TLDR The guideline recommends using specific drugs and surgery together for treating hidradenitis suppurativa effectively.
The S2k guideline for hidradenitis suppurativa/acne inversa (HS/AI) provides a framework for selecting appropriate therapies for this chronic, inflammatory skin disease affecting hair follicles. With a prevalence of 0.3% in Germany and often diagnosed after a significant delay, HS/AI significantly impacts quality of life. The guideline emphasizes the importance of using validated tools like the International Hidradenitis Suppurativa Severity Scoring System (IHS4) for classification and treatment decisions. Treatments include oral tetracyclines, intravenous clindamycin, and subcutaneous biologics like adalimumab, secukinumab, and bimekizumab. Surgical options are available for non-inflammatory forms, and combining drug and surgical treatments is recommended for a holistic approach.
15 citations
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December 2021 in “Pharmaceutics” The study found key factors in the cause of hidradenitis suppurativa, its link to other diseases, and identified existing drugs that could potentially treat it.
61 citations
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April 2021 in “Frontiers in Medicine” Hidradenitis suppurativa severely impacts quality of life, especially with severe symptoms and certain comorbidities, and current treatments don't significantly improve it.
78 citations
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October 2020 in “Experimental Dermatology” Hidradenitis suppurativa is caused by genetic factors, inflammation, bacteria, hormones, and lifestyle factors like obesity and smoking.
27 citations
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May 2019 in “American Journal of Clinical Dermatology” Antiandrogen therapy for hidradenitis suppurativa lacks strong evidence and needs more research.
September 2025 in “International Journal of Innovative Technologies in Social Science” Biologic agents are effective for severe hidradenitis suppurativa when other treatments fail.
4 citations
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January 2018 in “Journal of dermatology & dermatologic surgery” There is no gold standard treatment for hidradenitis suppurativa due to insufficient evidence.
66 citations
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March 2018 in “British journal of dermatology/British journal of dermatology, Supplement” An imbalance between certain immune cells is linked to a chronic skin condition and may be influenced by obesity, smoking, and autoimmune issues.
January 2018 in “Springer eBooks” Hidradenitis Suppurativa is likely an autoinflammatory disease, and better understanding its causes could improve treatments.
2 citations
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September 2016 in “Drug and therapeutics bulletin” Treating hidradenitis suppurativa needs long-term care and teamwork among doctors, but there's a lack of strong guidance on how to do it.
