RESOURCES
American Academy of Dermatology Association.
"Hidradenitis Suppurativa: Diagnosis and Treatment."
Accessed February 2021. www.aad.org/public/
diseases/a-z/hidradenitis-suppurativa-treatment.
Colino, Stacey. HealthCentral. "When It's Not Just HS." February
18, 2020. www.healthcentral.com/article/hs-comorbidities.
Constantinou, C. A., G. E. Fragoulis, and E. Nikiphorou.
"Hidradenitis Suppurativa: Infection, Autoimmunity, or
Both?" Therapeutic Advances in Musculoskeletal Disease
11 (2019). https://doi.org/10.1177/1759720X19895488.
Dellwo, Adrienne. Verywell Health. "Autoinflammatory
vs. Autoimmune: Dysfunction in Different Immune
Systems." June 1, 2021. www.verywellhealth.com/
autoimmunity-vs-autoimmune-5181168.
El-Shebiny, Emad M. et al. "Bridging Autoinflammatory and
Autoimmune Diseases." The Egyptian Journal of Internal Medicine
33, no. 1 (2021): 11. https://doi.org/10.1186/s43162-021-00040-5.
"Hidradenitis Suppurativa." NORD (National Organization for
Rare Disorders). Accessed February 2022. Available at: https://
rarediseases.org/rare-diseases/hidradenitis-suppurativa/.
Jovanovic, Marina. Medscape. "Hidradenitis Suppurativa."
Updated November 20, 2020. https://emedicine.
medscape.com/article/1073117-overview.
Lee, E. Y. et al. "What is Hidradenitis Suppurativa?" Canadian Family
Physician Medecin De Famille Canadien 63 (2017): 114–20.
Jovanovic, Marina. Medscape. "What is the Historical Understanding
of Hidradenitis Suppurativa (HS)?" Updated November 20,
2020. www.medscape.com/answers/1073117-30764/what-is-
the-historical-understanding-of-hidradenitis-suppurativa-hs.
McGonagle, Dennis and Abdulla Watad. "Autoinflammatory
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Narla, S., A. B. Lyons, and I. H. Hamzavi. F1000Research. "The Most
Recent Advances in Understanding and Managing Hidradenitis
Suppurativa." https://doi.org/10.12688/f1000research.26083.1.
National Institute of Arthritis and Musculoskeletal and Skin
Diseases. "Autoinflammatory Diseases." January 2017. www.
niams.nih.gov/health-topics/autoinflammatory-diseases.
Panter-Fixsen, Denise. Hope for HS. "My Understanding of Auto-
Inflammatory vs. Autoimmune: What is the Difference?" March 18,
2019. www.hopeforhs.org/auto-inflammatory-vs-autoimmune.
Saunte, Ditte Marie Lindhardt and Gregor Borut Ernst
Jemec. "Hidradenitis Suppurativa: Advances in Diagnosis
and Treatment." JAMA 318 (November 28, 2017):
2019–32. https://doi.org/10.1001/jama.2017.16691.
Wipperman, J., D. A. Bragg, and B. Litzner. "Hidradenitis Suppurativa:
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70 m a s s a g e & b o d y wo r k m a rc h /a p r i l 2 0 2 2
Hurley stage 2 involves recurring abscesses,
widely separated lesions, and scarring where
wounds have healed. And Hurley stage 3
shows widespread involvement, with multiple
interconnected abscesses and sinus tracts.
The abscesses and cysts seen with HS
can resemble other skin problems like boils
or folliculitis, but they have some important
differences. Many boils involve aggressive
and contagious bacteria, but the bacteria in
HS lesions tend to be less aggressive and
more opportunistic. Further, skin infections
like boils or acne involve an infection of the
sebaceous glands, which does not describe
HS. And while typical boils resolve with
appropriate antibiotic use, antibiotics
alone are not usually successful for HS.
TREATMENT OPTIONS
Treatment for HS begins with home care:
warm compresses, good hygiene, and
wearing loose-fitting, non-irritating clothing.
Weight loss and stopping smoking are high
priorities. Weight loss can be problematic,
since skin friction from exercise can be
painful and can trigger new lesions.
Medication to manage this condition
includes antibiotics, along with retinoids to
regulate epithelial cell growth, corticosteroids
for inflammation, estrogen derivatives,
and some biologic drugs that alter immune
system activity. No single medication strategy
seems to work for most patients, and many
people with HS find that a medication may
help for a while, and then it becomes less
effective. It can be a frustrating process.
Other interventions can include laser
hair removal to suppress follicle activity, and
a variety of surgeries to lance the abscesses
or fully remove them. These surgeries can
deal with current lesions, but they are not
curative: New abscesses may still arise in
the same location. At this point, HS has
no reliable treatment protocol or cure.
"It's just a pimple! It's something that we
should be able to fix. It's not a tumor. It's blood,
pus, and skin—why can't we figure this out?"
—VSW
