A clear new guide for this painful skin disease backs four biologic drugs

If you live with painful lumps that keep coming back in your armpits or groin, there is good news. Doctors now have a clear, written guide for treating this skin disease, and it gives you real things to ask about.

The skin disease is called hidradenitis suppurativa, or HS. New US guidelines strongly recommend four biologic drugs and say your pain should be checked as a routine part of care. So you can walk into your next appointment and ask your doctor about biologics by name.

How the study worked

These are joint guidelines from the American Academy of Dermatology and the Hidradenitis Suppurativa Foundation, published Oct. 20, 2026, in the Journal of the American Academy of Dermatology. A workgroup reviewed the research in a systematic way, rated how strong the evidence was, and turned it into 37 recommendations, built on the best evidence available today.

What is HS?

HS is a long-lasting skin disease. It causes painful lumps, abscesses and tunnels under the skin, usually in the armpits, groin and under the breasts. It affects between 0.7% and 1.5% of people worldwide, and it can change daily life in a big way. It is often missed or treated like a simple infection, which is why a clear guide matters.

What they found

The guidelines make 37 recommendations. Some are “strong,” which means the experts are confident the benefits clearly outweigh the downsides for most people. Strong recommendations go to:

• Four biologic drugs: adalimumab, bimekizumab, infliximab and secukinumab.
• Routine pain assessment, so your pain is asked about and taken seriously at your visits.

Biologics are medicines made from living cells that target the parts of your immune system driving the inflammation.

Other “conditional” recommendations mean an option can fit some people, depending on their situation. The list is long, which gives you and your doctor plenty to work with:

Notice the last row. Quitting tobacco, supportive pain care and fixing low vitamin D are all part of the recommended care, and they are things you can start on your own.

Why does a guide like this help you?

When experts agree on what works, care gets easier to ask for. You no longer have to guess which treatments to bring up. A strong recommendation for routine pain checks also means your pain counts as part of the disease, not as an afterthought.

What you can do today

Get ready for your next visit with a simple note on your phone. Write down where the lumps show up, how much they hurt, and snap a photo during a flare. Then ask your dermatologist, “Could a biologic be an option for me?” If you don’t have a dermatologist yet, mention HS when you book so the right person sees you.