British Association of Dermatologists Guidelines for the Management of Hidradenitis Suppurativa (Acne Inversa) 2018

J.R. Ingram; F. Collier; D. Brown; T. Burton; J. Burton; M.F. Chin; N. Desai; T.E.E. Goodacre; V. Piguet; A.E. Pink; L.S. Exton; M.F. Mohd Mustapa


The British Journal of Dermatology. 2019;180(5):1009-1017. 

In This Article

Purpose and Scope

The overall objective of the guideline is to provide up-to-date, evidence-based recommendations for the management of hidradenitis suppurativa (HS). The document aims to:

  • offer an appraisal of all relevant literature up to July 2018, focusing on any key developments;

  • address important, practical clinical questions relating to the primary guideline objective;

  • provide guideline recommendations and, if appropriate, research recommendations.

The guideline is presented as a detailed review with highlighted recommendations for practical use in primary care and secondary care, in addition to an updated Patient Information Leaflet [available on the British Association of Dermatologists (BAD) website,].


This guideline does not cover management of the non-HS elements of syndromes such as PASH (pyoderma gangrenosum, acne and HS) and PAPASH (pyoderma gangrenosum, acne, psoriasis, arthritis and suppurative hidradenitis). Nearly all the evidence underpinning the guideline relates to studies in adults. The guideline development group (GDG) is mindful that HS onset is often before adulthood and interventions used for adults with HS are quite often considered for young people and children. Given the paucity of high-quality evidence relating to HS in those younger than 18 years, with the exception of adalimumab being licensed for people with HS aged 12 years and above, specific recommendations about treatment in young people and children could not be included at the current time.