An overview of medications used to treat hidradenitis suppurativa.
There is no one-size-fits-all treatment plan for HS.
Treatment depends on disease severity, individual symptoms, medical history, and personal goals. Many people use more than one medication, and treatment plans are often adjusted over time. This guide offers a broad overview of medication classes that may be discussed as part of HS care.
Treatment is personal—and often changes over time
There is no single medication that works for everyone living with hidradenitis suppurativa. Treatment depends on your symptoms, disease severity, overall health, medical history, and personal goals. Many people use a combination of therapies, and treatment plans may change as symptoms, needs, and available options evolve.
Below is an overview of medication classes commonly used or studied in HS care. This information is intended to help you better understand your options and prepare for informed conversations with your dermatologist.
Medications by class
Different medications target different parts of HS. Some are applied to the skin, some are taken by mouth, and others are injected. A dermatologist may combine treatments based on symptoms, severity, response, and medical history.
Skin Cleansers
TopicalBenzoyl peroxide, Chlorhexidine, Zinc pyrithione, Resorcinol
Recommended as part of a daily skin-care routine for people with HS.
Intralesional Treatment
Injected into a lesionTriamcinolone
May be helpful for painful, inflamed HS lesions.
Antibiotics
Topical & OralClindamycin, Dapsone, Doxycycline, Minocycline, Tetracycline, Rifampin combinations, Ertapenem
May be effective alone in mild HS. More advanced HS often requires additional medications.
Hormonal & Metabolic Treatments
OralCombined contraceptive pills, Spironolactone, Finasteride, Metformin
May be useful in female patients, especially those who flare around their menstrual cycle. They may be effective alone in mild HS.
Retinoids
OralAcitretin, Isotretinoin, Alitretinoin
Acitretin is typically regarded as more effective than isotretinoin, although more evidence is needed.
Systemic Immune System Modulators
OralSteroids, Cyclosporine, Colchicine
Oral steroids can help manage flares quickly but are generally used short-term because of potential side effects.
Small Molecule Inhibitors
Oral & Topical
JAK inhibitors:
Povorcitinib*, Upadacitinib* (Rinvoq®),
Ruxolitinib* (Opzelura®)
PDE-4 inhibitors:
Apremilast (Otezla®), Roflumilast* (Zoryve®)
BTK/SYK inhibitors:
Remibrutinib*
JAK inhibitors carry an FDA warning based on an earlier, different medication in the class. Newer JAK-inhibitor studies in HS have been reassuring so far. Roflumilast is topical and already approved for certain eczemas.
Biologics
InjectionsAdalimumab (Humira®), Bimekizumab (Bimzelx®), Secukinumab (Cosentyx®), Sonelokimab, Lutikizumab*, Infliximab (Remicade®), Anakinra (Kineret®), Ustekinumab (Stelara®), Etanercept (Enbrel®), Golimumab (Simponi®)
Often used for moderate-to-severe HS. Medical history matters, especially inflammatory bowel disease, heart disease, infections, or certain cancers.
Questions that can help guide the conversation
It can be helpful to arrive with a few questions about the goals, benefits, risks, monitoring, and practical details of a recommended treatment.
What is this treatment targeting?
Ask how the medication works and what changes you might realistically expect in pain, drainage, flares, or lesion development.
How will we know if it is working?
Discuss how long a trial may take, which symptoms to track, and when your treatment plan should be reassessed.
What monitoring or precautions are needed?
Ask about laboratory testing, infection precautions, pregnancy considerations, medication interactions, and side effects.
This guide is educational—not medical advice.
Medication decisions should be made with a qualified healthcare professional who understands your symptoms, medical history, and goals.
This guide provides a broad overview of common treatment options for HS. It is not a complete list, and inclusion does not mean a medication is appropriate for every person.
Many people with HS use more than one medication, and treatment plans are often adjusted over time. Every medication carries possible risks, and your dermatologist weighs those risks against potential benefits.
HS research is advancing quickly, so treatment availability, study status, warnings, and approvals may change.
References
- Alikhan A, Sayed C, Alavi A, et al. North American clinical management guidelines for hidradenitis suppurativa: Part II. J Am Acad Dermatol. 2019;81(1):91–101.
- Sabat R, Alavi A, Wolk K, et al. Hidradenitis suppurativa. Lancet. 2025;405(10476):420–438.
- Garg A, Cohn E, Midgette B, Frasier K, Strunk A. Efficacy and Safety of Medical Interventions for Moderate to Severe HS. JAMA Dermatol. 2025;161(9):931–940.
- Fonjungo FE, Barnes LA, Aleshin MA. Antibiotic, hormonal/metabolic, and retinoid therapies for HS. J Am Acad Dermatol. 2024;91(6S):S37–S41.
- Almansouri D, Naasani A, Zouboulis CC. Emerging synthetic drugs for the management of HS: a comprehensive update. Expert Opin Pharmacother. 2026;27(10):995–1008.
Need help finding an HS-informed dermatologist?
Use the HS Connect Dermatologist Finder to search for providers who may have experience diagnosing and treating hidradenitis suppurativa.