TABLE 3.

Management of hidradenitis suppurativa by disease severity

Disease severity	Treatment type	Treatment names52
Mild to moderate	Antiseptic washes	Benzoyl peroxide, chlorhexidine
	Topical treatments	Clindamycin, dapsone, resorcinola
	Oral antibioticsb	Clindamycin, dapsone, doxycycline,a,c metronidazole, minocycline,a moxifloxacin, rifampin
	Hormonal therapies	Oral contraceptives,a finasteride,a metformin, spironolactonea
	Alternative medicine53	Magnesium sulfate salt bath, oral vitamin D, oral zinc
	Procedures	Deroofing (surgical or CO2 laser), intralesional triamcinolone, incision and drainage (for acute relief only given high recurrence rates), local excision, Nd:YAG laser
Moderate to severe	Biologics	TNF-α inhibitors, adalimumab,d infliximab; interleukin (IL)-1 antagonist, anakinra; IL-12 and IL-23 inhibitor, ustekinumab; IL-23 inhibitor, guselkumab; IL-17 inhibitor, secukinumab
	Systemic antibiotics	Ertapenem
	Systemic immunosuppressants and immunomodulators	Apremilast, colchicine, cyclosporine, systemic steroids
	Retinoids	Acitretin,a isotretinoina,e
	Procedures	CO2 laser excision, wide surgical excision, deroofing

Nd:YAG laser, neodymium-doped yttrium aluminum garnet laser; TNF-α, tumor necrosis factor alpha.

^aIf not pregnant or actively trying to get pregnant

^bCombinations of oral antibiotics may be used, such as clindamycin 300 mg twice a day+rifampin 300 mg twice a day (up to 12 weeks)⁵²; rifampin+moxifloxacin+metronidazole (up to 8 weeks)

^cUp to 100 mg twice a day⁵²

^dThe only Food and Drug Administration–approved therapy for hidradenitis suppurativa

^eMixed results in the literature.⁵⁴

Collier. Hidradenitis suppurativa and women’s health. Am J Obstet Gynecol 2021.