Botulinum toxin type A for the management of hidradenitis suppurativa

Hidradenitis suppurativa (HS) is a chronic, recurrent, inflammatory skin disease that centers around the hair follicle and occurs as a result of follicular occlusion. HS primarily presents as painful, inflamed lesions that begin during puberty and occur most commonly in areas with numerous apocrine glands. The etiology and pathogenesis of HS involve internal and external factors, including genetic susceptibility, inflammation and immunity, microorganisms, obesity, and smoking. Management of HS is difficult, and the current aim of treatment is to control the frequency and duration of disease flare-ups and improve the quality of life. Medical treatments include antibiotics, retinoids, biologics, immunosuppressive agents, and antiandrogen agents. Adjuvant treatment includes surgery, laser, and light therapy. However, the efficacy of these treatment modalities varies from person to person. In recent years, related reports have shown that injection of botulinum toxin type A has a positive effect in the management of HS. This article reviews the pathogenesis, clinical manifestations, diagnosis, and traditional treatment methods for the management of HS and investigates the use of botulinum toxin type A as a treatment option for this disease.