Hidradenitis suppurativa (HS) is a chronic skin condition that causes swollen and painful lesions beneath the skin. There is currently no cure for hidradenitis suppurativa and treatment focuses on management.

HS lumps often form in the groin, the buttocks, the armpits, and the area beneath the breasts.Healthcare professionals do not fully understand the cause of HS, but research indicates that it develops when hair follicles become clogged with keratin. This is a type of protein present in hair, skin, and nails.

According to the American Academy of Dermatology Association, the combination of sweat and keratin builds up inside hair follicles and breeds bacteria that can cause the hair follicle to burst.

This buildup results in painful, swollen, pus-filled lumps, or abscesses. The pus can spread to other hair follicles, resulting in more clogged follicles, bumps, and scars on the skin.

There is currently no cure for HS. However, recent advancements in treatment and other management strategies may help improve quality of life for individuals with HS.

Several recent studies have shed new light on ways to manage and treat the symptoms of HS.

How diet affects HS

In one 2020 survey of 242 individuals with HS, researchers found that eliminating or altering certain foods had a positive impact on the condition for some people.

The top five food groups that people eliminated were dairy, refined sugars, tomatoes, alcohol, and gluten. About 76% of the participants eliminated at least one of these food groups, and nearly 85% eliminated more than one food group.

As a result of this, about 31% of the participants reported feeling “much better.”

In addition, one 2019 study explored how adhering to a low inflammatory diet such as the Mediterranean diet can improve HS symptom management.

Complementary and alternative medicine

One recent study suggested that out of a group of 303 individuals with HS, about 84% reported using alternative medicine therapies. These people expressed frustration with conventional medicine and wanted to try natural treatments.

The most common natural supplements that people reported using were turmeric and curcumin. Other popular products included magnesium sulfate salt bath and zinc.

However, more research is necessary to determine the effectiveness of these complementary therapies for HS.

Weight and HS

According to one 2018 review, there may be a link between obesity and the development of HS. Adopting a weight loss program can help alleviate the symptoms and flare-ups associated with the condition.

In fact, another study found that “weight loss of more than 15% is associated with a significant reduction of disease severity.”

A person should talk with a healthcare professional to determine whether or not a weight loss program would be beneficial for reducing their HS symptoms.

There is currently only one Food and Drug Administration (FDA)-approved prescription biologic to treat HS. It is an injectable medication called adalimumab (Humira).

This medication works to manage HS symptoms by targeting the parts of the immune system that stimulate inflammation.

Topical medications

There are also several different types of topical medications to treat and manage the symptoms of HS. These come in the form of lotions, ointments, and creams.

Some topical medications that a healthcare professional may recommend include:

  • chlorhexidine
  • zinc pyrithione
  • resorcinol cream, 15%

In addition, clindamycin (Cleocin T) is a topical antibiotic that can treat HS symptoms.

Side effects of the above topical medications include skin flushing, itching, and burning sensations.

Oral medications

Oral antibiotics can also help treat mild-to-severe cases of HS.

Some examples of these include:

  • tetracycline antibiotics
  • dapsone
  • moxifloxacin (Avelox)
  • clindamycin
  • metronidazole (Flagyl)
  • rifampin (Rimactane)

People can take corticosteroids orally or by injection. These medications affect the entire body and reduce inflammation, swelling, and pain.

Potential side effects of oral corticosteroids include weight gain, high blood pressure, and mood changes.

In one recent study, researchers examined the effectiveness of an injectable medication called bermekimab.

The study consisted of two groups. One group included individuals in whom previous anti-TNF therapy had failed, and the other group included those who had not previously used anti-TNF therapy.

During the 13 weeks, both groups received a once-weekly 400-milligram injectable dose of bermekimab.

The drug was effective in both treatment groups regardless of their treatment history. Except for injection site reactions, there were no reported adverse effects.

After 12 weeks, the participants reported a 60% reduction in inflammatory nodules and a 64% reduction in pain.

Although promising, bermekimab is still in the trial phases and has not yet received FDA approval.

Anyone who wishes to participate in a clinical trial for HS treatments should first speak with a healthcare professional to become educated on the benefits and risks of the study.

A person can find a clinical trial to participate in using websites such as CenterWatch and ResearchMatch.

HS can be complicated and difficult to understand and treat. The good news is that there are plenty of resources available to support, encourage, and guide people who are living with this condition.

HS is a challenging condition that can be debilitating at times. However, there are several techniques, medications, and approaches that are available to help treat it.

Researchers are continuously studying new methods to help those with HS gain a better quality of life.