Materiały źródłowe

• #1 Secondary prevention of hidradenitis suppurativa

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6826242/

  Hidradenitis suppurativa (HS) is a multifactorial disease with many facets of uncertain importance for optimal treatment and prevention. In order to explore options for secondary prevention in HS, we randomly and retrospectively selected 40 patients with HS that were analyzed on the basis of supposed trigger factors and proposed prevention measures. Implementing secondary prevention by reducing irritation, avoiding shaving, improving skin care, performing laser epilation or applying fusidic acid/betamethasone cream led to an improvement in 62.5% of patients. We suggest a structured approach in daily practice in order to identify individual trigger factors. The crucial point for secondary prevention is the improvement of patient education. […] Prevention is considered to be the ultimate goal in medical practice.

• #2 Hidradenitis suppurativa: Diagnosis and treatment

  https://www.aad.org/public/diseases/a-z/hidradenitis-suppurativa-treatment

  Getting an accurate diagnosis and an individualized treatment plan can help prevent this condition from worsening. […] While this condition cannot be cured, your dermatologist will create a treatment plan that can: […] Prevent the condition from worsening […] To reduce irritation, your dermatologist can create a skin care plan for you. […] To help their patients get the best outcome from treatment, dermatologists recommend self-care.

• #3 Hidradenitis suppurativa – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hidradenitis-suppurativa/symptoms-causes/syc-20352306

  Hidradenitis suppurativa tends to start after puberty, usually before age 40. It can persist for many years and worsen over time. Combined medical and surgical therapy can help manage the disease and prevent complications. […] Early diagnosis of hidradenitis suppurativa is key to effective treatment. […] Your dermatologist can create a treatment plan for you. […] Hidradenitis suppurativa is more common and severe in people who are overweight. […] Smoking tobacco has been linked to hidradenitis suppurativa. […] Managing hidradenitis suppurativa: Early treatment is crucial.

• #4 Secondary prevention of hidradenitis suppurativa

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6826242/

  Secondary prevention aims to reduce the impact of a disease or injury that has already occurred. It has been proposed that the primary lesion of HS may be a spongiform infundibulofolliculitis and perifolliculitis in more than 95% of cases. […] Secondary prevention implies prevention of the infundibulofolliculitis from becoming a deep folliculitis, nodule or fistula. It also means prevention of a patient with Hurley stage I from progressing to Hurley stage II or III. […] Recently, we introduced a concept of secondary prevention of HS. […] Based on a first concept of secondary prevention we developed a catalogue of questions, that was used in daily practice by different doctors. The aim was to improve anamnestic accuracy and to identify individual trigger factors in order to be able to propose a modification of the identified factors instead of giving the same recommendations to every patient.

• #5 Hidradenitis suppurativa (HS)

  https://www.nhs.uk/conditions/hidradenitis-suppurativa/

  Hidradenitis suppurativa is a lifelong, recurring condition that is often difficult to manage, although the symptoms may improve or eventually stop with treatment. […] It’s important to recognise and diagnose the condition in its early stages to prevent it getting worse. […] If you have hidradenitis suppurativa you should: lose weight if you are overweight, stop smoking if you smoke, use an antiseptic skin wash or antiseptic soap this may be prescribed alongside other treatment, hold a warm flannel on the lumps to encourage the pus to drain, wear loose-fitting clothes, avoid shaving affected skin.

• #6 Hidradenitis Suppurativa: Early Recognition and Treatment by Primary Care Providers – Clinical Advisor

  https://www.clinicaladvisor.com/features/hidradenitis-suppurativa-early-recognition-and-treatment-by-primary-care-providers/

  Hidradenitis suppurativa early recognition and treatment Treatment of hidradenitis suppurativa early in the disease course is crucial to prevent progression to more severe manifestations. […] Treatment of HS early in the disease course is crucial to prevent progression to these more severe manifestations. […] Educating patients on the etiology of the disease is crucial. Patients may have misconceptions that HS results from poor hygiene or is somehow self-induced; it is important to dissuade patients from this misconception. […] clinical evidence demonstrates a reduction in HS severity and recurrence with smoking cessation and weight loss, likely because of a reduction in Notch pathway impairment, inflammation, and skin shearing. […] If primary care providers are able to close the 7-year average gap between symptom onset and a diagnosis of HS, patients can be adequately treated early in their disease course, avoiding the potentially disfiguring physical manifestations of the disease, reducing its psychosocial burden, and minimizing costly medical care.

• #7 How To Prevent Hidradenitis Suppurativa

  https://www.health.com/hidradenitis-suppurativa-prevention-8664765

  Hidradenitis suppurativa (HS) is a chronic skin condition that causes lesions, such as painful bumps and pus-filled lumps under the skin. While a blockage in your hair follicles can increase your risk of developing this condition, the exact cause of HS is unknown. That makes prevention of this skin disease a bit challenging. […] However, lifestyle habits, proper skincare, and certain medications can all lower your risk of experiencing flares or periods where symptoms of HS are most active. […] While there is no cure for HS at this time, there are several things you can do to improve symptoms, reduce the frequency of flares, and slow down disease progression. Your exact treatment and prevention plan will depend on the severity of your symptoms, but healthcare providers often recommend lifestyle habits, proper skincare, and medications. In severe cases, medical procedures may be necessary.

• #8 hidradenitis suppurativa | UAMS Department of Family and Preventive Medicine

  https://medicine.uams.edu/familymedicine/tag/hidradenitis-suppurativa/

  Hidradenitis suppurativa (HS) is a skin disorder that starts with blocked hair follicles, leading to painful nodules, abscesses and scarring. […] Dr. Shi recommended a pyramid of treatment. The front-line provider can manage all the treatments except for biologics, the top tier. In early moderate to severe patients (late Hurley 1 to early Hurley 2), Dr. Shi suggested preparing patients for biologic therapy by prescribing oral antibiotics because payors typically require patients to fail 90-plus days of systemic antibiotics to qualify. Regardless of disease stage, providers should refer the patient to a dermatologist for advanced therapy, while collaboratively managing the patient. […] The first tier of the pyramid is lifestyle modifications where the provider would screen for comorbidities and start treatments. In a recent JAMA Dermatology report, patients with HS said diet changes were the most used non-prescription treatment with the Mediterranean diet and intermittent fasting both being effective.

• #9 Hidradenitis Suppurativa (Acne Inversa): Symptoms & Treatments

  https://my.clevelandclinic.org/health/diseases/17716-hidradenitis-suppurativa

  Some risk factors, like family history, are out of your control. But there are steps you can take to lower the risk of HS flare-ups and complications. […] Prevention may include: […] Limit sweating by staying indoors when its hot outside. […] Lose weight if you have obesity (a BMI, or body mass index, greater than 30). […] Dont use scented deodorants or skin products. […] Quit smoking if you use tobacco. (A healthcare provider will have resources to help you.) […] Wear loose-fitting clothing.

• #10 Hidradenitis Suppurativa | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/h/hidradenitis-suppurativa.html

  Hidradenitis suppurativa is a chronic skin disease. Early treatment is important to prevent HS from getting worse. […] You may not be able to prevent hidradenitis suppurativa because the cause isn’t fully understood. But you can take steps to lower your risk of a flare-up: […] Not smoking and losing weight, if needed, may help lower the risk for flare-ups.

• #11 Hidradenitis Suppurativa: Rapid Evidence Review | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/1101/p562.html

  Hidradenitis suppurativa is associated with several comorbidities, including diabetes mellitus and Crohn disease. […] Treatment includes wearing loose-fitting clothes, losing weight if overweight, and smoking cessation. […] Smoking cessation and weight loss should be encouraged to decrease disease severity and improve response to treatment. […] Patients with hidradenitis suppurativa should be counseled on ways to prevent worsening symptoms or flare-ups, including wearing loose-fitting clothes to prevent friction, although evidence for this is limited; weight loss if overweight; and smoking cessation. A 15% weight loss is associated with significant improvement in disease severity. […] Patients who smoke are twice as likely to develop hidradenitis suppurativa compared with nonsmokers, and smoking is associated with decreased response to treatment.

• #12 Hidradenitis Suppurativa Treatment – Treatment Of Hidradenitis Suppurativa

  https://exemptia.com/hidradenitis_suppurativa_treatment.html

  Outcome: Lifestyle changes can be effective. […] Many people have HS for life. Studies continue to show that making certain lifestyle changes can help tremendously. Weight loss has proven so effective that some patients say maintaining a healthy weight prevents HS breakouts.

• #13 hidradenitis suppurativa | UAMS Department of Family and Preventive Medicine

  https://medicine.uams.edu/familymedicine/tag/hidradenitis-suppurativa/

  Hidradenitis suppurativa (HS) is a skin disorder that starts with blocked hair follicles, leading to painful nodules, abscesses and scarring. […] Dr. Shi recommended a pyramid of treatment. The front-line provider can manage all the treatments except for biologics, the top tier. In early moderate to severe patients (late Hurley 1 to early Hurley 2), Dr. Shi suggested preparing patients for biologic therapy by prescribing oral antibiotics because payors typically require patients to fail 90-plus days of systemic antibiotics to qualify. Regardless of disease stage, providers should refer the patient to a dermatologist for advanced therapy, while collaboratively managing the patient. […] The first tier of the pyramid is lifestyle modifications where the provider would screen for comorbidities and start treatments. In a recent JAMA Dermatology report, patients with HS said diet changes were the most used non-prescription treatment with the Mediterranean diet and intermittent fasting both being effective.

• #14 Hidradenitis Suppurativa: Rapid Evidence Review | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/1101/p562.html

  Hidradenitis suppurativa is associated with several comorbidities, including diabetes mellitus and Crohn disease. […] Treatment includes wearing loose-fitting clothes, losing weight if overweight, and smoking cessation. […] Smoking cessation and weight loss should be encouraged to decrease disease severity and improve response to treatment. […] Patients with hidradenitis suppurativa should be counseled on ways to prevent worsening symptoms or flare-ups, including wearing loose-fitting clothes to prevent friction, although evidence for this is limited; weight loss if overweight; and smoking cessation. A 15% weight loss is associated with significant improvement in disease severity. […] Patients who smoke are twice as likely to develop hidradenitis suppurativa compared with nonsmokers, and smoking is associated with decreased response to treatment.

• #15 Hidradenitis Suppurativa: Causes, Symptoms, Diagnosis, Stages, and Treatment

  https://www.webmd.com/skin-problems-and-treatments/hidradenitis-suppurativa

  There’s no cure for HS, but treatments and lifestyle changes can bring some relief and cut down on flare-ups. […] Try these tips to make your HS less severe and slow outbreaks. […] Lose extra weight. This can ease your symptoms by making your skin rub together less. […] Quit smoking. Not only does this cut your risk of cancer and heart disease, but it can make your HS less severe. […] Don’t shave trouble spots. This can keep you from irritating your skin. […] Wear loose-fitting clothes. Outfits that are tight can cause your skin to rub, making your flare-ups worse. […] Stay cool. You can get flare-ups when you get too warm and sweat. […] Keep clean. Wash HS areas gently every day with your fingers. […] Use the right bandage. If a pocket is leaking, cover it with a bandage that doesn’t stick to the bump.

• #16 hidradenitis suppurativa | UAMS Department of Family and Preventive Medicine

  https://medicine.uams.edu/familymedicine/tag/hidradenitis-suppurativa/

  Weight loss surgery is also a strong consideration if the patient is greater than 35 BMI, and if the patient smokes, encourage them to quit since cigarette smoke has dioxin-like compounds that can cause acne and scarring. Loose-fitting clothing and anti-chaffing products applied in skin folds can reduce friction and pain. […] If the patient has draining sinus tracts, bathing helps to rinse out the tunnels. Dr. Shi recommends alternating daily with 10-minute baths of Epsom salt, CBD oil and cup 6% commercial bleach which help with pain, itch, relaxation and decrease biofilm. […] Certain supplements also should be considered. Persons with HS typically have lower serum zinc levels. Prescribing 100-200 milligrams of daily zinc (with copper included after two months) has shown to reduce HS severity in 80% of patients. Another supplement to consider is Vitamin D since most patients with HS are deficient. Vitamin D regulates hair cycle and skin cell activity. […] Dr. Shi said providers should learn the basics of biologics so they can explain how it works before they refer to a dermatologist. The patient must be on at least 90 days of an oral antibiotic before most insurance will allow biologics.

• #17 Management of hidradenitis suppurativa: an Australasian consensus statement

  https://dermnetnz.org/topics/hidradenitis-suppurativa-guidelines

  Comprehensive care of HS should include encouragement of smoking cessation and weight control, wound care, and management of pain, itch and psychosocial health. […] Not smoking is associated with a better response to treatment and a 15% weight reduction in obese patients ameliorates disease severity. […] Patients with suspected HS should be assessed for predisposing factors such as smoking, being overweight, and having a personal or family history of HS, acne, inflammatory bowel disease, and rare skin disorders such as steatocystoma multiplex. […] It is essential to recognise the psychosocial costs of the disease and either provide, or refer for, appropriate support and treatment for consequences such as depression and anxiety. […] We recommend that it is reasonable to consider the use of acitretin (unless contraindicated by pregnancy or potential pregnancy) and avoid isotretinoin (unless the patient also has acne). […] Comorbidities should be considered before initiating any of these treatments, none of which are formally approved for the treatment of HS.

• #18 Hidradenitis Suppurativa (HS) Aventura, FL | Skin Cancer Treatment Aventura, FL

  https://www.drresnik.com/hidradenitis-suppurativa-hs-cosmetic-dermatologist-miami-florida.php

  It is important to reduce any friction in the areas where you have recurrent spots. Change to loose cotton clothing such as loose boxer shorts, avoid underwear with seams that rub in areas that give you new lesions. Try to wear clothing that is loose and cool so that you are not overheated and sweating in those areas. Take fresh underwear and a ZiplocR bag to work and change during the day. […] Try hard to reduce obesity and get down to ideal weight. The best diet is the Paleolithic diet (www.thepaleodiet.com) but the most important part is TOTAL avoidance of all dairy products, and a slow steady weight loss to ideal weight. […] Stopping all nicotine from any source is essential. Nicotine stimulates plugging of the pores. Also, toxins in smoke appear to interfere with proper healing. We have never successfully cleared a smoker of this disease.

• #19 Hidradenitis Suppurativa (Acne Inversa): Symptoms & Treatments

  https://my.clevelandclinic.org/health/diseases/17716-hidradenitis-suppurativa

  Some risk factors, like family history, are out of your control. But there are steps you can take to lower the risk of HS flare-ups and complications. […] Prevention may include: […] Limit sweating by staying indoors when its hot outside. […] Lose weight if you have obesity (a BMI, or body mass index, greater than 30). […] Dont use scented deodorants or skin products. […] Quit smoking if you use tobacco. (A healthcare provider will have resources to help you.) […] Wear loose-fitting clothing.

• #20 Hidradenitis suppurativa (HS)

  https://www.nhs.uk/conditions/hidradenitis-suppurativa/

  Hidradenitis suppurativa is a lifelong, recurring condition that is often difficult to manage, although the symptoms may improve or eventually stop with treatment. […] It’s important to recognise and diagnose the condition in its early stages to prevent it getting worse. […] If you have hidradenitis suppurativa you should: lose weight if you are overweight, stop smoking if you smoke, use an antiseptic skin wash or antiseptic soap this may be prescribed alongside other treatment, hold a warm flannel on the lumps to encourage the pus to drain, wear loose-fitting clothes, avoid shaving affected skin.

• #21 Hidradenitis Suppurativa (HS) Aventura, FL | Skin Cancer Treatment Aventura, FL

  https://www.drresnik.com/hidradenitis-suppurativa-hs-cosmetic-dermatologist-miami-florida.php

  It is important to reduce any friction in the areas where you have recurrent spots. Change to loose cotton clothing such as loose boxer shorts, avoid underwear with seams that rub in areas that give you new lesions. Try to wear clothing that is loose and cool so that you are not overheated and sweating in those areas. Take fresh underwear and a ZiplocR bag to work and change during the day. […] Try hard to reduce obesity and get down to ideal weight. The best diet is the Paleolithic diet (www.thepaleodiet.com) but the most important part is TOTAL avoidance of all dairy products, and a slow steady weight loss to ideal weight. […] Stopping all nicotine from any source is essential. Nicotine stimulates plugging of the pores. Also, toxins in smoke appear to interfere with proper healing. We have never successfully cleared a smoker of this disease.

• #22 Hidradenitis suppurativa: Self-care

  https://www.aad.org/public/diseases/a-z/hidradenitis-suppurativa-self-care

  Use a mild and effective antiperspirant or deodorant. Some products are too harsh for skin with HS. Look for an antiperspirant or deodorant that does NOT contain alcohol, baking soda, parabens, dyes, or fragrance. […] If you have a wound-care treatment plan, follow it. If HS has caused wounds, your dermatologist will create a treatment plan to help heal wounds and prevent infection. […] Wear looser clothing if your HS flares when you wear tight or form-fitting clothes. When clothing rubs on skin with HS, it can irritate your skin, causing HS to worsen. […] If you are overweight, lose weight. For many patients who are overweight and have HS, losing weight can reduce flare-ups and prevent HS from worsening. […] If you smoke, stop smoking. Quitting smoking can help you live a longer, healthier life. It can also reduce HS flare-ups and prevent HS from worsening.

• #23 Hidradenitis Suppurativa (Acne Inversa): Symptoms & Treatments

  https://my.clevelandclinic.org/health/diseases/17716-hidradenitis-suppurativa

  Some risk factors, like family history, are out of your control. But there are steps you can take to lower the risk of HS flare-ups and complications. […] Prevention may include: […] Limit sweating by staying indoors when its hot outside. […] Lose weight if you have obesity (a BMI, or body mass index, greater than 30). […] Dont use scented deodorants or skin products. […] Quit smoking if you use tobacco. (A healthcare provider will have resources to help you.) […] Wear loose-fitting clothing.

• #24 Hidradenitis suppurativa: Self-care

  https://www.aad.org/public/diseases/a-z/hidradenitis-suppurativa-self-care

  Wash your skin with an antimicrobial wash. This helps reduce bacteria on your skin. When there’s less bacteria, you may have fewer flare-ups. […] Quit scrubbing your skin. Patients often think that having HS means they have dirty skin. You dont have dirty skin. If youre scrubbing your skin to get it clean, stop. Scrubbing causes inflammation, which can worsen HS. […] Take care when shaving or waxing skin with HS. In general, dermatologists recommend that patients with HS never wax. Waxing can irritate the skin, which may cause more HS. […] Consider laser hair removal as a way to remove hair where you have HS. Studies have shown that getting laser hair removal can reduce flare-ups of HS. […] Avoid sweating and overheating. While applying heat to a painful lump can bring relief, sweating and overheating tend to worsen HS.

• #25 Hidradenitis Suppurativa: How to Live With It

  https://www.webmd.com/skin-problems-and-treatments/hidradenitis-suppurativa-what-happens

  How often will I have flare-ups? Is there a way to prevent them? […] Theres no sure way to prevent breakouts. But they may not come back as often or be as bad if you follow your treatment plan, take any medication your doctor prescribes, and make some changes to your lifestyle. […] Get to a healthy weight. HS is closely tied to obesity. Losing weight is one of the best ways to keep it under control. […] Quit smoking. […] Stay cool. Your HS may get worse in the summer, when heat and sweat can trigger a flare-up. Swimming is a good way to get exercise without overheating. […] Dont shave near a breakout. If your razor irritates your skin, laser hair removal may be a better choice. […] Watch what you eat. Theres some evidence that it may help to cut dairy and sugar from your diet. Ask your doctor if you should try it.

• #26 diagnosis and treatment of hidradenitis suppurativa | UAMS Department of Family and Preventive Medicine

  https://medicine.uams.edu/familymedicine/tag/diagnosis-and-treatment-of-hidradenitis-suppurativa/

  The first tier of the pyramid is lifestyle modifications where the provider would screen for comorbidities and start treatments. In a recent JAMA Dermatology report, patients with HS said diet changes were the most used non-prescription treatment with the Mediterranean diet and intermittent fasting both being effective. The two exercises that HS patients can tolerate are Pilates and swimming. Weight loss surgery is also a strong consideration if the patient is greater than 35 BMI, and if the patient smokes, encourage them to quit since cigarette smoke has dioxin-like compounds that can cause acne and scarring. Loose-fitting clothing and anti-chaffing products applied in skin folds can reduce friction and pain. […] If the patient has draining sinus tracts, bathing helps to rinse out the tunnels. Dr. Shi recommends alternating daily with 10-minute baths of Epsom salt, CBD oil and cup 6% commercial bleach which help with pain, itch, relaxation and decrease biofilm.

• #27 Hidradenitis suppurativa: Self-care

  https://www.aad.org/public/diseases/a-z/hidradenitis-suppurativa-self-care

  Wash your skin with an antimicrobial wash. This helps reduce bacteria on your skin. When there’s less bacteria, you may have fewer flare-ups. […] Quit scrubbing your skin. Patients often think that having HS means they have dirty skin. You dont have dirty skin. If youre scrubbing your skin to get it clean, stop. Scrubbing causes inflammation, which can worsen HS. […] Take care when shaving or waxing skin with HS. In general, dermatologists recommend that patients with HS never wax. Waxing can irritate the skin, which may cause more HS. […] Consider laser hair removal as a way to remove hair where you have HS. Studies have shown that getting laser hair removal can reduce flare-ups of HS. […] Avoid sweating and overheating. While applying heat to a painful lump can bring relief, sweating and overheating tend to worsen HS.

• #28 Skin-Care Tips for Hidradenitis Suppurativa

  https://www.everydayhealth.com/hidradenitis-suppurativa/skin-care-tips/

  Help control your HS with these dermatologist-recommended skin-care tips. […] For many people with HS who are overweight, losing weight can reduce flare-ups and keep HS from worsening. If youre a smoker, quitting may reduce the frequency and severity of HS flare-ups. […] Another way you can manage HS is to follow a regular skin-care routine. […] An antiseptic or antibacterial wash used in areas prone to HS can reduce draining and odor caused by bacteria. […] Nonprescription antiseptic washes containing benzoyl peroxide, typically used to treat acne, can also be effective for inflammatory skin conditions such as HS. […] Choose antimicrobial washes and light moisturizers rather than thicker over-the-counter creams and ointments. […] Keep hair follicles from getting clogged to help prevent HS lesions.

• #29 Hidradenitis suppurativa (HS)

  https://www.nhs.uk/conditions/hidradenitis-suppurativa/

  Hidradenitis suppurativa is a lifelong, recurring condition that is often difficult to manage, although the symptoms may improve or eventually stop with treatment. […] It’s important to recognise and diagnose the condition in its early stages to prevent it getting worse. […] If you have hidradenitis suppurativa you should: lose weight if you are overweight, stop smoking if you smoke, use an antiseptic skin wash or antiseptic soap this may be prescribed alongside other treatment, hold a warm flannel on the lumps to encourage the pus to drain, wear loose-fitting clothes, avoid shaving affected skin.

• #30 How To Prevent Hidradenitis Suppurativa

  https://www.health.com/hidradenitis-suppurativa-prevention-8664765

  Because certain lifestyle habits can increase your risk of developing HS, making some changes to your daily life may help reduce symptoms. Consider the following adjustments: Avoid smoking, including cigarettes, hookah, or tobacco; Eat nutritious foods to manage a weight that’s right for you; Limit strenuous activities in hot or humid places to prevent flares. […] Your healthcare provider may also recommend several skincare approaches to prevent injuries or irritation to the skin lesions, as the inflammation can worsen HS. They may offer the following suggestions: Use antimicrobial soaps: Antimicrobial washes help reduce the bacteria in your skin and limit the risk of skin infections. Body washes that include ingredients like benzoyl peroxide or zinc pyrithione can effectively reduce skin bacteria. Don’t scrub the skin: Scrubbing the affected area of the skin can cause inflammation, which can worsen HS. Avoid waxing skin: Dermatologists recommend that people with HS avoid waxing the hair on their skin, as this can irritate your lesions and worsen symptoms. Try warm compresses: To reduce any pain associated with HS, apply a compress (such as a heating pad or warm towel) to your skin lesions. Limit deodorant use: Many deodorants and antiperspirants may contain ingredients such as alcohol, fragrances, baking soda, dyes, and parabens, all of which can irritate the skin. Instead, dermatologists recommend using mild or organic versions of deodorants. Keep sweating at bay: Because skin friction can worsen symptoms, staying in cool or shaded areas, drinking plenty of water, and wearing loose-fitting fabrics can help. Try laser hair removal: This has been shown to prevent the development or progression of HS in the treated areas.

• #31 Hidradenitis suppurativa (syn. acne inversa)

  https://www.pcds.org.uk/clinical-guidance/hidradenitis-suppurativa

  The aim is to start treatment at an early stage – the longer it remains untreated the more severe the condition becomes and more difficult it is to treat. […] Initial assessment and annual review of risk factors: CVD / metabolic assessment – ask about smoking and FHx of CVD, record BMI and blood pressure, check lipids and HbA1C. Manage risk factors accordingly. […] All patients should be prescribed topical antiseptics. Octenisan is preferable as it has the advantage of breaking biofilms and may gentler on the skin than some of the other products e.g. 4% chlorhexidine solution. […] For mild HS, consider topical clindamycin BD, or oral doxycycline 200 mg OD (or lymecycline 408 mg caps, two caps once a day) both initially for 3 months. Aim for reduction in flares and improved disease control.

• #32 Skin-Care Tips for Hidradenitis Suppurativa

  https://www.everydayhealth.com/hidradenitis-suppurativa/skin-care-tips/

  Help control your HS with these dermatologist-recommended skin-care tips. […] For many people with HS who are overweight, losing weight can reduce flare-ups and keep HS from worsening. If youre a smoker, quitting may reduce the frequency and severity of HS flare-ups. […] Another way you can manage HS is to follow a regular skin-care routine. […] An antiseptic or antibacterial wash used in areas prone to HS can reduce draining and odor caused by bacteria. […] Nonprescription antiseptic washes containing benzoyl peroxide, typically used to treat acne, can also be effective for inflammatory skin conditions such as HS. […] Choose antimicrobial washes and light moisturizers rather than thicker over-the-counter creams and ointments. […] Keep hair follicles from getting clogged to help prevent HS lesions.

• #33 Hidradenitis suppurativa – British Skin Foundation

  https://knowyourskin.britishskinfoundation.org.uk/condition/hidradenitis-suppurativa/

  Medical treatment to try to prevent flares of HS: […] Antibacterial lotions and washes: While not evidence-based, some patients find antiseptics such as 4% chlorhexidine wash helpful. An antibiotic lotion such as clindamycin may be recommended for affected skin. […] Antibiotic tablets: These may be prescribed for a prolonged time (3 months or longer) in order to help suppress further attacks. Tetracycline antibiotics such as lymecycline and doxycycline are often tried initially. The combination of clindamycin and rifampicin for 10-12 weeks is another option; potential side effects include an upset stomach, orange tears and urine, and preventing hormonal contraceptives from working. In HS, antibiotics may work by suppressing inflammation rather than by killing bacteria so longer courses are thought to be more beneficial.

• #34 Hidradenitis suppurativa: Self-care

  https://www.aad.org/public/diseases/a-z/hidradenitis-suppurativa-self-care

  Wash your skin with an antimicrobial wash. This helps reduce bacteria on your skin. When there’s less bacteria, you may have fewer flare-ups. […] Quit scrubbing your skin. Patients often think that having HS means they have dirty skin. You dont have dirty skin. If youre scrubbing your skin to get it clean, stop. Scrubbing causes inflammation, which can worsen HS. […] Take care when shaving or waxing skin with HS. In general, dermatologists recommend that patients with HS never wax. Waxing can irritate the skin, which may cause more HS. […] Consider laser hair removal as a way to remove hair where you have HS. Studies have shown that getting laser hair removal can reduce flare-ups of HS. […] Avoid sweating and overheating. While applying heat to a painful lump can bring relief, sweating and overheating tend to worsen HS.

• #35 Hidradenitis Suppurativa: Causes, Symptoms, Diagnosis, Stages, and Treatment

  https://www.webmd.com/skin-problems-and-treatments/hidradenitis-suppurativa

  There’s no cure for HS, but treatments and lifestyle changes can bring some relief and cut down on flare-ups. […] Try these tips to make your HS less severe and slow outbreaks. […] Lose extra weight. This can ease your symptoms by making your skin rub together less. […] Quit smoking. Not only does this cut your risk of cancer and heart disease, but it can make your HS less severe. […] Don’t shave trouble spots. This can keep you from irritating your skin. […] Wear loose-fitting clothes. Outfits that are tight can cause your skin to rub, making your flare-ups worse. […] Stay cool. You can get flare-ups when you get too warm and sweat. […] Keep clean. Wash HS areas gently every day with your fingers. […] Use the right bandage. If a pocket is leaking, cover it with a bandage that doesn’t stick to the bump.

• #36 Hidradenitis suppurativa: Self-care

  https://www.aad.org/public/diseases/a-z/hidradenitis-suppurativa-self-care

  Use a mild and effective antiperspirant or deodorant. Some products are too harsh for skin with HS. Look for an antiperspirant or deodorant that does NOT contain alcohol, baking soda, parabens, dyes, or fragrance. […] If you have a wound-care treatment plan, follow it. If HS has caused wounds, your dermatologist will create a treatment plan to help heal wounds and prevent infection. […] Wear looser clothing if your HS flares when you wear tight or form-fitting clothes. When clothing rubs on skin with HS, it can irritate your skin, causing HS to worsen. […] If you are overweight, lose weight. For many patients who are overweight and have HS, losing weight can reduce flare-ups and prevent HS from worsening. […] If you smoke, stop smoking. Quitting smoking can help you live a longer, healthier life. It can also reduce HS flare-ups and prevent HS from worsening.

• #37 How To Prevent Hidradenitis Suppurativa

  https://www.health.com/hidradenitis-suppurativa-prevention-8664765

  Because certain lifestyle habits can increase your risk of developing HS, making some changes to your daily life may help reduce symptoms. Consider the following adjustments: Avoid smoking, including cigarettes, hookah, or tobacco; Eat nutritious foods to manage a weight that’s right for you; Limit strenuous activities in hot or humid places to prevent flares. […] Your healthcare provider may also recommend several skincare approaches to prevent injuries or irritation to the skin lesions, as the inflammation can worsen HS. They may offer the following suggestions: Use antimicrobial soaps: Antimicrobial washes help reduce the bacteria in your skin and limit the risk of skin infections. Body washes that include ingredients like benzoyl peroxide or zinc pyrithione can effectively reduce skin bacteria. Don’t scrub the skin: Scrubbing the affected area of the skin can cause inflammation, which can worsen HS. Avoid waxing skin: Dermatologists recommend that people with HS avoid waxing the hair on their skin, as this can irritate your lesions and worsen symptoms. Try warm compresses: To reduce any pain associated with HS, apply a compress (such as a heating pad or warm towel) to your skin lesions. Limit deodorant use: Many deodorants and antiperspirants may contain ingredients such as alcohol, fragrances, baking soda, dyes, and parabens, all of which can irritate the skin. Instead, dermatologists recommend using mild or organic versions of deodorants. Keep sweating at bay: Because skin friction can worsen symptoms, staying in cool or shaded areas, drinking plenty of water, and wearing loose-fitting fabrics can help. Try laser hair removal: This has been shown to prevent the development or progression of HS in the treated areas.

• #38 Hidradenitis Suppurativa (HS): Symptoms, Causes, and Treatment

  https://patient.info/skin-conditions/hidradenitis-suppurativa-leaflet

  Hidradenitis suppurativa is a long-term (chronic) skin condition that leads to painful and repeated lumps of pus (boils or abscesses). […] Unfortunately, there is no 'cure’ for hidradenitis suppurativa, although it can settle down after some time (usually years). […] Try to lose weight if you are obese, and stop smoking if you smoke. […] Also, the following may help relieve some of your symptoms: Wear loose-fitting cotton clothing. Avoid tight underwear. Wash the affected areas carefully and gently, preferably using an antibacterial or antiseptic soap or shower gel. This is to try to get rid of germs (bacteria) on the skin. […] Avoid shaving affected areas, such as the underarms. […] Avoid using deodorants and antiperspirants if the underarms are affected and avoid perfumes on affected areas too.

• #39 Hidradenitis suppurativa: Self-care

  https://www.aad.org/public/diseases/a-z/hidradenitis-suppurativa-self-care

  Wash your skin with an antimicrobial wash. This helps reduce bacteria on your skin. When there’s less bacteria, you may have fewer flare-ups. […] Quit scrubbing your skin. Patients often think that having HS means they have dirty skin. You dont have dirty skin. If youre scrubbing your skin to get it clean, stop. Scrubbing causes inflammation, which can worsen HS. […] Take care when shaving or waxing skin with HS. In general, dermatologists recommend that patients with HS never wax. Waxing can irritate the skin, which may cause more HS. […] Consider laser hair removal as a way to remove hair where you have HS. Studies have shown that getting laser hair removal can reduce flare-ups of HS. […] Avoid sweating and overheating. While applying heat to a painful lump can bring relief, sweating and overheating tend to worsen HS.

• #40 How To Prevent Hidradenitis Suppurativa

  https://www.health.com/hidradenitis-suppurativa-prevention-8664765

  Because certain lifestyle habits can increase your risk of developing HS, making some changes to your daily life may help reduce symptoms. Consider the following adjustments: Avoid smoking, including cigarettes, hookah, or tobacco; Eat nutritious foods to manage a weight that’s right for you; Limit strenuous activities in hot or humid places to prevent flares. […] Your healthcare provider may also recommend several skincare approaches to prevent injuries or irritation to the skin lesions, as the inflammation can worsen HS. They may offer the following suggestions: Use antimicrobial soaps: Antimicrobial washes help reduce the bacteria in your skin and limit the risk of skin infections. Body washes that include ingredients like benzoyl peroxide or zinc pyrithione can effectively reduce skin bacteria. Don’t scrub the skin: Scrubbing the affected area of the skin can cause inflammation, which can worsen HS. Avoid waxing skin: Dermatologists recommend that people with HS avoid waxing the hair on their skin, as this can irritate your lesions and worsen symptoms. Try warm compresses: To reduce any pain associated with HS, apply a compress (such as a heating pad or warm towel) to your skin lesions. Limit deodorant use: Many deodorants and antiperspirants may contain ingredients such as alcohol, fragrances, baking soda, dyes, and parabens, all of which can irritate the skin. Instead, dermatologists recommend using mild or organic versions of deodorants. Keep sweating at bay: Because skin friction can worsen symptoms, staying in cool or shaded areas, drinking plenty of water, and wearing loose-fitting fabrics can help. Try laser hair removal: This has been shown to prevent the development or progression of HS in the treated areas.

• #41 Secondary prevention of hidradenitis suppurativa

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6826242/

  More than 60% of patients considered early intervention with a fusidic acid/betamethasone cream (FA/B) a helpful measure, as described earlier. […] In addition to FA/B treatment, weight loss (1 patient), diet (3 patients), reduction of irritation by change of clothing style (1 patient), improvement of skin care (2 patients) or laser epilation (4 patients) were reported as successful measures to reduce HS inflammatory intensity and frequency of new abscess formation. Altogether 70% of patients judged preventive measures that had been suggested to be beneficial. […] Secondary prevention means, we have to identify individual trigger factors together with the patient in order to prevent HS from progressing. Our study, for the first time, shows that secondary prevention of HS is possible already today and beneficial for the patient.

• #42 How To Prevent Hidradenitis Suppurativa

  https://www.health.com/hidradenitis-suppurativa-prevention-8664765

  Because certain lifestyle habits can increase your risk of developing HS, making some changes to your daily life may help reduce symptoms. Consider the following adjustments: Avoid smoking, including cigarettes, hookah, or tobacco; Eat nutritious foods to manage a weight that’s right for you; Limit strenuous activities in hot or humid places to prevent flares. […] Your healthcare provider may also recommend several skincare approaches to prevent injuries or irritation to the skin lesions, as the inflammation can worsen HS. They may offer the following suggestions: Use antimicrobial soaps: Antimicrobial washes help reduce the bacteria in your skin and limit the risk of skin infections. Body washes that include ingredients like benzoyl peroxide or zinc pyrithione can effectively reduce skin bacteria. Don’t scrub the skin: Scrubbing the affected area of the skin can cause inflammation, which can worsen HS. Avoid waxing skin: Dermatologists recommend that people with HS avoid waxing the hair on their skin, as this can irritate your lesions and worsen symptoms. Try warm compresses: To reduce any pain associated with HS, apply a compress (such as a heating pad or warm towel) to your skin lesions. Limit deodorant use: Many deodorants and antiperspirants may contain ingredients such as alcohol, fragrances, baking soda, dyes, and parabens, all of which can irritate the skin. Instead, dermatologists recommend using mild or organic versions of deodorants. Keep sweating at bay: Because skin friction can worsen symptoms, staying in cool or shaded areas, drinking plenty of water, and wearing loose-fitting fabrics can help. Try laser hair removal: This has been shown to prevent the development or progression of HS in the treated areas.

• #43 Secondary prevention of hidradenitis suppurativa

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6826242/

  Secondary prevention aims to reduce the impact of a disease or injury that has already occurred. It has been proposed that the primary lesion of HS may be a spongiform infundibulofolliculitis and perifolliculitis in more than 95% of cases. […] Secondary prevention implies prevention of the infundibulofolliculitis from becoming a deep folliculitis, nodule or fistula. It also means prevention of a patient with Hurley stage I from progressing to Hurley stage II or III. […] Recently, we introduced a concept of secondary prevention of HS. […] Based on a first concept of secondary prevention we developed a catalogue of questions, that was used in daily practice by different doctors. The aim was to improve anamnestic accuracy and to identify individual trigger factors in order to be able to propose a modification of the identified factors instead of giving the same recommendations to every patient.

• #44 Hidradenitis suppurativa – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hidradenitis-suppurativa/symptoms-causes/syc-20352306

  Hidradenitis suppurativa tends to start after puberty, usually before age 40. It can persist for many years and worsen over time. Combined medical and surgical therapy can help manage the disease and prevent complications. […] Early diagnosis of hidradenitis suppurativa is key to effective treatment. […] Your dermatologist can create a treatment plan for you. […] Hidradenitis suppurativa is more common and severe in people who are overweight. […] Smoking tobacco has been linked to hidradenitis suppurativa. […] Managing hidradenitis suppurativa: Early treatment is crucial.

• #45 Secondary prevention of hidradenitis suppurativa

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6826242/

  Secondary prevention aims to reduce the impact of a disease or injury that has already occurred. It has been proposed that the primary lesion of HS may be a spongiform infundibulofolliculitis and perifolliculitis in more than 95% of cases. […] Secondary prevention implies prevention of the infundibulofolliculitis from becoming a deep folliculitis, nodule or fistula. It also means prevention of a patient with Hurley stage I from progressing to Hurley stage II or III. […] Recently, we introduced a concept of secondary prevention of HS. […] Based on a first concept of secondary prevention we developed a catalogue of questions, that was used in daily practice by different doctors. The aim was to improve anamnestic accuracy and to identify individual trigger factors in order to be able to propose a modification of the identified factors instead of giving the same recommendations to every patient.

• #46 Secondary prevention of hidradenitis suppurativa

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6826242/

  More than 60% of patients considered early intervention with a fusidic acid/betamethasone cream (FA/B) a helpful measure, as described earlier. […] In addition to FA/B treatment, weight loss (1 patient), diet (3 patients), reduction of irritation by change of clothing style (1 patient), improvement of skin care (2 patients) or laser epilation (4 patients) were reported as successful measures to reduce HS inflammatory intensity and frequency of new abscess formation. Altogether 70% of patients judged preventive measures that had been suggested to be beneficial. […] Secondary prevention means, we have to identify individual trigger factors together with the patient in order to prevent HS from progressing. Our study, for the first time, shows that secondary prevention of HS is possible already today and beneficial for the patient.

• #47 Hidradenitis suppurativa (syn. acne inversa)

  https://www.pcds.org.uk/clinical-guidance/hidradenitis-suppurativa

  The aim is to start treatment at an early stage – the longer it remains untreated the more severe the condition becomes and more difficult it is to treat. […] Initial assessment and annual review of risk factors: CVD / metabolic assessment – ask about smoking and FHx of CVD, record BMI and blood pressure, check lipids and HbA1C. Manage risk factors accordingly. […] All patients should be prescribed topical antiseptics. Octenisan is preferable as it has the advantage of breaking biofilms and may gentler on the skin than some of the other products e.g. 4% chlorhexidine solution. […] For mild HS, consider topical clindamycin BD, or oral doxycycline 200 mg OD (or lymecycline 408 mg caps, two caps once a day) both initially for 3 months. Aim for reduction in flares and improved disease control.

• #48 Hidradenitis suppurativa (syn. acne inversa)

  https://www.pcds.org.uk/clinical-guidance/hidradenitis-suppurativa

  The aim is to start treatment at an early stage – the longer it remains untreated the more severe the condition becomes and more difficult it is to treat. […] Initial assessment and annual review of risk factors: CVD / metabolic assessment – ask about smoking and FHx of CVD, record BMI and blood pressure, check lipids and HbA1C. Manage risk factors accordingly. […] All patients should be prescribed topical antiseptics. Octenisan is preferable as it has the advantage of breaking biofilms and may gentler on the skin than some of the other products e.g. 4% chlorhexidine solution. […] For mild HS, consider topical clindamycin BD, or oral doxycycline 200 mg OD (or lymecycline 408 mg caps, two caps once a day) both initially for 3 months. Aim for reduction in flares and improved disease control.

• #49 Hidradenitis suppurativa – British Skin Foundation

  https://knowyourskin.britishskinfoundation.org.uk/condition/hidradenitis-suppurativa/

  Medical treatment to try to prevent flares of HS: […] Antibacterial lotions and washes: While not evidence-based, some patients find antiseptics such as 4% chlorhexidine wash helpful. An antibiotic lotion such as clindamycin may be recommended for affected skin. […] Antibiotic tablets: These may be prescribed for a prolonged time (3 months or longer) in order to help suppress further attacks. Tetracycline antibiotics such as lymecycline and doxycycline are often tried initially. The combination of clindamycin and rifampicin for 10-12 weeks is another option; potential side effects include an upset stomach, orange tears and urine, and preventing hormonal contraceptives from working. In HS, antibiotics may work by suppressing inflammation rather than by killing bacteria so longer courses are thought to be more beneficial.

• #50 Secondary prevention of hidradenitis suppurativa

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6826242/

  More than 60% of patients considered early intervention with a fusidic acid/betamethasone cream (FA/B) a helpful measure, as described earlier. […] In addition to FA/B treatment, weight loss (1 patient), diet (3 patients), reduction of irritation by change of clothing style (1 patient), improvement of skin care (2 patients) or laser epilation (4 patients) were reported as successful measures to reduce HS inflammatory intensity and frequency of new abscess formation. Altogether 70% of patients judged preventive measures that had been suggested to be beneficial. […] Secondary prevention means, we have to identify individual trigger factors together with the patient in order to prevent HS from progressing. Our study, for the first time, shows that secondary prevention of HS is possible already today and beneficial for the patient.

• #51 Hidradenitis suppurativa (HS)

  https://www.nhs.uk/conditions/hidradenitis-suppurativa/

  Hidradenitis suppurativa is a lifelong, recurring condition that is often difficult to manage, although the symptoms may improve or eventually stop with treatment. […] It’s important to recognise and diagnose the condition in its early stages to prevent it getting worse. […] If you have hidradenitis suppurativa you should: lose weight if you are overweight, stop smoking if you smoke, use an antiseptic skin wash or antiseptic soap this may be prescribed alongside other treatment, hold a warm flannel on the lumps to encourage the pus to drain, wear loose-fitting clothes, avoid shaving affected skin.

• #52 How To Prevent Hidradenitis Suppurativa

  https://www.health.com/hidradenitis-suppurativa-prevention-8664765

  Because certain lifestyle habits can increase your risk of developing HS, making some changes to your daily life may help reduce symptoms. Consider the following adjustments: Avoid smoking, including cigarettes, hookah, or tobacco; Eat nutritious foods to manage a weight that’s right for you; Limit strenuous activities in hot or humid places to prevent flares. […] Your healthcare provider may also recommend several skincare approaches to prevent injuries or irritation to the skin lesions, as the inflammation can worsen HS. They may offer the following suggestions: Use antimicrobial soaps: Antimicrobial washes help reduce the bacteria in your skin and limit the risk of skin infections. Body washes that include ingredients like benzoyl peroxide or zinc pyrithione can effectively reduce skin bacteria. Don’t scrub the skin: Scrubbing the affected area of the skin can cause inflammation, which can worsen HS. Avoid waxing skin: Dermatologists recommend that people with HS avoid waxing the hair on their skin, as this can irritate your lesions and worsen symptoms. Try warm compresses: To reduce any pain associated with HS, apply a compress (such as a heating pad or warm towel) to your skin lesions. Limit deodorant use: Many deodorants and antiperspirants may contain ingredients such as alcohol, fragrances, baking soda, dyes, and parabens, all of which can irritate the skin. Instead, dermatologists recommend using mild or organic versions of deodorants. Keep sweating at bay: Because skin friction can worsen symptoms, staying in cool or shaded areas, drinking plenty of water, and wearing loose-fitting fabrics can help. Try laser hair removal: This has been shown to prevent the development or progression of HS in the treated areas.

• #53 Hidradenitis suppurativa (syn. acne inversa)

  https://www.pcds.org.uk/clinical-guidance/hidradenitis-suppurativa

  The aim is to start treatment at an early stage – the longer it remains untreated the more severe the condition becomes and more difficult it is to treat. […] Initial assessment and annual review of risk factors: CVD / metabolic assessment – ask about smoking and FHx of CVD, record BMI and blood pressure, check lipids and HbA1C. Manage risk factors accordingly. […] All patients should be prescribed topical antiseptics. Octenisan is preferable as it has the advantage of breaking biofilms and may gentler on the skin than some of the other products e.g. 4% chlorhexidine solution. […] For mild HS, consider topical clindamycin BD, or oral doxycycline 200 mg OD (or lymecycline 408 mg caps, two caps once a day) both initially for 3 months. Aim for reduction in flares and improved disease control.

• #54 hidradenitis suppurativa | UAMS Department of Family and Preventive Medicine

  https://medicine.uams.edu/familymedicine/tag/hidradenitis-suppurativa/

  Weight loss surgery is also a strong consideration if the patient is greater than 35 BMI, and if the patient smokes, encourage them to quit since cigarette smoke has dioxin-like compounds that can cause acne and scarring. Loose-fitting clothing and anti-chaffing products applied in skin folds can reduce friction and pain. […] If the patient has draining sinus tracts, bathing helps to rinse out the tunnels. Dr. Shi recommends alternating daily with 10-minute baths of Epsom salt, CBD oil and cup 6% commercial bleach which help with pain, itch, relaxation and decrease biofilm. […] Certain supplements also should be considered. Persons with HS typically have lower serum zinc levels. Prescribing 100-200 milligrams of daily zinc (with copper included after two months) has shown to reduce HS severity in 80% of patients. Another supplement to consider is Vitamin D since most patients with HS are deficient. Vitamin D regulates hair cycle and skin cell activity. […] Dr. Shi said providers should learn the basics of biologics so they can explain how it works before they refer to a dermatologist. The patient must be on at least 90 days of an oral antibiotic before most insurance will allow biologics.

• #55 Hidradenitis suppurativa (syn. acne inversa)

  https://www.pcds.org.uk/clinical-guidance/hidradenitis-suppurativa

  The aim is to start treatment at an early stage – the longer it remains untreated the more severe the condition becomes and more difficult it is to treat. […] Initial assessment and annual review of risk factors: CVD / metabolic assessment – ask about smoking and FHx of CVD, record BMI and blood pressure, check lipids and HbA1C. Manage risk factors accordingly. […] All patients should be prescribed topical antiseptics. Octenisan is preferable as it has the advantage of breaking biofilms and may gentler on the skin than some of the other products e.g. 4% chlorhexidine solution. […] For mild HS, consider topical clindamycin BD, or oral doxycycline 200 mg OD (or lymecycline 408 mg caps, two caps once a day) both initially for 3 months. Aim for reduction in flares and improved disease control.

• #56 Hidradenitis suppurativa – British Skin Foundation

  https://knowyourskin.britishskinfoundation.org.uk/condition/hidradenitis-suppurativa/

  Medical treatment to try to prevent flares of HS: […] Antibacterial lotions and washes: While not evidence-based, some patients find antiseptics such as 4% chlorhexidine wash helpful. An antibiotic lotion such as clindamycin may be recommended for affected skin. […] Antibiotic tablets: These may be prescribed for a prolonged time (3 months or longer) in order to help suppress further attacks. Tetracycline antibiotics such as lymecycline and doxycycline are often tried initially. The combination of clindamycin and rifampicin for 10-12 weeks is another option; potential side effects include an upset stomach, orange tears and urine, and preventing hormonal contraceptives from working. In HS, antibiotics may work by suppressing inflammation rather than by killing bacteria so longer courses are thought to be more beneficial.

• #57 Hidradenitis suppurativa – British Skin Foundation

  https://knowyourskin.britishskinfoundation.org.uk/condition/hidradenitis-suppurativa/

  Medical treatment to try to prevent flares of HS: […] Antibacterial lotions and washes: While not evidence-based, some patients find antiseptics such as 4% chlorhexidine wash helpful. An antibiotic lotion such as clindamycin may be recommended for affected skin. […] Antibiotic tablets: These may be prescribed for a prolonged time (3 months or longer) in order to help suppress further attacks. Tetracycline antibiotics such as lymecycline and doxycycline are often tried initially. The combination of clindamycin and rifampicin for 10-12 weeks is another option; potential side effects include an upset stomach, orange tears and urine, and preventing hormonal contraceptives from working. In HS, antibiotics may work by suppressing inflammation rather than by killing bacteria so longer courses are thought to be more beneficial.

• #58 Hidradenitis suppurativa – British Skin Foundation

  https://knowyourskin.britishskinfoundation.org.uk/condition/hidradenitis-suppurativa/

  Retinoids (vitamin A derived tablets) such as acitretin may help by unblocking the hair follicles. They are available only from dermatology clinics. People of child-bearing potential who have taken acitretin should avoid pregnancy for three years after stopping the medication and so this treatment is usually avoided in people of child-bearing potential. People of childbearing potential must use effective contraception. […] For people who have flares of HS before each menstrual period, anti-androgen tablets can sometimes be useful. Anti-androgen treatment can be included in your contraceptive pill. Alternatively, a tablet called spironolactone may be prescribed. […] Anti-diabetic medications such as metformin have shown some improvement for HS and can provide additional benefit in those who have pre-diabetes, diabetes and in females with polycystic ovarian syndrome (PCOS). These are thought to work by changing the way the body responds to insulin. These medications can be associated with nausea, abdominal pain and diarrhoea. Metformin can be taken during pregnancy. Newer medications such as semaglutide may be taken by patients to treat diabetes or for weight management but are not currently available for HS.

• #59 Management of hidradenitis suppurativa: an Australasian consensus statement

  https://dermnetnz.org/topics/hidradenitis-suppurativa-guidelines

  Comprehensive care of HS should include encouragement of smoking cessation and weight control, wound care, and management of pain, itch and psychosocial health. […] Not smoking is associated with a better response to treatment and a 15% weight reduction in obese patients ameliorates disease severity. […] Patients with suspected HS should be assessed for predisposing factors such as smoking, being overweight, and having a personal or family history of HS, acne, inflammatory bowel disease, and rare skin disorders such as steatocystoma multiplex. […] It is essential to recognise the psychosocial costs of the disease and either provide, or refer for, appropriate support and treatment for consequences such as depression and anxiety. […] We recommend that it is reasonable to consider the use of acitretin (unless contraindicated by pregnancy or potential pregnancy) and avoid isotretinoin (unless the patient also has acne). […] Comorbidities should be considered before initiating any of these treatments, none of which are formally approved for the treatment of HS.

• #60 Hidradenitis suppurativa (syn. acne inversa)

  https://www.pcds.org.uk/clinical-guidance/hidradenitis-suppurativa

  In patients with PCOS and/or pre-menstrual flares, consider spironolactone (max. 100mg OD; off-license) and/or an oral contraceptive with a favourable progestogen profile (eg Yasmin, Eloine, Mercilon). […] Ensure appropriate analgesia is prescribed and available. […] Patients may need multiple dressings for differing needs and preferences: Absorbent, low adhesive, foam and gentle border dressings reduce friction. […] Consider referral to a local tissue viability team for expert wound care. […] Severe psychological impact. […] No improvement following adequate first-line treatment (mild-moderate disease; refer whilst instituting second-line treatment). […] Severe disease (refer whilst instituting first-line treatment). […] Diagnostic uncertainty. […] Pregnancy. […] Scarring.

• #61 Hidradenitis suppurativa – British Skin Foundation

  https://knowyourskin.britishskinfoundation.org.uk/condition/hidradenitis-suppurativa/

  Retinoids (vitamin A derived tablets) such as acitretin may help by unblocking the hair follicles. They are available only from dermatology clinics. People of child-bearing potential who have taken acitretin should avoid pregnancy for three years after stopping the medication and so this treatment is usually avoided in people of child-bearing potential. People of childbearing potential must use effective contraception. […] For people who have flares of HS before each menstrual period, anti-androgen tablets can sometimes be useful. Anti-androgen treatment can be included in your contraceptive pill. Alternatively, a tablet called spironolactone may be prescribed. […] Anti-diabetic medications such as metformin have shown some improvement for HS and can provide additional benefit in those who have pre-diabetes, diabetes and in females with polycystic ovarian syndrome (PCOS). These are thought to work by changing the way the body responds to insulin. These medications can be associated with nausea, abdominal pain and diarrhoea. Metformin can be taken during pregnancy. Newer medications such as semaglutide may be taken by patients to treat diabetes or for weight management but are not currently available for HS.

• #62 Hidradenitis Suppurativa (HS) Aventura, FL | Skin Cancer Treatment Aventura, FL

  https://www.drresnik.com/hidradenitis-suppurativa-hs-cosmetic-dermatologist-miami-florida.php

  For women it is best to block male hormones. This can be done using birth control pills (BCPs) such as Yasmin (or Ocella) or Yaz (or its generic). We can add an extra hormone blocker called spironolactone to the BCP. […] For Hurley Stage II – systemic anti-inflammatory antibiotics are used as in Stage I, for weeks or months. Clindamycin may be combined with rifampin. Intralesional triamcinolone may be used. Dapsone can be very useful. […] Surgical unroofing is a simple, yet very effective technique that can stop forever the progression of the treated lesions. It is far more effective than prolonged antibiotics and anti-inflammatory therapy, which do not treat the cause. […] Preliminary work suggests that a zero dairy diet may lead to clearing in some patients. The diet needs to be really well controlled. Nothing at all from cow source can be used. In addition to no milk, cream, cheese, butter, yoghurt, cream cheese, cottage cheese, ice cream and derivatives like cheeseburgers and lasagna, this means checking protein powders and protein drinks to be sure there is no casein, whey, milk protein isolate, or milk solids. […] Complete healing generally takes 8-10 weeks.

• #63 Guidelines for the management of hidradenitis suppurativa: recommendations supported by the Centre of Evidence of the French Society of Dermatology

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8247998/

  Hidradenitis suppurativa (HS) is a painful chronic inflammatory skin disease that impacts quality of life substantially. Its prevalence is estimated to be 07%. […] Therefore, the Centre of Evidence of the French Society of Dermatology initiated a standardized recommendation process for HS. […] The most important recommendations, supported by both evidence and expertise-based data, were used to design a decision-making algorithm. […] A medico-surgical approach is strongly recommended for all patients, either after or in combination with medical steps. […] For HS associated with inflammatory diseases, such as Crohn disease or spondyloarthropathy, preventive treatment with anti-TNF is recommended, in agreement with gastroenterologists or rheumatologists. […] The WG highlighted the importance of following recommendations for complete wide margins during surgical management to achieve resection, taking the subclinical peripheral extension of HS lesions into account, in accordance with the model for oncological skin surgery. […] HS is a chronic disease requiring long-term and multidisciplinary management that takes into consideration the pain and psychological impact, the different medical and surgical treatments available and the preservation of the microbial ecology.

• #64 HUMIRA® (adalimumab) for Hidradenitis Suppurativa (HS)

  https://www.humira.com/hidradenitis-suppurativa

  HUMIRA is a prescription medicine used to reduce the signs and symptoms of moderate to severe hidradenitis suppurativa (HS) in people 12 years and older. […] You should not start taking HUMIRA if you have any kind of infection unless your doctor says it is okay. […] Your doctor should test you for TB before starting HUMIRA, and check you closely for signs and symptoms of TB during treatment with HUMIRA, even if your TB test was negative. […] You should continue taking HUMIRA as directed by your doctor. […] Remember, HUMIRA is a treatment, not a cure. Your doctor can tell you if and when you should stop taking HUMIRA. […] If you experience any adverse reactions or discomfort when taking HUMIRA, discuss them with your doctor right away.

• #65 hidradenitis suppurativa | UAMS Department of Family and Preventive Medicine

  https://medicine.uams.edu/familymedicine/tag/hidradenitis-suppurativa/

  Weight loss surgery is also a strong consideration if the patient is greater than 35 BMI, and if the patient smokes, encourage them to quit since cigarette smoke has dioxin-like compounds that can cause acne and scarring. Loose-fitting clothing and anti-chaffing products applied in skin folds can reduce friction and pain. […] If the patient has draining sinus tracts, bathing helps to rinse out the tunnels. Dr. Shi recommends alternating daily with 10-minute baths of Epsom salt, CBD oil and cup 6% commercial bleach which help with pain, itch, relaxation and decrease biofilm. […] Certain supplements also should be considered. Persons with HS typically have lower serum zinc levels. Prescribing 100-200 milligrams of daily zinc (with copper included after two months) has shown to reduce HS severity in 80% of patients. Another supplement to consider is Vitamin D since most patients with HS are deficient. Vitamin D regulates hair cycle and skin cell activity. […] Dr. Shi said providers should learn the basics of biologics so they can explain how it works before they refer to a dermatologist. The patient must be on at least 90 days of an oral antibiotic before most insurance will allow biologics.

• #66 diagnosis and treatment of hidradenitis suppurativa | UAMS Department of Family and Preventive Medicine

  https://medicine.uams.edu/familymedicine/tag/diagnosis-and-treatment-of-hidradenitis-suppurativa/

  Certain supplements also should be considered. Persons with HS typically have lower serum zinc levels. Prescribing 100-200 milligrams of daily zinc (with copper included after two months) has shown to reduce HS severity in 80% of patients. Another supplement to consider is Vitamin D since most patients with HS are deficient. Vitamin D regulates hair cycle and skin cell activity.

• #67 hidradenitis suppurativa | UAMS Department of Family and Preventive Medicine

  https://medicine.uams.edu/familymedicine/tag/hidradenitis-suppurativa/

  Weight loss surgery is also a strong consideration if the patient is greater than 35 BMI, and if the patient smokes, encourage them to quit since cigarette smoke has dioxin-like compounds that can cause acne and scarring. Loose-fitting clothing and anti-chaffing products applied in skin folds can reduce friction and pain. […] If the patient has draining sinus tracts, bathing helps to rinse out the tunnels. Dr. Shi recommends alternating daily with 10-minute baths of Epsom salt, CBD oil and cup 6% commercial bleach which help with pain, itch, relaxation and decrease biofilm. […] Certain supplements also should be considered. Persons with HS typically have lower serum zinc levels. Prescribing 100-200 milligrams of daily zinc (with copper included after two months) has shown to reduce HS severity in 80% of patients. Another supplement to consider is Vitamin D since most patients with HS are deficient. Vitamin D regulates hair cycle and skin cell activity. […] Dr. Shi said providers should learn the basics of biologics so they can explain how it works before they refer to a dermatologist. The patient must be on at least 90 days of an oral antibiotic before most insurance will allow biologics.

• #68 diagnosis and treatment of hidradenitis suppurativa | UAMS Department of Family and Preventive Medicine

  https://medicine.uams.edu/familymedicine/tag/diagnosis-and-treatment-of-hidradenitis-suppurativa/

  Certain supplements also should be considered. Persons with HS typically have lower serum zinc levels. Prescribing 100-200 milligrams of daily zinc (with copper included after two months) has shown to reduce HS severity in 80% of patients. Another supplement to consider is Vitamin D since most patients with HS are deficient. Vitamin D regulates hair cycle and skin cell activity.

• #69 diagnosis and treatment of hidradenitis suppurativa | UAMS Department of Family and Preventive Medicine

  https://medicine.uams.edu/familymedicine/tag/diagnosis-and-treatment-of-hidradenitis-suppurativa/

  The first tier of the pyramid is lifestyle modifications where the provider would screen for comorbidities and start treatments. In a recent JAMA Dermatology report, patients with HS said diet changes were the most used non-prescription treatment with the Mediterranean diet and intermittent fasting both being effective. The two exercises that HS patients can tolerate are Pilates and swimming. Weight loss surgery is also a strong consideration if the patient is greater than 35 BMI, and if the patient smokes, encourage them to quit since cigarette smoke has dioxin-like compounds that can cause acne and scarring. Loose-fitting clothing and anti-chaffing products applied in skin folds can reduce friction and pain. […] If the patient has draining sinus tracts, bathing helps to rinse out the tunnels. Dr. Shi recommends alternating daily with 10-minute baths of Epsom salt, CBD oil and cup 6% commercial bleach which help with pain, itch, relaxation and decrease biofilm.

• #70 Hidradenitis Suppurativa: How to Live With It

  https://www.webmd.com/skin-problems-and-treatments/hidradenitis-suppurativa-what-happens

  How often will I have flare-ups? Is there a way to prevent them? […] Theres no sure way to prevent breakouts. But they may not come back as often or be as bad if you follow your treatment plan, take any medication your doctor prescribes, and make some changes to your lifestyle. […] Get to a healthy weight. HS is closely tied to obesity. Losing weight is one of the best ways to keep it under control. […] Quit smoking. […] Stay cool. Your HS may get worse in the summer, when heat and sweat can trigger a flare-up. Swimming is a good way to get exercise without overheating. […] Dont shave near a breakout. If your razor irritates your skin, laser hair removal may be a better choice. […] Watch what you eat. Theres some evidence that it may help to cut dairy and sugar from your diet. Ask your doctor if you should try it.

• #71 Hidradenitis Suppurativa (HS) Aventura, FL | Skin Cancer Treatment Aventura, FL

  https://www.drresnik.com/hidradenitis-suppurativa-hs-cosmetic-dermatologist-miami-florida.php

  It is important to reduce any friction in the areas where you have recurrent spots. Change to loose cotton clothing such as loose boxer shorts, avoid underwear with seams that rub in areas that give you new lesions. Try to wear clothing that is loose and cool so that you are not overheated and sweating in those areas. Take fresh underwear and a ZiplocR bag to work and change during the day. […] Try hard to reduce obesity and get down to ideal weight. The best diet is the Paleolithic diet (www.thepaleodiet.com) but the most important part is TOTAL avoidance of all dairy products, and a slow steady weight loss to ideal weight. […] Stopping all nicotine from any source is essential. Nicotine stimulates plugging of the pores. Also, toxins in smoke appear to interfere with proper healing. We have never successfully cleared a smoker of this disease.

• #72 Hidradenitis Suppurativa (HS) Aventura, FL | Skin Cancer Treatment Aventura, FL

  https://www.drresnik.com/hidradenitis-suppurativa-hs-cosmetic-dermatologist-miami-florida.php

  For women it is best to block male hormones. This can be done using birth control pills (BCPs) such as Yasmin (or Ocella) or Yaz (or its generic). We can add an extra hormone blocker called spironolactone to the BCP. […] For Hurley Stage II – systemic anti-inflammatory antibiotics are used as in Stage I, for weeks or months. Clindamycin may be combined with rifampin. Intralesional triamcinolone may be used. Dapsone can be very useful. […] Surgical unroofing is a simple, yet very effective technique that can stop forever the progression of the treated lesions. It is far more effective than prolonged antibiotics and anti-inflammatory therapy, which do not treat the cause. […] Preliminary work suggests that a zero dairy diet may lead to clearing in some patients. The diet needs to be really well controlled. Nothing at all from cow source can be used. In addition to no milk, cream, cheese, butter, yoghurt, cream cheese, cottage cheese, ice cream and derivatives like cheeseburgers and lasagna, this means checking protein powders and protein drinks to be sure there is no casein, whey, milk protein isolate, or milk solids. […] Complete healing generally takes 8-10 weeks.

• #73 Hidradenitis Suppurativa (HS) Aventura, FL | Skin Cancer Treatment Aventura, FL

  https://www.drresnik.com/hidradenitis-suppurativa-hs-cosmetic-dermatologist-miami-florida.php

  It is important to reduce any friction in the areas where you have recurrent spots. Change to loose cotton clothing such as loose boxer shorts, avoid underwear with seams that rub in areas that give you new lesions. Try to wear clothing that is loose and cool so that you are not overheated and sweating in those areas. Take fresh underwear and a ZiplocR bag to work and change during the day. […] Try hard to reduce obesity and get down to ideal weight. The best diet is the Paleolithic diet (www.thepaleodiet.com) but the most important part is TOTAL avoidance of all dairy products, and a slow steady weight loss to ideal weight. […] Stopping all nicotine from any source is essential. Nicotine stimulates plugging of the pores. Also, toxins in smoke appear to interfere with proper healing. We have never successfully cleared a smoker of this disease.

• #74 How Hidradenitis Suppurativa Is Treated

  https://www.verywellhealth.com/hidradenitis-suppurativa-treatment-4777730

  Certain foods have been found to worsen HS symptoms. If any of these are a regular part of your diet, you may want to avoid them for a time to see if your skin clears up: Dairy, Sugar, Tomatoes, Eggplant, Potatoes. […] There’s a strong link between cigarette smoking and hidradenitis suppurativa. If you smoke, you may have fewer flare-ups and less severe symptoms. Kicking the habit also may help your medications work better. […] Extra pounds can increase the risk of hidradenitis suppurativa and make symptoms worse, especially in skin folds that can trap sweat and cause friction. […] Self-care measures like proper skin care, dietary changes, and quitting smoking are important to managing HS. Maintaining a healthy weight can also help reduce symptoms.

• #75 Hidradenitis Suppurativa Treatment | New Treatment for Hidradenitis Suppurativa

  https://resources.healthgrades.com/right-care/hidradenitis-suppurativa/treatment-advances-for-hidradenitis-suppurativa

  One of the biggest difficulties when it comes to treating HS is there’s often a significant delay in diagnosis. […] However, there’s been a push to change this and improve the awareness and recognition of HS by medical professionals. This is significant because early treatment, especially under collaboration of a dermatologist and plastic surgeon, can reduce the risk of worsening symptoms and complications. Lifestyle modifications such as losing weight and quitting smoking can help decrease disease severity. Removing dairy, eating less sugar, and avoiding yeast in your diet may improve skin lesions. […] With hidradenitis suppurativa, a few lifestyle changes can help you prevent flare-ups.

• #76 Management of hidradenitis suppurativa: an Australasian consensus statement

  https://dermnetnz.org/topics/hidradenitis-suppurativa-guidelines

  Comprehensive care of HS should include encouragement of smoking cessation and weight control, wound care, and management of pain, itch and psychosocial health. […] Not smoking is associated with a better response to treatment and a 15% weight reduction in obese patients ameliorates disease severity. […] Patients with suspected HS should be assessed for predisposing factors such as smoking, being overweight, and having a personal or family history of HS, acne, inflammatory bowel disease, and rare skin disorders such as steatocystoma multiplex. […] It is essential to recognise the psychosocial costs of the disease and either provide, or refer for, appropriate support and treatment for consequences such as depression and anxiety. […] We recommend that it is reasonable to consider the use of acitretin (unless contraindicated by pregnancy or potential pregnancy) and avoid isotretinoin (unless the patient also has acne). […] Comorbidities should be considered before initiating any of these treatments, none of which are formally approved for the treatment of HS.

• #77 Hidradenitis Suppurativa: Rapid Evidence Review | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/1101/p562.html

  Patients with hidradenitis suppurativa should be screened for associated conditions, including depression and diabetes mellitus, and these conditions should be appropriately addressed. […] Combining biologic agents with surgical treatment is associated with decreased recurrence compared with surgery alone.

• #78 Global Hidradenitis Suppurativa Treatment Guidelines: 7 Takeaways | Integra LifeSciences

  https://tissuetechnologies.integralife.com/global-hidradenitis-suppurativa-treatment-guidelines-7-takeaways/

  Hidradenitis suppurativa management requires a team-centered approach. […] All of the HS treatment guidelines endorse a multidisciplinary treatment approach, including dermatology, primary care, gynecology, mental health, pain management and surgery. […] Because there is no one treatment for hidradenitis suppurativa, all nine of the guidelines favor a broad treatment approach that may include lifestyle changes, topicals, antibiotics, anti-inflammatories and biologics, lasers, phototherapy and surgery. […] Early interventions are recommended, such as: Screening for comorbidities including cardiovascular disease, diabetes, metabolic syndrome, autoimmune conditions, polycystic ovary syndrome, depression and anxiety. Encouraging patients to quit smoking. A higher percentage of HS patients smoke compared to the general population and using tobacco is associated with increased symptom severity.

• #79 Hidradenitis suppurativa (syn. acne inversa)

  https://www.pcds.org.uk/clinical-guidance/hidradenitis-suppurativa

  In patients with PCOS and/or pre-menstrual flares, consider spironolactone (max. 100mg OD; off-license) and/or an oral contraceptive with a favourable progestogen profile (eg Yasmin, Eloine, Mercilon). […] Ensure appropriate analgesia is prescribed and available. […] Patients may need multiple dressings for differing needs and preferences: Absorbent, low adhesive, foam and gentle border dressings reduce friction. […] Consider referral to a local tissue viability team for expert wound care. […] Severe psychological impact. […] No improvement following adequate first-line treatment (mild-moderate disease; refer whilst instituting second-line treatment). […] Severe disease (refer whilst instituting first-line treatment). […] Diagnostic uncertainty. […] Pregnancy. […] Scarring.

• #80 Global Hidradenitis Suppurativa Treatment Guidelines: 7 Takeaways | Integra LifeSciences

  https://tissuetechnologies.integralife.com/global-hidradenitis-suppurativa-treatment-guidelines-7-takeaways/

  Encouraging patients to lose weight because higher BMI is associated with more severe symptoms. […] There’s a lack of wound care dressings made specifically for hidradenitis suppurativa management. Guidelines from Canada, Europe and Brazil recommend studies to evaluate dressings and wound care specifically for the HS population. […] Addressing pain should be central in hidradenitis suppurativa management. […] All guidelines acknowledge the pain with hidradenitis suppurativa. Specific recommended therapies include topical analgesics and non-steroidal anti-inflammatories. Guidelines hold that opioids should only be as a last resort if other methods are ineffective.

• #81 Hidradenitis Suppurativa (HS) | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/hidradenitis-suppurativa-hs

  Pain medicines. Over-the-counter pain medicines can ease pain and limit inflammation. Your child may need stronger medicines for a severe case. […] Injected medicines. Injectable and IV medicines can be used if your child has more severe symptoms. They work to limit the body’s ability to become inflamed. […] Procedures. A steroid may be injected into the bump to ease pain. In certain cases, bumps can be drained with special tools. For severe cases, your doctor may perform surgery to remove the area of affected skin or use a laser to destroy the affected area.

• #82 Management of hidradenitis suppurativa: an Australasian consensus statement

  https://dermnetnz.org/topics/hidradenitis-suppurativa-guidelines

  Comprehensive care of HS should include encouragement of smoking cessation and weight control, wound care, and management of pain, itch and psychosocial health. […] Not smoking is associated with a better response to treatment and a 15% weight reduction in obese patients ameliorates disease severity. […] Patients with suspected HS should be assessed for predisposing factors such as smoking, being overweight, and having a personal or family history of HS, acne, inflammatory bowel disease, and rare skin disorders such as steatocystoma multiplex. […] It is essential to recognise the psychosocial costs of the disease and either provide, or refer for, appropriate support and treatment for consequences such as depression and anxiety. […] We recommend that it is reasonable to consider the use of acitretin (unless contraindicated by pregnancy or potential pregnancy) and avoid isotretinoin (unless the patient also has acne). […] Comorbidities should be considered before initiating any of these treatments, none of which are formally approved for the treatment of HS.

• #83 Guidelines for the management of hidradenitis suppurativa: recommendations supported by the Centre of Evidence of the French Society of Dermatology

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8247998/

  Hidradenitis suppurativa (HS) is a painful chronic inflammatory skin disease that impacts quality of life substantially. Its prevalence is estimated to be 07%. […] Therefore, the Centre of Evidence of the French Society of Dermatology initiated a standardized recommendation process for HS. […] The most important recommendations, supported by both evidence and expertise-based data, were used to design a decision-making algorithm. […] A medico-surgical approach is strongly recommended for all patients, either after or in combination with medical steps. […] For HS associated with inflammatory diseases, such as Crohn disease or spondyloarthropathy, preventive treatment with anti-TNF is recommended, in agreement with gastroenterologists or rheumatologists. […] The WG highlighted the importance of following recommendations for complete wide margins during surgical management to achieve resection, taking the subclinical peripheral extension of HS lesions into account, in accordance with the model for oncological skin surgery. […] HS is a chronic disease requiring long-term and multidisciplinary management that takes into consideration the pain and psychological impact, the different medical and surgical treatments available and the preservation of the microbial ecology.

• #84 How To Prevent Hidradenitis Suppurativa

  https://www.health.com/hidradenitis-suppurativa-prevention-8664765

  If your hidradenitis suppurativa is severe, your dermatologist may recommend certain procedures to improve symptoms and prevent additional flares from occurring. These may include: Getting corticosteroid injections; Draining the pus out of some lesions; Fully removing lesions with a medical knife; Deroofing (removing the skin) from the top of the lesions; Trying laser surgery. […] It’s worth noting that these preventative treatments are only necessary if you have serious symptoms that are extremely painful or recur despite using other prevention and treatment methods. […] The exact cause of hidradenitis suppurativa is unknown, so healthcare providers don’t have surefire ways to prevent the condition. However, several prevention strategies can limit the frequency of symptom flares (periods when HS symptoms are most active and painful). Your healthcare provider may recommend strategies such as lifestyle changes, skincare techniques, and certain medications or procedures to reduce symptoms and improve your quality of life.

• #85 Hidradenitis Suppurativa (HS) Aventura, FL | Skin Cancer Treatment Aventura, FL

  https://www.drresnik.com/hidradenitis-suppurativa-hs-cosmetic-dermatologist-miami-florida.php

  For women it is best to block male hormones. This can be done using birth control pills (BCPs) such as Yasmin (or Ocella) or Yaz (or its generic). We can add an extra hormone blocker called spironolactone to the BCP. […] For Hurley Stage II – systemic anti-inflammatory antibiotics are used as in Stage I, for weeks or months. Clindamycin may be combined with rifampin. Intralesional triamcinolone may be used. Dapsone can be very useful. […] Surgical unroofing is a simple, yet very effective technique that can stop forever the progression of the treated lesions. It is far more effective than prolonged antibiotics and anti-inflammatory therapy, which do not treat the cause. […] Preliminary work suggests that a zero dairy diet may lead to clearing in some patients. The diet needs to be really well controlled. Nothing at all from cow source can be used. In addition to no milk, cream, cheese, butter, yoghurt, cream cheese, cottage cheese, ice cream and derivatives like cheeseburgers and lasagna, this means checking protein powders and protein drinks to be sure there is no casein, whey, milk protein isolate, or milk solids. […] Complete healing generally takes 8-10 weeks.

• #86 How To Prevent Hidradenitis Suppurativa

  https://www.health.com/hidradenitis-suppurativa-prevention-8664765

  If your hidradenitis suppurativa is severe, your dermatologist may recommend certain procedures to improve symptoms and prevent additional flares from occurring. These may include: Getting corticosteroid injections; Draining the pus out of some lesions; Fully removing lesions with a medical knife; Deroofing (removing the skin) from the top of the lesions; Trying laser surgery. […] It’s worth noting that these preventative treatments are only necessary if you have serious symptoms that are extremely painful or recur despite using other prevention and treatment methods. […] The exact cause of hidradenitis suppurativa is unknown, so healthcare providers don’t have surefire ways to prevent the condition. However, several prevention strategies can limit the frequency of symptom flares (periods when HS symptoms are most active and painful). Your healthcare provider may recommend strategies such as lifestyle changes, skincare techniques, and certain medications or procedures to reduce symptoms and improve your quality of life.

• #87 Hidradenitis Suppurativa (HS) | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/hidradenitis-suppurativa-hs

  Pain medicines. Over-the-counter pain medicines can ease pain and limit inflammation. Your child may need stronger medicines for a severe case. […] Injected medicines. Injectable and IV medicines can be used if your child has more severe symptoms. They work to limit the body’s ability to become inflamed. […] Procedures. A steroid may be injected into the bump to ease pain. In certain cases, bumps can be drained with special tools. For severe cases, your doctor may perform surgery to remove the area of affected skin or use a laser to destroy the affected area.

• #88 How To Prevent Hidradenitis Suppurativa

  https://www.health.com/hidradenitis-suppurativa-prevention-8664765

  If your hidradenitis suppurativa is severe, your dermatologist may recommend certain procedures to improve symptoms and prevent additional flares from occurring. These may include: Getting corticosteroid injections; Draining the pus out of some lesions; Fully removing lesions with a medical knife; Deroofing (removing the skin) from the top of the lesions; Trying laser surgery. […] It’s worth noting that these preventative treatments are only necessary if you have serious symptoms that are extremely painful or recur despite using other prevention and treatment methods. […] The exact cause of hidradenitis suppurativa is unknown, so healthcare providers don’t have surefire ways to prevent the condition. However, several prevention strategies can limit the frequency of symptom flares (periods when HS symptoms are most active and painful). Your healthcare provider may recommend strategies such as lifestyle changes, skincare techniques, and certain medications or procedures to reduce symptoms and improve your quality of life.

• #89 Guidelines for the management of hidradenitis suppurativa: recommendations supported by the Centre of Evidence of the French Society of Dermatology

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8247998/

  Hidradenitis suppurativa (HS) is a painful chronic inflammatory skin disease that impacts quality of life substantially. Its prevalence is estimated to be 07%. […] Therefore, the Centre of Evidence of the French Society of Dermatology initiated a standardized recommendation process for HS. […] The most important recommendations, supported by both evidence and expertise-based data, were used to design a decision-making algorithm. […] A medico-surgical approach is strongly recommended for all patients, either after or in combination with medical steps. […] For HS associated with inflammatory diseases, such as Crohn disease or spondyloarthropathy, preventive treatment with anti-TNF is recommended, in agreement with gastroenterologists or rheumatologists. […] The WG highlighted the importance of following recommendations for complete wide margins during surgical management to achieve resection, taking the subclinical peripheral extension of HS lesions into account, in accordance with the model for oncological skin surgery. […] HS is a chronic disease requiring long-term and multidisciplinary management that takes into consideration the pain and psychological impact, the different medical and surgical treatments available and the preservation of the microbial ecology.

• #90 How To Prevent Hidradenitis Suppurativa

  https://www.health.com/hidradenitis-suppurativa-prevention-8664765

  If your hidradenitis suppurativa is severe, your dermatologist may recommend certain procedures to improve symptoms and prevent additional flares from occurring. These may include: Getting corticosteroid injections; Draining the pus out of some lesions; Fully removing lesions with a medical knife; Deroofing (removing the skin) from the top of the lesions; Trying laser surgery. […] It’s worth noting that these preventative treatments are only necessary if you have serious symptoms that are extremely painful or recur despite using other prevention and treatment methods. […] The exact cause of hidradenitis suppurativa is unknown, so healthcare providers don’t have surefire ways to prevent the condition. However, several prevention strategies can limit the frequency of symptom flares (periods when HS symptoms are most active and painful). Your healthcare provider may recommend strategies such as lifestyle changes, skincare techniques, and certain medications or procedures to reduce symptoms and improve your quality of life.

• #91 Hidradenitis Suppurativa: Rapid Evidence Review | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/1101/p562.html

  Patients with hidradenitis suppurativa should be screened for associated conditions, including depression and diabetes mellitus, and these conditions should be appropriately addressed. […] Combining biologic agents with surgical treatment is associated with decreased recurrence compared with surgery alone.

• #92 Guidelines for the management of hidradenitis suppurativa: recommendations supported by the Centre of Evidence of the French Society of Dermatology

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8247998/

  Hidradenitis suppurativa (HS) is a painful chronic inflammatory skin disease that impacts quality of life substantially. Its prevalence is estimated to be 07%. […] Therefore, the Centre of Evidence of the French Society of Dermatology initiated a standardized recommendation process for HS. […] The most important recommendations, supported by both evidence and expertise-based data, were used to design a decision-making algorithm. […] A medico-surgical approach is strongly recommended for all patients, either after or in combination with medical steps. […] For HS associated with inflammatory diseases, such as Crohn disease or spondyloarthropathy, preventive treatment with anti-TNF is recommended, in agreement with gastroenterologists or rheumatologists. […] The WG highlighted the importance of following recommendations for complete wide margins during surgical management to achieve resection, taking the subclinical peripheral extension of HS lesions into account, in accordance with the model for oncological skin surgery. […] HS is a chronic disease requiring long-term and multidisciplinary management that takes into consideration the pain and psychological impact, the different medical and surgical treatments available and the preservation of the microbial ecology.

• #93 HS Treatment and Management | HS Awareness | HCP

  https://www.hs-awareness.com/treatment-and-management

  Early intervention with systemic treatment can help control inflammatory activity and avoid a destructive disease course. The window of opportunity for intervention with targeted treatment occurs prior to the development of tunnels and fibrotic scarring. […] Treatment and management of hidradenitis suppurativa requires a multidisciplinary and individualized approach. While there are no curative treatments, pharmacological approaches and other interventions could help. […] Today’s treatment options encompass several approaches, including lifestyle modifications, topicals, and surgery. Treatments should be individualized according to a patient’s needs. […] HS is a systemic condition requiring prompt action to help limit disease progression. Mild cases can often be managed by topical treatments and lifestyle adjustments. Moderate or severe cases may require more. Consider treatment strategies based on the individual. […] Smoking cessation and weight loss counseling should be considered, among other lifestyle modifications. Treatment requires an individualized approach.

• #94 Global Hidradenitis Suppurativa Treatment Guidelines: 7 Takeaways | Integra LifeSciences

  https://tissuetechnologies.integralife.com/global-hidradenitis-suppurativa-treatment-guidelines-7-takeaways/

  Hidradenitis suppurativa management requires a team-centered approach. […] All of the HS treatment guidelines endorse a multidisciplinary treatment approach, including dermatology, primary care, gynecology, mental health, pain management and surgery. […] Because there is no one treatment for hidradenitis suppurativa, all nine of the guidelines favor a broad treatment approach that may include lifestyle changes, topicals, antibiotics, anti-inflammatories and biologics, lasers, phototherapy and surgery. […] Early interventions are recommended, such as: Screening for comorbidities including cardiovascular disease, diabetes, metabolic syndrome, autoimmune conditions, polycystic ovary syndrome, depression and anxiety. Encouraging patients to quit smoking. A higher percentage of HS patients smoke compared to the general population and using tobacco is associated with increased symptom severity.

• #95 An Update on Current Clinical Management and Emerging Treatments in Hidradenitis Suppurativa

  https://www.skintherapyletter.com/hidradenitis-suppurativa/emerging-treatments-update/

  The management of HS involves a multimodal approach including lifestyle modifications, such as weight loss and smoking cessation, various medical/surgical therapies and psychological support. […] The mainstay of medical management in mild-to-moderate disease is oral antibiotics and topical therapies, with consideration of hormonal treatments and systemic retinoids as adjunctive therapy. […] Surgical intervention is often necessary with advanced disease refractory to medical management to address tunnels and chronic scarring. […] An improved understanding of the disease mechanisms and wider range of biologic therapies aimed at these underlying inflammatory pathways and specific pathophysiology of HS is poised to create a major shift in this management conundrum. […] The further development of new therapies for the treatment of HS is crucial in continuing to improve outcomes and quality of life for patients with this debilitating disease.

• #96 HS Treatment and Management | HS Awareness | HCP

  https://www.hs-awareness.com/treatment-and-management

  Early intervention with systemic treatment can help control inflammatory activity and avoid a destructive disease course. The window of opportunity for intervention with targeted treatment occurs prior to the development of tunnels and fibrotic scarring. […] Treatment and management of hidradenitis suppurativa requires a multidisciplinary and individualized approach. While there are no curative treatments, pharmacological approaches and other interventions could help. […] Today’s treatment options encompass several approaches, including lifestyle modifications, topicals, and surgery. Treatments should be individualized according to a patient’s needs. […] HS is a systemic condition requiring prompt action to help limit disease progression. Mild cases can often be managed by topical treatments and lifestyle adjustments. Moderate or severe cases may require more. Consider treatment strategies based on the individual. […] Smoking cessation and weight loss counseling should be considered, among other lifestyle modifications. Treatment requires an individualized approach.

• #97 Secondary prevention of hidradenitis suppurativa

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6826242/

  Hidradenitis suppurativa (HS) is a multifactorial disease with many facets of uncertain importance for optimal treatment and prevention. In order to explore options for secondary prevention in HS, we randomly and retrospectively selected 40 patients with HS that were analyzed on the basis of supposed trigger factors and proposed prevention measures. Implementing secondary prevention by reducing irritation, avoiding shaving, improving skin care, performing laser epilation or applying fusidic acid/betamethasone cream led to an improvement in 62.5% of patients. We suggest a structured approach in daily practice in order to identify individual trigger factors. The crucial point for secondary prevention is the improvement of patient education. […] Prevention is considered to be the ultimate goal in medical practice.

• #98 Hidradenitis Suppurativa: Early Recognition and Treatment by Primary Care Providers – Clinical Advisor

  https://www.clinicaladvisor.com/features/hidradenitis-suppurativa-early-recognition-and-treatment-by-primary-care-providers/

  Hidradenitis suppurativa early recognition and treatment Treatment of hidradenitis suppurativa early in the disease course is crucial to prevent progression to more severe manifestations. […] Treatment of HS early in the disease course is crucial to prevent progression to these more severe manifestations. […] Educating patients on the etiology of the disease is crucial. Patients may have misconceptions that HS results from poor hygiene or is somehow self-induced; it is important to dissuade patients from this misconception. […] clinical evidence demonstrates a reduction in HS severity and recurrence with smoking cessation and weight loss, likely because of a reduction in Notch pathway impairment, inflammation, and skin shearing. […] If primary care providers are able to close the 7-year average gap between symptom onset and a diagnosis of HS, patients can be adequately treated early in their disease course, avoiding the potentially disfiguring physical manifestations of the disease, reducing its psychosocial burden, and minimizing costly medical care.

• #99 Secondary prevention of hidradenitis suppurativa

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6826242/

  More than 60% of patients considered early intervention with a fusidic acid/betamethasone cream (FA/B) a helpful measure, as described earlier. […] In addition to FA/B treatment, weight loss (1 patient), diet (3 patients), reduction of irritation by change of clothing style (1 patient), improvement of skin care (2 patients) or laser epilation (4 patients) were reported as successful measures to reduce HS inflammatory intensity and frequency of new abscess formation. Altogether 70% of patients judged preventive measures that had been suggested to be beneficial. […] Secondary prevention means, we have to identify individual trigger factors together with the patient in order to prevent HS from progressing. Our study, for the first time, shows that secondary prevention of HS is possible already today and beneficial for the patient.

• #100 A Patient-Centered Guide to Hidradenitis Suppurativa Flare Prevention – JDDonline – Journal of Drugs in Dermatology

  https://jddonline.com/articles/a-patient-centered-guide-to-hidradenitis-suppurativa-flare-prevention-S1545961621P1295X/

  Hidradenitis suppurativa (HS) is a chronic debilitating skin disease characterized by painful dermal abscesses, subcutaneous inflammatory nodules, draining sinuses and hypertrophic scars. […] Quality of life and symptom improvement are viable outcomes from preventative interventions in patients with HS. […] While there is not a cure for HS, symptoms can be managed, and recurrence can be reduced following various lifestyle changes. […] Treatment should be focused on prevention of disease progression, reducing the frequency of recurrence, and treating existing lesions to minimize pain and drainage. […] Common goals of management include prevention of disease progression, reducing the frequency of recurrence, and treating existing lesions to minimize pain and drainage. […] The link between HS and obesity is rooted in obesity’s inflammatory nature, which creates a milieu of pro-inflammatory cytokines including interleukin (IL)-1, IL-6, and tumor necrosis factor (TNF)-alpha all of which mediate inflammation seen in HS.

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