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It can lead to immediate relief, but can promote lesion recurrence and scarring Stage II and III - Can try everything above, but if not working, usually this is when we would say you should refer out for other treatments If they donโt achieve good control with antibiotics, metformin or antiandrogenic therapy, may require oral retinoids, dapsone and biologics Weโll mention some, but we wonโt go into detail, since we donโt really do this stuff as Ob/Gyns Oral retinoids - may only have limited benefit Oral dapsone - sulfone drug with immunomodulatory and antibacterial properties Adalimumab - FDA approved treatment for moderate to severe HS Acute symptomatic lesions: oral glucocorticoids may also be used For severe, refractory disease Wide excision - extensive surgical intervention can get to greatest likelihood for resolution of active inflammation, but can be disfiguring and involve a prolonged recovery time.
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