Who Is the Ideal Candidate for Biologics to Treat Hidradenitis Suppurativa (HS)?

Biologic medications can help control the inflammation that causes hidradenitis suppurativa (HS), a chronic skin condition. 

HS is marked by tender, painful nodules that form under the skin when hair follicles become inflamed and blocked. Biologic therapy can reduce the inflammation and help to lessen painful HS symptoms.

“Understanding where a patient is [in their disease] might dictate how aggressive we are to control that inflammatory response that they have,” says Erum Ilyas, MD, Dermatologist with Montgomery Dermatology in Pennsylvania.

Who is the ideal candidate for biologics to treat HS?

Biologics are typically used to treat more moderate to severe cases of hidradenitis suppurativa, says Ilyas. 

Doctors have ways of “scoring” how severe your case of HS is. For example, they may consider:

• How many and what type of nodules you have

• How often your nodules occur

• How many areas of your body are affected

• How often you need to change the bandages on your lesions

If you do have a lot of nodules on your body, or if other treatments such as topical antibiotics or anti-inflammatories aren’t helping, you may be a good candidate for biologics. 

What are some reasons you might not be eligible for biologics?

If you have a history of infection with tuberculosis or hepatitis, you may not be able to start a biologic medication right away. You may become eligible once the infection is treated.

It’s also important to consider how you feel about needles, because you’ll generally need to self-inject the medication.

The good news is that your care team can help train you to give yourself the injections. Many biologics for HS come in an auto-injector pen form, which administers the medicine just into the surface of the skin. Many people are surprised at how minimal the discomfort is.

“If you’re curious about biologics, and if you would be a good candidate based on where you’re at with the symptoms you’re experiencing, talk to your dermatologist,” says Ilyas. “We can go through this with you, and talk through some of your concerns.”