{"id":940,"date":"2026-05-20T10:54:45","date_gmt":"2026-05-20T10:54:45","guid":{"rendered":"https:\/\/www.mirascare.com\/blogs\/?p=940"},"modified":"2026-05-20T10:54:45","modified_gmt":"2026-05-20T10:54:45","slug":"hidradenitis-suppurativa-latest-treatment-guidelines-expert-care-in-gurgaon-delhincr","status":"publish","type":"post","link":"https:\/\/www.mirascare.com\/blogs\/hidradenitis-suppurativa-latest-treatment-guidelines-expert-care-in-gurgaon-delhincr\/","title":{"rendered":"Understanding Hidradenitis Suppurativa: Latest Treatment Guidelines &amp; Expert Care at Mirascare Clinic, Gurgaon"},"content":{"rendered":"\n<p><em>A comprehensive look at the 2024\u20132025 European &amp; North American clinical guidelines for Hidradenitis Suppurativa, and how Dr. Mir Asif Rehman at Mirascare Clinic is bringing world-class surgical expertise to patients across Delhi NCR.<\/em><\/p>\n\n\n\n<p><\/p>\n\n\n\n<p><strong><a href=\"https:\/\/www.mirascare.com\/hidradenitis-suppurativa-treatment\">Hidradenitis suppurativa<\/a><\/strong> \u2014 known in medical literature as <strong>HS or acne inversa<\/strong> \u2014 is one of the most under-diagnosed and poorly understood chronic skin conditions of our time. Affecting approximately<strong> 1% <\/strong>of the global population, it causes painful nodules, abscesses, and sinus tracts in areas where skin surfaces meet, including the armpits, groin, perianal region, and beneath the breasts. Yet despite its prevalence and devastating impact on quality of life, many patients spend years without a correct diagnosis.<\/p>\n\n\n\n<p>The good news is that <strong>2024<\/strong> and<strong> 2025 <\/strong>have brought a landmark revision to how the medical community classifies, evaluates, and treats HS. Both the European Academy of <strong>Dermatology and Venereology (EADV)<\/strong> and the North American Hidradenitis Suppurativa Foundation have issued updated guidelines that completely overhaul prior thinking \u2014 incorporating newly approved biologics, refined surgical approaches, and critical guidance for special patient populations.<\/p>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td><em>&#8220;<\/em><mark style=\"background-color:#7bdcb5\" class=\"has-inline-color\"><em>Validation of new therapeutic approaches has almost completely overhauled the knowledge in the field of hidradenitis suppurativa treatment since the prior guidelines were published.&#8221;<\/em>\u2014 European S2k Guidelines, JEADV, December 2024<\/mark><\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>What is Hidradenitis Suppurativa?<\/strong><\/h2>\n\n\n\n<p>HS is a chronic, recurrent inflammatory disease of intertriginous skin \u2014 those body areas where two skin surfaces touch and create friction. It involves the apocrine sweat glands and hair follicles, beginning typically as a deep folliculitis that expands over time. The armpits, inner thighs, groin, buttocks, and perineum are most commonly affected.<\/p>\n\n\n\n<p>The causes are not fully known, but several factors are implicated: bacterial infections (staphylococci or streptococci), trapped sweat in hair follicles, hormonal changes, smoking, and obesity. Crucially, HS is not contagious, nor is it caused by poor hygiene \u2014 a misconception that causes significant psychological harm to patients.<\/p>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td><strong>Important: Long-term Risk<\/strong> In rare circumstances, particularly if left untreated for prolonged periods, HS can raise the risk of several cancers \u2014 including cutaneous squamous cell carcinoma (SCC) arising from chronic lesion sites, as well as hematologic malignancies and other solid tumors. Early, consistent treatment is essential.<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>How HS is Classified Today<\/strong><\/h2>\n\n\n\n<p>The 2025 European S2k Guidelines introduced a dual classification system that replaces the older one-dimensional approach. Clinicians now distinguish between:<\/p>\n\n\n\n<p><strong>The Inflammatory Form: <\/strong>Graded as mild, moderate, or severe using the IHS4 (International Hidradenitis Suppurativa Severity Score System) \u2014 a validated tool that counts nodules, abscesses, and draining tunnels to produce a numeric score guiding treatment intensity.<\/p>\n\n\n\n<p><strong>The Predominantly Non-Inflammatory Form: <\/strong>Assessed using the classic Hurley Staging System (Stages I, II, and III), which evaluates the extent of scarring, sinus tract formation, and skin destruction \u2014 particularly relevant for surgical planning.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>The 2024\u20132025 Treatment Algorithm<\/strong><\/h2>\n\n\n\n<p>The most significant development in the updated guidelines is the tiered, multimodal treatment algorithm \u2014 matching therapeutic intensity to disease severity, and emphasising a combination of medical and surgical approaches as the gold standard of holistic care.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>STAGE-BY-STAGE TREATMENT APPROACH<\/strong><\/h3>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td><strong>Mild \u00b7 Hurley Stage I<\/strong>First-Line Medical Therapy<\/td><td><strong>Moderate \u00b7 Hurley Stage II<\/strong>Combination Systemic Therapy<\/td><td><strong>Severe \u00b7 Hurley Stage III<\/strong>Advanced Biologic &amp; Surgical<\/td><\/tr><tr><td>Topical clindamycin 1%<\/td><td>Clindamycin + rifampicin<\/td><td>Secukinumab (EMA-approved)<\/td><\/tr><tr><td>Topical resorcinol 15%<\/td><td>IV clindamycin (short-term)<\/td><td>Bimekizumab (EMA-approved)<\/td><\/tr><tr><td>Oral tetracyclines<\/td><td>Retinoids (acitretin)<\/td><td>Infliximab (off-label)<\/td><\/tr><tr><td>Spironolactone (women)<\/td><td>Dapsone<\/td><td>Adjunct corticosteroids<\/td><\/tr><tr><td>Finasteride (men)<\/td><td>Intralesional steroids<\/td><td>Wide surgical excision<\/td><\/tr><tr><td>Oral contraceptives<\/td><td>Adalimumab (EMA-approved)<\/td><td>Advanced laser surgery<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>NEWLY APPROVED BIOLOGICS<\/strong><\/h3>\n\n\n\n<p>Perhaps the most clinically impactful development in recent years is the approval of two new biologic agents for moderate-to-severe HS, adding to the existing armamentarium of adalimumab (approved since 2015):<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Secukinumab <\/strong>\u2014 an IL-17A inhibitor that demonstrated strong efficacy and safety in real-world settings for moderate-to-severe HS.<\/li>\n\n\n\n<li><strong>Bimekizumab <\/strong>\u2014 a dual IL-17A\/IL-17F inhibitor showing significant results in the landmark BE HEARD I and BE HEARD II Phase 3 trials (The Lancet, 2024), with rapid onset and sustained disease control.<\/li>\n<\/ul>\n\n\n\n<p>These approvals mean clinicians now have three distinct biologic pathways \u2014 each with different mechanisms of action \u2014 to offer patients who do not respond to initial medical management.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>THE SURGICAL DIMENSION<\/strong><\/h3>\n\n\n\n<p>The updated guidelines firmly establish that surgery is not a last resort \u2014 it is a core component of comprehensive HS care. While biologics and systemic therapies control active inflammation, they cannot reverse the scarring, sinus tract formation, and irreversible tissue destruction that severe HS causes. The combination of ongoing medical therapy with well-timed surgical intervention is now recognised as the most effective holistic approach.<\/p>\n\n\n\n<p>Surgical techniques range from incision and drainage (for acute abscesses) and deroofing of sinus tracts, to wide local excision in advanced <strong>Hurley Stage III disease<\/strong>. At specialised centres, advanced laser techniques have emerged as a minimally invasive, high-precision alternative \u2014 offering near-painless procedures with rapid recovery.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>LIFESTYLE MODIFICATIONS &amp; COMORBIDITY SCREENING<\/strong><\/h3>\n\n\n\n<p>Comprehensive care includes screening for metabolic syndrome, diabetes, hypertension, depression, anxiety, inflammatory bowel disease, and inflammatory arthropathy \u2014 all of which occur at elevated rates in HS patients. Weight loss, smoking cessation, and avoiding tight clothing are key lifestyle interventions that significantly modify disease course.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>SPECIAL PATIENT POPULATIONS<\/strong><\/h3>\n\n\n\n<p>For the first time, dedicated North American clinical guidelines now exist for HS management in seven special populations: pregnancy, breastfeeding, paediatrics, active malignancy, tuberculosis infection, hepatitis B or C infection, and HIV disease \u2014 filling a critical gap in evidence-based care for patients frequently excluded from clinical trials.<\/p>\n\n\n\n<p>\u00b7 \u00b7 \u00b7<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Expert hidradenitis suppurativa Care in Delhi NCR: Mirascare Clinic<\/strong><\/h2>\n\n\n\n<p>For patients across Delhi, Gurgaon, and the wider NCR region, accessing a surgeon with specialised expertise in hidradenitis suppurativa \u2014 and equipped with the latest laser technology \u2014 has historically been a challenge. Mirascare Multispeciality Clinic, founded and led by <strong><a href=\"https:\/\/www.mirascare.com\/dr-mir-asif-rehman\">Dr. Mir Asif Rehman<\/a><\/strong>, has changed that equation.<\/p>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td><strong>Mirascare Multispeciality Clinic<\/strong><\/td><\/tr><tr><td><strong>Services Offered<\/strong> : Advanced Laser HS Surgery (1470 nm diode, 15W) Advanced Laser Piles Treatment (Stapled Hemorrhoidopexy) Complex Fistula Surgeries, Advanced 3D Laparoscopic Hernia Surgery,  Single Incision Laparoscopic Surgery (SILS) \u2014 Gallbladder, Bariatric \/ Weight Loss Surgery, Lipoma Removal, Fundoplication Surgery, Abscess Drainage &amp; Wound Care<br><br><strong>Contact<\/strong> -Phone: +91 8882 521 281 \u00a0 | \u00a0 Web: www.mirascare.com<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>About Dr. Mir Asif Rehman<\/strong><\/h2>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td><strong>Dr. Mir Asif Rehman &#8211; DNB General Surgeon\u00a0 \u00b7\u00a0 Laparoscopic Surgeon\u00a0 \u00b7\u00a0 Proctologist<\/strong> <br><br>Dr. Mir Asif Rehman is the founder and lead surgeon at Mirascare Clinic, widely regarded as one of the foremost laparoscopic surgeons and proctologists in the Delhi NCR region. He has undergone extensive international training in advanced laser surgical techniques and has successfully treated thousands of patients across a wide spectrum of surgical conditions. His approach is defined by a commitment to minimally invasive methods \u2014 minimising patient discomfort, reducing recovery times, and delivering world-class outcomes in a compassionate, patient-centred environment.<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>HIDRADENITIS SUPPURATIVA LASER TREATMENT AT MIRASCARE<\/strong><\/h3>\n\n\n\n<p>For HS patients, Mirascare offers one of the most advanced laser surgical pathways available in North India. Using the 1470 nm diode laser system at 15W \u2014 the same technology used in leading international centres \u2014 Dr. Mir Asif performs precise, minimally invasive excision and deroofing of HS lesions with significantly less trauma than conventional open surgery.<\/p>\n\n\n\n<p><strong>Key advantages of the laser approach at Mirascare:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Almost painless procedure with no major incisions<\/li>\n\n\n\n<li>Very few post-operative complications<\/li>\n\n\n\n<li>Significantly faster return to daily activities<\/li>\n\n\n\n<li>High precision especially valuable in sensitive intertriginous areas<\/li>\n\n\n\n<li>Active patient counselling on lifestyle factors and comorbidity management<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td><strong><em>&#8220;The longer HS is left untreated, the greater the risk of permanent scarring, damage to surrounding structures, and \u2014 in rare cases \u2014 malignant transformation. Patients deserve early, accurate diagnosis and access to the most advanced treatment available.&#8221;<\/em>\u2014 Dr. Mir Asif Rehman, Mirascare Clinic, Gurgaon<\/strong><\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>When to Seek Specialist Care<\/strong><\/h2>\n\n\n\n<p>If you have been experiencing recurring painful lumps, abscesses, or draining wounds in the armpit, groin, buttocks, or thigh areas \u2014 especially if these have persisted for more than three months or have recurred in the same locations \u2014 you should seek evaluation from a specialist experienced in HS.<\/p>\n\n\n\n<p>HS is frequently misdiagnosed as simple boils, carbuncles, or skin infections, leading to years of ineffective treatment. A specialist assessment, including clinical examination and appropriate scoring using the IHS4 or Hurley staging systems, will determine the right treatment pathway \u2014 medical, surgical, or combined \u2014 for your specific condition.<\/p>\n\n\n\n<p>At Mirascare Clinic in Gurgaon, Dr. Mir Asif Rehman offers precisely this expertise: an accurate diagnosis, a clear explanation of your disease stage, and access to the full spectrum of 2024\u20132025 guideline-aligned treatments, including advanced laser surgery.<\/p>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td><strong>Medical Disclaimer<\/strong>This article is for informational and educational purposes only. It does not constitute medical advice and should not replace a consultation with a qualified healthcare professional. Treatment decisions for Hidradenitis Suppurativa must be made on an individual basis by a licensed physician.<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p>Source&nbsp;<\/p>\n\n\n\n<figure class=\"wp-block-embed\"><div class=\"wp-block-embed__wrapper\">\nhttps:\/\/pubmed.ncbi.nlm.nih.gov\/39699926\n<\/div><\/figure>\n\n\n\n<p><a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jdv.20472\" target=\"_blank\" rel=\"noopener\">https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jdv.20472<\/a><br><\/p>\n","protected":false},"excerpt":{"rendered":"<p>A comprehensive look at the 2024\u20132025 European &amp; North American clinical guidelines for Hidradenitis Suppurativa, and how Dr. Mir Asif Rehman at Mirascare Clinic is bringing world-class surgical expertise to patients across Delhi NCR. Hidradenitis suppurativa \u2014 known in medical literature as HS or acne inversa \u2014 is one of the most under-diagnosed and poorly 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