Naturopathic Knowledge and Approaches to Managing Hidradenitis Suppurativa: A Cross-Sectional Survey of Australian...

Hidradenitis suppurativa (HS) is a chronic autoinflammatory skin condition that significantly impacts quality of life and causes comorbidities. Current clinical guidelines focus on antibiotic and biological therapies, which face limitations in efficacy, access, and concerns with antibiotic resistance. This has led patients to seek complementary and alternative medicine (CAM) treatments, often without the guidance of CAM practitioners. Moreover, there is also a significant gap in assessing treatment efficacy of CAM practitioners for HS through validated measures and mental health support in routine care. This is the first Australian survey on the naturopathic treatment of HS.

A cross-sectional survey was conducted in July 2025 targeting Australian naturopaths. The self-administered, anonymous, 36-item questionnaire investigated the knowledge, treatment strategies, referral practices, and treatment efficacy of naturopaths treating HS.

Of 29 respondents, most were female (n = 28,96.6%) and held a bachelor's degree (n = 18, 62.1%). Half had treated HS clinically, primarily via nutritional/dietary modification (n = 12, 92.3%), customized herbal formulations (n = 9, 69.2%), and lifestyle counseling (n = 9, 69.2%). Systemic inflammation (n = 12, 92.3%) and wound healing (n = 10, 76.9%) were the highest priority treatment aims. Interdisciplinary referrals for general practitioners (n = 7, 77.7%) and acupuncturists (n = 5, 55.5%) were frequent, but rarely reciprocal. Treatment efficacy was tracked mainly by patient self-report (n = 12, 92.3%) and clinical observation (n = 7, 53.8%), with no use of validated patient-reported outcome measures (PROMs).

A percentage of Australian naturopaths demonstrated substantial awareness and engagement with HS management, emphasizing individualized care through systemic inflammation reduction, wound healing, and targeted nutritional and herbal medicine interventions. Their approaches align with current understanding of HS pathophysiology and patient needs, but notable gaps remain in incorporating validated PROMs and integrating mental health support as a treatment priority. Further research into whole systems naturopathic practices will strengthen the evidence base and enhance multidisciplinary care for patients with HS.