Table 1.
Emerging procedural therapies for hidradenitis suppurativa
| Treatment(s) | Author or clinical trial no. (ClinicalTrials.gov identifier) | Study type | Study goal and primary endpoint(s) | Patients enrolled | (Anticipated) completion date | Results or recruitment status |
|---|---|---|---|---|---|---|
| Laser therapies | ||||||
| Intralesional diode laser (1470 nm) | NCT04508374 | Randomized, contralaterally-controlled, within-person design |
Evaluate the efficacy and safety of laser fiber treatments for HS fistulas Endpoint: change in VAS pain scores for each individual HS tunnel |
20 | September 2025 | Recruiting |
| Alexandrite laser (755 nm) | NCT03054155 | Open label, contralaterally-controlled, within-person design trial |
Patients with bilateral HS in the axilla, groin, and/or inframammary area will be treated with laser on one side and compared to untreated contralateral side Endpoint: HS-LASI every month for 4 months and then after 2 months (6 months total) |
30 | October 2022 | Active, not recruiting |
| Deroofing and long-pulsed Nd:YAG laser (1064 nm) | NCT05484674 | Open label, contralaterally-controlled, within-person design trial |
Determine if the use of serial Nd:YAG laser treatments after deroofing of nodules and sinus tracts can improve HS outcomes compared to untreated contralateral axilla Endpoints: HiSCR, IHS4, and clinical exam after 12 months |
6 | December 2023 | Not yet recruiting |
| Fractional ablative Er:YAG laser (2490 nm) | NCT05470322 | Open label trial |
Evaluate the efficacy and tolerability of a Sciton fractionated ablative laser in the treatment of HS scarring (in patients without active HS lesions) Endpoints: GAIS and mSHSS scales at various times from months 0 to 6 |
19 | December 2023 | Not yet recruiting |
| Fractional ablative CO2 laser (10,600 nm) | NCT05580029 | Early phase 1 open label trial |
Understand the efficacy of fractional ablative CO2 laser therapy combined with topical triamcinolone acetonide in mild-moderate HS disease Endpoints: lesion counts, pain/itch levels, scar measurements, physician/patient assessment after every treatment session |
10 | March 2023 | Not yet recruiting |
| Radiation-based therapies | ||||||
| Low-dose radiotherapy | NCT03040804 | Phase I open label trial |
Evaluate the safety of low-dose radiotherapy for the treatment of stage II or III HS Endpoint: number of participants who have treatment-related grade ≥ 3 adverse events during treatment or within 3 months of treatment completion, assessed using CTCAE version 4.0 (follow-up for 3–6 months post treatment) |
2 | December 2020 | Terminated due to Covid-19, no adverse events reported in 2 participants |
| RF-based selective electrothermolysis | NCT05066113 | Open label trial |
Assess the tolerability, safety, and histometric changes in skin-RF interactions in the axillary skin of participants with HS and healthy volunteers Endpoint: safety and tolerability of skin-RF interactions in axillary skin at 4 months |
50 | August 2025 | Recruiting |
| Other procedural and interventional treatments | ||||||
| Battlefield acupuncture | NCT04218422 | Single-blinded, randomized trial |
Evaluate battlefield acupuncture versus sham acupuncture for treatment of pain in HS Endpoint: change in pain NRS score |
32 | February 2023 | Recruiting |
| Botulinum toxin | Grimstad et al. 2020 [46] | Randomized, triple-blinded trial |
Determine if intradermal injection with Botulinum toxin B is an effective treatment for HS Endpoint: improvement in DLQI after 3 months in treatment versus placebo group |
20 | September 2018 | Median DLQI decreased from 17 at baseline to 8 after 3 months in the treatment group compared to a change from 13.5 to 11 in placebo group (p < 0.05) |
| Botulinum toxin | NCT05403710 | Observational (patient registry) |
Determine if non-specific inhibition of neuropeptide release reduces IL-17-driven skin inflammation, relieves pain, and improves quality of life in HS patients Endpoint: quantification and phenotyping of skin resident dendritic cell, macrophage, and T cell populations in patients before and after treatment (1–2 months after first treatment) |
20 | July 2025 | Recruiting |
| Fecal microbiota transplantation | NCT04924270 | Phase 2 randomized, quadruple-blind |
Explore efficacy, safety, and patient acceptability of capsule fecal microbiota transplantation in newly diagnosed, untreated patients with chronic inflammatory rheumatic, dermatological, gastrointestinal, and pulmonary diseases Endpoint: change from baseline in physical component score of the 36-Item Short Form Health Survey |
20 | December 2024 | Not yet recruiting |
| Sclerotherapy | Porter et al. 2022 [56] | Phase 2 open label trial |
Analyze the effects of 23.4% hypertonic saline injection in sinus tracts of adults with HS Endpoint: HS Physician Local Improvement Assessment at baseline and after 8 weeks |
21 | November 2022 | Statistically significant improvement in drainage (p = 0.035), erythema intensity (p = 0.008), and swelling (p = 0.025) at week 8 compared to baseline |
CO2 Carbon dioxide, CTCAE Common Terminology Criteria for Adverse Events, DLQI Dermatology Life Quality Index, GAIS Global Aesthetic Improvement Scale, HiSCR hidradenitis suppurativa clinical response, HS hidradenitis suppurativa, HS-LASI hidradenitis suppurativa lesion, area, and severity index, IHS4 International Hidradenitis Suppurativa Severity Score System, IL interleukin; mSHSS modified Hidradenitis Suppurativa Score (for scar severity), Er:YAG erbium yttrium aluminum garnet, ND:YAG neodymium:yttrium aluminum garnet, nm nanometer, NRS numerical rating scale, RF radiofrequency, VAS visual analog scale