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Recommendations developed for management of hidradenitis suppurativa

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Recommendations developed for management of hidradenitis suppurativa

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Evidence-based recommendations are presented for the management of hidradenitis suppurativa (HS) in guidelines of care issued by the American Academy of Dermatology and the Hidradenitis Suppurativa Foundation and published online Oct. 20 in the Journal of the American Academy of Dermatology.

Haley B. Naik, M.D., from the University of California in San Francisco, and colleagues conducted a systematic review to provide evidence-based recommendations for the management of HS.

The authors presented 37 evidence-based recommendations. Adalimumab, bimekizumab, infliximab, secukinumab and routine pain assessment were strongly recommended. Conditional recommendations included use of topical therapies (clindamycin, resorcinol and ruxolitinib), as well as systemic antibiotics (oral doxycycline, tetracycline, clindamycin with rifampin and intravenous ertapenem). In addition, there were conditional recommendations for hormone therapy with spironolactone, short-term systemic corticosteroids and upadacitinib. Specific procedural interventions, tobacco cessation, supportive pain management, and zinc supplementation and vitamin D repletion were also conditionally recommended.

"These guidelines establish an evidence-based standard of care for HS, giving patients, dermatologists and payers a shared roadmap for what high-quality HS care looks like," Naik said in a statement. "Every person living with HS deserves care that meets this standard."

Haley B. Naik et al., Joint American Academy of Dermatology-Hidradenitis Suppurativa Foundation guidelines of care for the management of hidradenitis suppurativa, Journal of the American Academy of Dermatology (2026). DOI: 10.1016/j.jaad.2026.08.125



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