A Narrative Review of Local Therapies in Hidradenitis Suppurativa: Treatment Landscape and Current Issues

Hidradenitis suppurativa (HS) is an insidious, chronic inflammatory skin disease, leading to a negative impact on a patient's quality of life and a poor prognosis. The pathogenesis of HS is complex and multifaceted including genetic, sex hormones, smoking, obesity, and immune dysregulation as the main contributing factors to the development of the disease. HS is challenging to treat and a multimodal approach, combining topical treatment, systemic therapy, and lifestyle modifications, is a strongly recommended strategy to manage the disease. Regular skin care, topical therapy, and intralesional intervention are the mainstay of the management in HS as monotherapy in mild disease, and in combination with systemic antibiotic or immunomodulatory agents in moderate-to-severe HS. The main aim of this review is to examine local therapeutic interventions that are currently available and under investigation for the treatment of HS.