AAD and HS Foundation Issue First Joint Hidradenitis Suppurativa Guidelines

The American Academy of Dermatology and the Hidradenitis Suppurativa Foundation have issued their first joint guidelines of care for hidradenitis suppurativa, the two organizations announced.

This is a first. Until now, dermatologists managing HS have worked from separate guidance streams, and the absence of a unified document has been a persistent friction point in a disease that already suffers from delayed diagnosis and inconsistent treatment pathways. A joint guideline changes that baseline.

Hidradenitis suppurativa is a chronic inflammatory condition presenting with painful nodules, abscesses and sinus tracts, typically in intertriginous areas — axillae, inguinal and anogenital regions. It is one of the most commonly misdiagnosed conditions in general dermatology practice, frequently mistaken for recurrent boils or infections before the correct label arrives, often years after symptom onset.

What does the joint guideline change for practitioners?

For anyone treating HS, the practical question is straightforward: what does a single, co-signed document actually change at the bedside?

The core shift is authority and consistency. When the AAD and the HS Foundation speak with one voice, the recommendations carry weight across both the academic and patient-advocacy channels that shape referral patterns and payer conversations. Practices that have built HS protocols around older or fragmented guidance now have a single reference point to audit against.

It also matters for access. Joint guidelines from major societies are the documents payers cite when evaluating coverage for biologic therapy, surgical referral and adjunctive care in HS. A unified standard gives practices firmer ground when prior-authorization disputes arise.

Why HS needed this

HS care has long been described as fragmented. Patients rotate between dermatology, general surgery and emergency departments before landing on a coherent regimen, and treatment decisions have historically depended heavily on local expertise rather than a shared framework.

A joint guideline signals that both organizations see standardization as overdue. For a disease whose severity spans mild recurrent flares to debilitating, fistulating disease, agreed care pathways help stratify who gets stepped up to systemic therapy or surgery — and when.

What comes next

Watch for uptake in residency curricula, payer policy language and the next revision cycle. As the first document of its kind for this disease, it sets the reference standard against which future HS care — and future guideline updates from both organizations — will be measured.