Hidradenitis Suppurativa

Hidradenitis suppurativa (HS) is a chronic disease of a type of sweat gland. It can occur in one or multiple areas of your body. HS usually develops in your armpits, groin and anal area. It causes long-term skin inflammation and can be painful.

Symptoms include

  • Blackheads and red, tender bumps, called abscesses. The abscesses get bigger, break open and leak pus
  • Tunnels that form under the skin between abscesses
  • Scarring

No one knows what causes HS. It is more common in women, African-Americans and people who have had acne. It usually starts after the teenage years. Treatments include antibiotics, anti-inflammatory medicines and sometimes surgery. Sometimes, wearing loose clothing and possibly weight loss may also help.

No single treatment is effective in all patients.

Since 2001, Photodynamic Therapy (PDT) has also received many other non-FDA approved ( also called “off-label” ) uses including acne, rosacea, skin cancer, sun damage, cosmetic skin improvement, oily skin, enlarged sebaceous glands, wrinkles, rejuvenation (anti-aging), warts, hidradenitis suppurativa, psoriasis, and many other skin conditions.

Treatment of hidradenitis suppurativa by photodynamic therapy with aminolevulinic acid: preliminary results.

Schweiger ES, Riddle CC, Aires DJ.


Department of Dermatology, Mount Sinai Medical Center, New York, NY.



The current standard of care for hidradenitis suppurativa (HS) includes antibiotics (oral/topical), retinoids (oral/topical) and intralesional steroids and is unsatisfactory. Photodynamic therapy (PDT) with 20% 5-aminolevulinic acid (ALA) has been used ?off label? to treat acne vulgaris and may hold promise as a therapy for HS. This open-label, non-blinded study investigated the efficacy and safety of ALA PDT for the treatment of HS using two blue light sources and intense pulsed light (IPL) for photoactivation.


Twelve subjects with active HS enrolled to undergo ALA PDT once weekly for four weeks with follow-up visits 4, 8, and 12 or more weeks later. Nine subjects completed the study through the week 8 follow-up visit. Lesions were counted at each treatment visit at week 4, week 8 and at the final week.


Mean lesion counts were 11.25 at baseline, 6.5 at 4 weeks (50.8% reduction), and 7.5 at 8 weeks (29.9% reduction). Mean Global Severity Scores were 2.2 at baseline, 1.5 at 4 weeks, and 1.8 at 8 weeks. Mean DLQI scores were 17.3 at baseline, 13.1 at 4 weeks (27.2% improvement), 14.00 at 8 weeks (19.3% improvement) and 14.0 (19.3% improvement) at the final week (16-62 weeks). Three subjects (25%) had complete clearance and no active lesions 4 weeks after the final treatment. Treatments were more tolerable for subjects treated with blue light than with IPL.


ALA PDT may be a safe and effective treatment of hidradenitis suppurativa.


Aminolevulinic acid photodynamic therapy for hidradenitis suppurativa.


Gold Skin Care Center, Tennessee Clinical Research Center, 2000 Richard Jones Road, Suite 220, Nashville, TN 37215, USA. goldskin@goldskincare.com


Hidradenitis suppurative (HS) is a chronic, often suppurative chronic dermatologic disorder that is often misdiagnosed. It has presented therapeutic challenges for decades since its first descriptions in the medical literature in 1854. HS is an apocrine disorder with high prevalence, which has a genetic predisposition. Numerous treatment options have been described, some to control the acute disease process and others to control its long-term consequences. The use of photodynamic therapy (PDT) recently has been described as a treatment option for intractable HS. The clinical trials that are associated with PDT and HS are reviewed, and thoughts about the probably mechanisms of actions of this therapy are given. PDT should be considered in patients who have severe HS.