How Biologics Work for Hidradenitis Suppurativa (HS)

Biologic medications are now available for hidradenitis suppurativa (HS). These medications are helping people with HS to manage their pain and other symptoms.

Hidradenitis suppurativa is a chronic skin condition marked by blocked hair follicles that cause tender, inflamed nodules under the skin. Biologic medications for HS are made from living organisms that can target specific parts of the immune system that create this inflammation.

“The treatment options have changed vastly over the past decade,” explains Erum Ilyas, MD, Dermatologist with Montgomery Dermatology in Pennsylvania. She notes that HS had been difficult to treat in the past.

How do biologics treat hidradenitis suppurativa?

Immune cells communicate with each other in order to manage the body’s immune response. 

Ilyas explains that in people who have HS, the immune system mistakenly directs inflammation toward the hair follicles. Biologic medications work by blocking certain receptors on the immune cells that contribute to HS activity.

Unlike immunosuppressants, which weaken the entire immune system, biologic medications work on a very specific, targeted part of the immune system.

“We can reduce the tendency for that inflammation to get out of control,” she says.

Which biologics are available for HS?

The current biologics that treat HS are TNF blockers and IL-17 blockers. These focus on blocking TNF alpha and IL-17, which are mediators for inflammation in the hair follicles. 

“Think of it as having the keys to understand which cells to work with and which cells to avoid,” Ilyas says.

How are biologics administered?

Biologic medications for HS are usually administered by injections. Biologic injections may be given every week, every other week, or every 4 weeks: It depends on which one you’re taking. Sometimes, biologics can also be given via infusions.

Ilyas notes that many people tolerate biologic medications well, and they are generally very effective at reducing inflammation and pain. Keep in mind that treatment outcomes and side effects may vary from person to person.

Biologics aren’t cures for HS, but starting on biologic therapy early in the disease progression means that you may avoid scarring, too.