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Over 80% of Patients With HS Use Alternative Medicine

Over 80% of patients with hidradenitis suppurativa (HS) reported using complementary and alternative medicine (CAM), according to the findings of a recent research letter published in JAMA Dermatology.

“To our knowledge, this study is the largest and most comprehensive survey to date that explores CAM use in patients with HS,” the researchers said. They recruited 303 patients from HS specialty clinics in Tucson, Arizona; Los Angeles, California; and Richmond Hill, Ontario, Canada, as well as through social media support groups, including Hope for HS, International Association of HS Network, and HS Warriors.

Participants completed an anonymous, multiple-choice, 25-item questionnaire between June 2019 and August 2019. The mean age of participants was 38 years, and 268 participants identified as female (88.4%).

While 97.7% of respondents (n=296) reported using conventional therapies, 49.7% of respondents reported that conventional therapies were not very successful (147 of 296), the researchers observed.
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Among conventional therapies, respondents reported surgical excisions (73 of 126 respondents [57.9%]), prescription pain medications (79 of 148 [53.4%]), intralesional steroids (71 of 133 [53.4%]), and biologics (56 of 112 [50%]) as helpful. Only about one-third of respondents reported oral (75 of 267 [28.1%]) and topical (76 of 235 [32.3%]) antibiotics as helpful, the researchers added.

CAM use was reported by 255 respondents (84.2%), but only 177 participants (69.4%) reported disclosing their CAM use to a health care provider, the researchers said. The most commonly reported reasons for using CAM included “frustration with conventional treatment” (163 respondents [63.9%]), and a desire to try something “new” (130 [51%]) or “more ‘natural’” (113 [44.3%]) treatments.

The researchers found turmeric/curcumin (152 of 255 respondents [59.6%]), magnesium sulfate salt bath (151 of 255 [59.2%]), and zinc (140 of 255 [54.9%]) were the most commonly used CAM products. Among CAM products, marijuana (59 of 103 [57.3%]), magnesium sulfate bath (72 of 151 [47.7%]), and topical cannabidiol oil (30 of 67 [44.8%]) were reported as the most helpful.

Dietary changes (230 of 255 respondents [90.2%]), tobacco cessation (86 of 255 [33.7%]), and yoga or Pilates (58 of 255 [22.7%]) were the most commonly reported lifestyle practices among respondents, the researchers said. A total of 106 respondents (46.1%) reported dietary changes as beneficial for HS, they added.

Overall, the majority of respondents who used CAM reported at least mild success (166 of 255 [65.1%]), and most would recommend CAM to others (183 of 255 [71.8%]).

“The use of CAM among this cohort of patients with HS (84.2%) is more common than in patients with psoriasis (46.7%) and atopic dermatitis (50.4%),” the researchers noted.

“Respondents with HS reported inadequate response to conventional therapy, which may lead to frustration and lower treatment adherence,” the researchers concluded. “The efficacy and safety of CAM modalities, as well as the role of CAM as adjunctive therapy in HS treatment, warrant further investigation.”

Reference

Price KN, Thompson AM, Rizvi O, et al. Complementary and alternative medicine use in patients with hidradenitis suppurativa [published online January 29, 2020]. JAMA Dermatol. doi:10.1001/jamadermatol.2019.4595

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