Advances in the Treatment of Acne Inversa/Hidradenitis Suppurativa: A Narrative Review

Hidradenitis suppurativa (HS), also known as acne inversa, is a chronic inflammatory skin disorder characterized by recurrent inflammatory nodules, abscesses, sinus tracts (tunnels), and hypertrophic scarring. The condition often causes significant psychological distress and markedly reduces quality of life. Although its pathogenesis remains incompletely understood, multiple contributing factors—including genetic predisposition, immune dysregulation, hormonal influences, and lifestyle factors—have been implicated. The disease’s recurrence, complexity, and poorly defined pathogenesis make effective treatment particularly challenging. While lifestyle modifications, weight loss, smoking cessation, topical therapies, and oral antibiotics may be effective in mild cases, moderate-to-severe HS remains difficult to manage. This narrative review summarizes recent advances in therapeutic strategies for HS based on published literature and clinical trials. Our goal is to update clinicians on current treatment developments and support improved disease management to enhance the quality of life for individuals affected by HS.