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Which Modality Is Effective for HS Pain?

While patients use a variety of different therapies to treat pain from hidradenitis suppurativa (HS), they did not report any of these options as highly effective, according to the findings of a recent survey study.

Pain is one of the most common and debilitating symptoms of HS, Fernandez et al wrote. To identify effective pain management therapies, they conducted a study using an anonymous online survey posted to Facebook HS support groups. Participants selected one or more therapies that they have used to try and manage HS pain from a list of 20 options. For each selected therapy, the participants rated their effectiveness on a 5-point scale, with 1 being not successful and 5 being extremely successful. The researchers calculated the mean effectiveness ratings of each therapy.

A total of 438 participants completed surveys, with 8.2%, 53.4%, and 38.4% identifying themselves as having Hurley stage I, II, and III, respectively.

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The most commonly reported therapy used for pain was warm compresses (82.4%), followed by ibuprofen/naproxen (74.7%), Epsom salt baths (57.8%), cold compresses (45.4%), and acetaminophen (44.7%).

In addition, the highest mean effectiveness rating was for marijuana smoking (2.92 ± 1.10), followed by marijuana edibles (2.87 ± 1.10) and opioids (2.83 ± 0.98). Bleach baths (1.52 ± 0.80), sitz baths (1.53 ± 0.56), massage (1.61 ± 0.92), gabapentin (1.64 ± 0.73), and acetaminophen (1.71 ± 0.75) had the lowest mean effectiveness ratings.

“Even the highest-rated pain management modalities are considered only moderately effective by patients with HS,” the researchers concluded.


Fernandez JM, Thompson AM, Borgstrom M, Orenstein LAV, Hsiao JL, Shi VY. Pain management modalities for hidradenitis suppurativa: a patient survey. J Dermatolog Treat. Published online September 11, 2020. doi:10.1080/09546634.2020.1822501

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