Hidradenitis Suppurativa - Antibiotic Prescribing

  • Recurrent abscesses and boils with sinus formation in flexural apocrine gland bearing skin e.g. axillae/groin/perineum/inframammary areas.
  • History may present as recurring ‘ingrowing hairs’, abscesses or occasionally pilonidal sinuses.
  • Refer for early dermatological assessment


  • Topical measures: Dalacin C lotion daily to affected areas.
  • Bleach baths (see eczema).
  • Treat acute abcesses with flucloxacillin 500mgs qds for 7 days
  • Consider Tetracyclines such as Tetralysal (300mgs od) or Minocycline (100mgs od)
  • Rifampicin  (300mgs bd) and Clindamycin (300mgs bd) for 10 weeks (note enzyme inducers) usually under specialist supervision.
  • Adalimumab (Humira) is licensed for the treatment of severe Hidradenitis suppurativa. 160mgs Day 1, 80mgs day 15 and 40mgs day 29, followed by weekly injections of 40mgs subcutaneously. The regimen is a higher loading dose and higher maintenance dose than in psoriasis

Reviewed June 2017