Largest Prospective Study of CO ₂ Laser Treatment in Hidradenitis Suppurativa Patients Showing Improved Quality of Life

ABSTRACT Background Hidradenitis suppurativa (HS) can be a difficult disease to manage, especially in patients with prominent disease. CO 2 laser can be used for the treatment of recurrent HS lesions with or without simultaneous systemic treatment. There is a lack of evidence for the validity of CO 2 laser treatment as well as the rate of complications. Objectives Our study aimed to evaluate CO 2 laser treatment on multiple aspects, including patient‐reported outcomes such as quality of life before and after treatment, complications and recurrence of HS in CO 2 laser‐treated areas. Methods The study was performed as a prospective cohort study focusing on patient‐reported outcomes. We collected preoperative interviews before CO 2 laser treatment with follow‐up at approximately Week 2, 6 and 12 post‐procedure. Fifty‐three patients were successfully included. Results CO 2 laser treatment resulted in a significantly improved quality of life in both ΔDLQI 3.5 (1.6−5.4 95% CI, p < 0.0002) and ΔHiSQOL 7.1 (3.1−11.1 95% CI, p < 0.006) when comparing baseline data with data 12 weeks post‐procedure. We observed a low risk of infection (5.8%) as well as a low risk of severe bleeding (7.7%) and sensory disturbance post‐procedure (7.7%). We found a moderate risk of recurrence of HS at the edge of the treated area (26.9%) and prolonged healing > 12 weeks (26.9%). Moreover, a higher BMI and biological treatment simultaneously with treatment appear to result in prolonged wound healing. Conclusions This study is to our knowledge one of the largest prospective study evaluating CO 2 laser treatment in HS patients and demonstrates that CO 2 laser treatment of recurrent HS elements improve quality of life in HS patients significantly. The most common complications are prolonged wound healing and recurrence of HS in the treatment edge.