Learn more about hidradenitis suppurativa.
Read about available treatments.
Learn about your hidradenitis suppurativa.
Express what is important to you.
Compare treatments with your values.
Your results and next steps.
Each colour shows how well a treatment might match the values you said were important to you.
The values on the left are listed in the order you placed them in the "My Values" step. The values are listed from top to bottom in the order you placed them in the "My Values" step.
From most important to least.
| Risk of serious side effects |
No treatment No risk of serious side effects. |
Biologic • Possible risk of some potentially serious side effects with all biologic treatments. • Caution should be taken in those who are pregnant or nursing. Systemic Immunosuppressant • Possible risk of some serious side effects. • Some treatments should be avoided in pregnant or nursing women. Surgical • Possible risk of some serious side effects. • Caution should be exercised in pregnant or nursing women. |
Topical • Resorcinol 15% cream: circulatory system collapse, blood disorders, seizures. Pregnant and nursing women should refrain from using this treatment. • Clindamycin 1% solution: microbial resistance or life-threatening allergic reactions; considered safe for pregnant and nursing women. Complementary & Alternative • Dietary modifications, vitamin D supplementation, smoking cessation, weight loss: no risk of serious side effects. • Oral zinc gluconate supplementation: life-threatening allergic reactions • Caution should be taken in those who are pregnant or nursing. |
Systemic • Possible risk of some potentially serious side effects. • Colchicine + minocycline, methotrexate, finasteride, spironolactone, tetracyclines, and retinoids should not be taken while pregnant or nursing. Light • Nd:YAG, CO2 laser, and PDT: risk of serious infection. • Caution should be exercised in pregnant or nursing women. |
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| Speed of results |
Systemic People saw improvement in as little as 3 months for some treatment options. Biologic People saw improvement in as little as 8-12 weeks for some treatment options. Systemic immunosuppressant People saw improvement in as little as a few months for some treatment options. Light People saw improvement in as little as 3-4 sessions for some treatment options. |
Surgical • Some of these treatment options require a hospital stay and can require weeks to heal. • Wound healing can occur as early as 6 weeks, depending on the wound closure method. Complementary & Alternative There is not enough research yet to know the speed of the results. |
No treatment Does not apply. |
Topical People saw some improvement in as early as 3 months and 1 year for clindamycin and resorcinol, respectively. |
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| Convenience |
No Treatment No treatment takes no effort and does not cause inconvenience. Topical If your HS is in areas that are difficult to reach, topical treatments may be inconvenient or time-consuming. |
Systemic Immunosuppressant Various blood tests may need to be performed. Light • Some treatments may require multiple treatment sessions. • Daily dressing changes may be needed for some wounds. • For PDT treatment, sun avoidance should be maintained for 48 hours post-procedure. |
Surgical • Wide excision is typically performed in a hospital under an anesthetic and patents may be predisposed to developing larger wounds and experiencing prolonged recovery periods. • Unroofing/deroofing requires an anesthetic and possible daily dressing changes for wounds. • Recurrence is almost inevitable with incision & drainage procedures. |
Systemic • Need to be taken daily or weekly. • Most are taken by pill, but some are taken by needle. • These treatments may require regular check-ups at clinics. • Some treatments may have sexual side effects. • Alitretinoin is not available in the United States. Complementary & Alternative • Dietary modifications: it may take some time to see results when dietary changes are made. • Oral zinc gluconate: long-term treatment may require modification based on efficacy. • Oral vitamin D supplements are easy to use. • Smoking, weight loss, choice of clothing, and personal care: these changes may inconvenience some individuals. |
Biologic • Some of these treatments are taken by needle, which some people may not like. • Injections can be done at a clinic or at home. • These treatments require regular check-ups at clinics. |
| Cost |
No Treatment No cost. |
Topical, Systemic, Biologic, Systemic Immunosuppressant, Light, Surgical • Prices vary according to insurance and out-of-pocket expenses. Complementary & Alternative • Prices vary for all treatments. |
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| How well treatment works |
Systemic Level II • Oral contraceptive pills • Retinoids • Clindamycin + rifampin • Rifampin + moxifloxacin + metronidazole Level III • Spironolactone • Metformin • Finasteride • Ertapenem • Dapsone Level II, III • Tetracyclines These levels are according to the North American Guidelines (with I and III being the highest and lowest quality of evidence, respectively). Please click "Symbols to Know" at the top of the page for a detailed description. |
No Treatment • Without treatment, the natural progression of HS is typically chronic and progressive |
Biologic Level I • Adalimumab Level II • Infliximab • Etanercept • Anakinra • Ustekinumab Level III • Golimumab • Cyclosporine • Colchicine + minocycline • Systemic steroids • Methotrexate • Azathioprine Surgical Level II • Wide excision • Unroofing/deroofing • CO2 laser excision • STEEP • Incision & drainage • Combined medical-surgical treatment • Wound closure methods (secondary intention healing, delayed primary closure skin flaps, skin grafts, skin substitutes) Level III • Cryosurgery These levels are according to the North American Guidelines (with I and III being the highest and lowest quality of evidence, respectively). Please click "Symbols to Know" at the top of the page for a detailed description. |
Topical Level III • Resorcinol 15% cream • Zinc pyrithione • Triamcinolone • Benzoyl peroxide Level II, III • Clindamycin 1% Expert Opinion • Chlorhexidine Systemic Immunosuppressant Level III • Cyclosporine • Colchicine + minocycline • Systemic steroids • Methotrexate • Azathioprine Light Level II • Nd: YAG laser Level III • Electrosurgery/radiotherapy • External beam radiation • Intense pulsed light • Diode laser • Long-pulsed Alexandrite laser • Fractionated CO2 laser Level II, III Complementary & Alternative Level III These levels are according to the North American Guidelines (with I and III being the highest and lowest quality of evidence, respectively). Please click "Symbols to Know" at the top of the page for a detailed description. |
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| Length of treatment |
No Treatment Does not apply. |
Topical, Systemic, Biologic, Systemic Immunosuppressant • Ongoing- These are taken until symptoms fade and then taken again when symptoms flare. Light • Length of treatment can vary. Surgical • Length of treatment can vary. • Some treatments can take weeks and others months. Complementary & Alternative Treatments • Length of treatments can vary. • Some of these may be taken until symptoms fade and then be taken again when symptoms flare. |
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Last Updated: July 2019