population. The following guidelines are based on current evidence and practice trends, emphasizing the role of dermatologists in treatment recommendations.

Access the full hidradenitis suppurativa guideline from JAAD (free access):

A work group of 18 recognized HS experts selected in consultation with the Hidradenitis Suppurativa Foundation and Canadian Hidradenitis Suppurativa Foundation including 17 dermatologists and one plastic surgeon was gathered to determine the scope of the guideline and identify clinical questions (Table I) in HS diagnosis and treatment. A research librarian and patient advocate were also included in the group.  Read the full statement on methods here

What patients should know about the
North American Hidradenitis Suppurativa Treatment Guidelines


Q: Why are these guidelines important?

A:  While treatment guidelines for Hidradenitis Suppurativa have been published in the past, they have focused on treatments available in other parts of the world.  These guidelines capture the nuances of Hidradenitis Suppurativa treatment driven by practice trends in North America.

Q: Do the guidelines tell my dermatologist what to do?

A:  These guidelines don’t tell your dermatologist exactly what to do, but they may help your doctor find treatments that you haven’t yet tried or gain coverage from insurance for treatments that are new or novel.

Q:  Should my doctor prescribe the treatments with the highest Strength of Recommendation/Level of Evidence first?

A:  Strength of Recommendation and Level of Evidence are related to how many and what kind of studies have been done on that treatment.  They are not related to how effective those treatments are.

Q: How can I use these guidelines?

A:  Exploring these guidelines may expose you to treatment options that you weren’t yet aware of.  If you are unhappy with your current HS treatment regimen, these guidelines may be a starting point for a discussion with your doctor.

Q: How can I talk about the guidelines with my dermatologist?

A:  You can print off the open access files, circle treatments you’d like to discuss, and bring them to your next appointment.  Or you may choose to make use of a Patient Decision Aid, based on the information contained in these treatment guidelines, which may make it easier to discuss what is most important to you in your Hidradenitis Suppurativa care.

Part I

Diagnosis, evaluation, and the use of complementary and procedural management

Part II

Topical, intralesional, and systemic medical management

Supplemental Materials

Background and recommendations regarding use of systemic antibiotics, biologics, and systemic retinoids for Hidradenitis Suppurativa

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