Just when one painful hidradenitis suppurativa (HS) lump finally heals, another starts forming. You may ask yourself, “I treated it, so why is it back?” After rounds of treatment, draining lesions, new flare-ups, and scars that don’t go away, you may start wondering if there’s a permanent cure for hidradenitis suppurativa.

One myHSteam member summed up this frustration: “Some treatments I received helped a little, but never enough to make my HS go away.”

There’s currently no cure for HS, but symptoms can improve and stay under control for long periods. Here, we’ll discuss what HS remission can look like, whether symptoms can return, and how treatment may help you reach and maintain it.

🗳️ Have you ever had a period when your HS symptoms improved or went away?

Yes, for a long time

Yes, but only for a short time

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Can Hidradenitis Suppurativa Go Into Remission?

Yes, HS can go into remission, meaning you may have periods with few or no active symptoms or flare-ups. In fact, newer research suggests that remission and complete disease regression may be more common than earlier studies suggested.

Some myHSteam members have shared their own experiences with long-term remission. “I’m two years into remission,” one member said, adding that they avoid sugar and processed foods and follow a low-carb diet.

How long remission lasts varies from person to person. You may go weeks, months, or even years without a flare. But because HS is a chronic condition, symptoms may return.

Remission in Hidradenitis Suppurativa

People with HS credit different treatments, from medications and diet to other lifestyle changes, with helping them reach remission. Some approaches have stronger scientific evidence than others, and what works for one person may not work for another.

Here are some current treatment options that may help get HS under control and keep symptoms away for longer.

Antibiotics

Antibiotics can help HS even when there’s no infection. Some antibiotics reduce inflammation, which may help calm flare-ups. Pus or drainage from an HS sore doesn’t always mean it’s infected.

Your dermatologist may prescribe an antibiotic you apply to your skin, such as clindamycin, or an oral antibiotic, such as doxycycline. When HS is harder to control, your doctor may prescribe two antibiotics, such as clindamycin plus rifampin.

Antibiotics are often one part of a long-term HS treatment plan, and symptoms may recur.

Biologics

If you have moderate to severe HS or other treatments haven’t worked, your doctor may recommend a biologic. U.S. Food and Drug Administration (FDA)-approved options include adalimumab (Humira), secukinumab (Cosentyx), and bimekizumab (Bimzelx).

In select situations, if a biologic stops working well, your dermatologist may use blood tests to check drug levels. This helps them decide whether you need to change your treatment.

Corticosteroids

For a painful HS flare, your dermatologist may inject a corticosteroid called triamcinolone acetonide directly into a new, noninfected nodule. This can help reduce pain and inflammation, though it doesn’t treat tunnels (sinus tracts) under the skin.

For more severe flares, your doctor may prescribe a short course of an oral steroid, such as prednisone. Steroids may offer temporary relief, but they usually aren’t used long term due to side effects and the risk of symptoms returning after treatment.

Hormonal Therapy

Hormonal therapy may help some people with HS, especially those whose symptoms flare around their menstrual period. Options may include certain birth control pills containing estrogen, cyproterone acetate or finasteride, spironolactone, and metformin. Each of these hormonal therapies works differently and is prescribed individually.

Your doctor will consider your symptoms, medical history, and potential risks when deciding whether hormonal therapy is right for you.

Oral Retinoids

Isotretinoin is an acne treatment sometimes used off-label for HS. Results are mixed, but it may help some people, particularly those with severe acne. Acitretin has also shown mixed results, appearing to provide greater improvement in some studies.

“It’s been three years since my dermatologist gave me the gift of isotretinoin,” one myHSteam member shared.

Oral retinoids can cause serious birth defects and should not be taken during pregnancy.

Laser and Light Therapy

Laser treatments may help reduce HS lumps or remove damaged scar tissue. Some options include laser hair reduction and carbon dioxide (CO2) laser treatment.

In one study, CO2 laser treatment was used on 185 affected areas in 61 people. Over follow-up periods ranging from one to 19 years, HS returned in only two treated areas. Even then, HS can recur in treated areas or develop elsewhere.

Other studies have found higher recurrence rates, especially with higher body mass index, so results can vary by technique and the person being treated.

Punch Debridement

Punch debridement, or limited unroofing, is a procedure used to remove a single inflamed HS bump. The treated bump may return, and the procedure doesn’t prevent HS from developing elsewhere.

Surgery

For severe HS with persistent tunnels or scarring, surgery may be used to remove affected skin and tissue. Surgery can improve your quality of life by providing long-term relief in the treated area. However, HS can still develop elsewhere.

Unroofing

For moderate or severe HS, unroofing removes the skin covering tunnels or recurring sores. The treated area often doesn’t need another procedure, but HS can still develop elsewhere.

Weight Loss

For people with a higher body weight or who have been diagnosed with obesity, weight loss may help improve HS symptoms. Research on weight loss and HS has shown mixed results, and people at any weight can have severe HS.

One report found complete remission after bariatric surgery in two people with HS, but researchers couldn’t determine whether weight loss alone caused the improvement. Weight loss may support HS management for some people, but it isn’t a cure.