Glucagon-like peptide-1 (GLP-1) receptor agonists could help manage hidradenitis suppurativa (HS), with up to 60% of patients showing significant improvement after six months, according to a research letter recently published in JAMA Dermatology.
HS is a chronic inflammatory skin disease characterized by painful, draining nodules and abscesses that typically form in areas where skin rubs together, such as the underarms, groin and beneath the breasts. The condition is often misdiagnosed as acne or boils, but its long-term effects can be much more severe, leading to scarring, restricted mobility and reductions in quality of life.
GLP-1 receptor agonists show promise in treating hidradenitis suppurativa, offering significant symptom relief and improved quality of life for patients. © Kristina Blokhin – stock.adobe.com
While it can be thought of as uncommon, HS is relatively widespread, affecting an estimated 1% to 2% of people in the U.S. According to the HS Foundation, the disease mainly affects women and minority populations.
Beyond its visible skin symptoms, HS is strongly connected to overall health, particularly metabolic and inflammatory conditions.
The JAMA Dermatology study noted that more than half of HS patients are overweight or obese. HS is closely linked with metabolic disorders, including insulin resistance, hypertension and type 2 diabetes. Fat tissue itself can drive inflammation by producing proinflammatory cytokines while reducing levels of protective, anti-inflammatory signals. Weight loss can lessen HS symptoms, but long-term success with lifestyle changes or bariatric surgery is often difficult to achieve.
GLP-1 receptor agonists, medications originally developed for type 2 diabetes, are now widely prescribed for obesity management because they support significant and sustained weight loss. GLP-1s may also reduce systemic inflammation.
A recent study in the American Journal of Clinical Dermatology suggests that GLP-1s may help HS patients not only by lowering weight and mechanical stress on skin folds but also by directly dampening inflammation and promoting skin healing.
Current HS treatments—such as antibiotics, hormone therapy, biologics and minor surgical procedures—tend to focus on symptom control, reducing flare-ups, and preventing new lesions. However, many patients continue to experience only partial relief and require ongoing, repetitive care. By addressing both weight and underlying inflammation, GLP-1s could represent a more durable therapeutic option and influence further investigation in clinical trials.
In this retrospective, multicenter cohort analysis, researchers examined folks with HS who were treated with GLP-1 between 2017 and 2024. Data were collected through the HS-France network and biomedical databases from eight French hospitals. Eligible participants were adults with dermatologist-confirmed HS who had received GLP-1 RAs for at least three months.
Clinical outcomes were evaluated at the start of treatment, at six months and at discontinuation or last follow-up. These outcomes included Hidradenitis Suppurativa Physician’s Global Assessment (HS-PGA) scores, flare frequency, pain and suppuration measured by Numerical Rating Scales, Dermatology Life Quality Index and body mass index (BMI).
A subgroup analysis was also conducted in those with stable HS treatment for 12 months before month six.
Out of 66 patients with HS treated with GLP-1s for a median of 18.5 months, most (48) received semaglutide—which is sold under the names Ozempic, Wegovy and Rybelsus—while others received Trulicity (dulaglutide) (13) or liraglutide—sold under the names Victoza and Saxenda (5). The median age was 46 years, and 58% were women. The median body mass index (BMI) was 39.4, and 86% had diabetes.
At the beginning of the investigation, it was found that 45% had mild HS, 32% had recurrent HS, and 23% had severe cases. Over half were also receiving HS therapy, including antibiotics or biologics.
Clinical improvements were significant.
By six months, 54% of patients achieved at least a one-point reduction in the HS-PGA, rising to 62% by the last visit. A two-point or greater reduction was seen in 12% at six months and 32% at the study’s end. Pain, drainage, flare frequency and quality-of-life scores all showed significant improvements, even among patients with stable background treatments.
Building on the study’s strengths, this multicenter cohort included a decent amount of patients and used data warehouses to reduce recall bias, while focusing on those whose HS treatments remained unchanged for 12 months, supporting a clear link between GLP-1s and symptom improvement. The study’s limitations include its review of past data, the fact that it included patients on different HS treatments, that it did not collect biological measurements and that it provided only limited information on long-term effects.
Authors suggest randomized clinical trials to confirm GLP-1 efficacy, explore mechanisms beyond weight loss and evaluate effects in patients without obesity. Collecting metabolic and inflammatory markers in future studies could also clarify how these medications influence HS and systemic inflammation.