Joint American Academy of Dermatology-Hidradenitis Suppurativa Foundation guidelines of care for the management of hidradenitis suppurativa
In brief
New hidradenitis guidelines strongly recommend five drugs and routine pain assessment
The guidelines make 37 evidence-based recommendations, with strong recommendations for adalimumab, bimekizumab, infliximab, secukinumab and routine pain assessment. Many other options, including antibiotics, procedures and supportive care, receive conditional recommendations; the guidance reflects the best evidence found in a systematic review, so gaps in the available evidence remain.
- Journal
- Journal of the American Academy of Dermatology (Q1)
- Published
- 20 October 2026
- Study design
- Practice guideline / consensus
- Evidence level
- Level 1, High (CEBM 1c)
- Authors
- Haley B Naik, Howa Yeung, Lindsy Frazer-Green, Steven Daniel Daveluy, Amit Garg, Amy J McMichael, et al.
- PMID
- 42900024
- DOI
- 10.1016/j.jaad.2026.08.125
Why clinicians should know about it
- Picked for Dermatology (paper of the day, 21 October 2026): Evidence-based multidisciplinary guideline for hidradenitis suppurativa
Abstract
BACKGROUND: Hidradenitis suppurativa affects 0.7% to 1.5% of the global population and causes substantial disability and meaningfully impairs quality of life. OBJECTIVE: To provide evidence-based recommendations for the management of hidradenitis suppurativa. METHODS: A workgroup conducted a systematic review and applied the Grading of Recommendations, Assessment, Development, and Evaluation approach to assess the certainty of evidence and to develop recommendations. RESULTS: This guideline presents 37 evidence-based recommendations. Strong recommendations are made for adalimumab, bimekizumab, infliximab, secukinumab, and routine pain assessment. Conditional recommendations are made for topical clindamycin, resorcinol, and ruxolitinib; oral doxycycline, tetracycline, and clindamycin with rifampin; intravenous ertapenem; spironolactone; short-term systemic corticosteroids; upadacitinib; specific procedural interventions; tobacco cessation; supportive pain management; and zinc supplementation and vitamin D repletion. LIMITATIONS: Analysis is limited to best evidence available from systematic review. CONCLUSIONS: These guidelines provide evidence-based recommendations for the management of hidradenitis suppurativa.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.