Hidradenitis suppurativa (HS) is a chronic, painful skin condition affecting approximately one in every 100 people in the United Kingdom, yet awareness remains limited. Characterized by painful, boil-like lumps that develop beneath the skin, commonly in areas such as the armpits and groin, HS results from blocked hair follicles and triggers an excessive inflammatory response. Severe cases can lead to open, weeping sores that may require surgical removal.

Historically, treatment options for HS have been limited, primarily involving antibiotics, antibacterial washes, and pain relief, which often prove insufficient in preventing or fully resolving flare-ups. However, recent research points to a new class of drugs, known as Janus kinase (JAK) inhibitors, as a promising approach to managing the condition by targeting inflammation—the root cause of the disease at a cellular level.

JAK inhibitors are already prescribed for various inflammatory disorders, including rheumatoid arthritis and eczema, and emerging evidence suggests they may also effectively reduce HS symptoms. According to Dr. Abirami Pararajasingam, a consultant dermatologist and spokesperson for the British Skin Foundation, these medications could be transformative for early-stage or less severe HS, although they cannot reverse advanced skin damage. She highlights that patients in the United States have greater access to these treatments due to fewer regulatory barriers, while high costs limit availability within the UK’s National Health Service (NHS).

Hidradenitis suppurativa affects over 700,000 individuals in the UK and is more prevalent among women, often manifesting during adolescence. Diagnosis is frequently delayed—sometimes by a decade—because HS can mimic other skin conditions and lacks a definitive laboratory test. Dr. Beibei Du-Harpur, clinical lecturer in dermatology at King’s College London, stresses that earlier diagnosis and treatment could prevent significant skin damage, yet many patients remain undiagnosed and manage symptoms without adequate support. She also points to a general lack of awareness among healthcare providers.

While the precise cause of HS remains unclear, genetic factors account for an estimated one-third of cases. Additional risk factors include smoking and excess body weight. Chemicals in tobacco smoke may promote abnormal skin thickening and follicle blockage, while excess fat tissue can contribute to systemic inflammation. Yet, not all sufferers possess these risk factors; some individuals may have a genetic predisposition related to hair follicle and oil gland structure.

Treatment for early-stage HS usually involves antibiotics and topical agents, but advances in biologic therapies offer new hope. These drugs specifically target molecules involved in the inflammatory process, reducing flare-ups and preventing progression. For many patients, biologics have significantly improved quality of life. For example, Laurelle-Maria Sterling, 32, who has battled HS since her teens, found limited success with antibiotics and surgery but experienced substantial relief after starting adalimumab, a biologic used for rheumatoid arthritis and psoriasis. She reports fewer and less severe flare-ups since treatment began four years ago.

In the United States, adalimumab and JAK inhibitors are already prescribed for milder HS cases. A recent study published in Nature demonstrated that the JAK inhibitor povorcitinib reduced inflammatory nodules and abscesses in HS patients by over 50 percent. Experts like Dr. Du-Harpur anticipate that such drugs could be introduced through the NHS within the next one to two years, potentially transforming care for many living with this challenging condition.