COVID-19 and Hidradenitis Suppurativa

Hidradenitis suppurativa (HS) is a chronic, painful skin condition that causes abscesses, cysts, and scarring on the skin. The lesions usually occur near hair follicles where there are sweat glands, such as in the groin, bottom, breasts, or armpits.

You may be concerned about whether having HS puts you at a higher risk of contracting COVID-19 or developing more severe symptoms. Research regarding HS, COVID-19, and related medications is ongoing as scientists continuously learn more about the disease.

People with HS often have other conditions known to negatively affect COVID-19 outcomes, such as obesity, metabolic syndrome, and cardiovascular disease.

The therapies given for HS may suppress or moderate the immune system. There are concerns that the effectiveness of the COVID-19 vaccine is diminished by higher doses of these types of medications.

This article will discuss the current evidence for how HS affects your COVID-19 risk, complications, effects of HS treatment, and how to stay safe.

Hidradenitis Suppurativa and COVID-19 Risk

HS alone is not considered a significant risk factor for getting sick with or having a more severe case of COVID-19. It is an autoinflammatory disease (which means your immune system is overactive) rather than an autoimmune disease.

HS is not considered a specific risk factor for COVID-19. But people with HS and other specific comorbidities (conditions they have at the same time) may be more at risk. HS is associated with diabetes and obesity, both of which the Centers for Disease Control and Prevention (CDC) advises can make you more likely to get severely ill from COVID-19.

HS is more prevalent among ethnic minorities. With reduced healthcare resources during the COVID-19 pandemic and data demonstrating racial and ethnic disparities in COVID-19 transmission, management, and outcomes, there may be a significant difference in the level of care received. This could lead to poorer outcomes.

Scientists are still learning about COVID-19 and its interaction with other conditions and medication. Therefore, to capture data on risks, clinical course, and outcomes of COVID‐19 in HS patients, a new global HS COVID‐19 Registry has been developed.

Complications of Hidradenitis Suppurativa and COVID-19 

Although HS is not considered a risk factor for developing severe COVID-19, the overlapping comorbidities of HS do pose a greater risk.

Obesity, cardiovascular conditions, diabetes, hypertension, metabolic syndrome, and smoking history are all comorbidities that are risk factors for developing severe COVID-19 infection.

Therefore, experts advise people with HS to exercise caution during the pandemic, follow guidelines from the CDC, and discuss an HS action plan with their healthcare professional.

Hidradenitis Suppurativa Treatments and COVID-19 

Some people with HS take treatments that affect the immune system, such as Humira (adalimumab), a biological therapy. Steroid medication or injections can also suppress the immune system. The HS Foundation advises that the biologic medicines used to treat HS suppress the immune system but don't stop it from working.

There is currently no concern about people with HS on biological therapy having the COVID-19 vaccine. However, the HS Foundation recommends that you always speak to your HS specialist team before making any medication changes or having the COVID-19 vaccine.

While the vaccine is considered safe, clinicians advise that they still do not know whether being on an immunosuppressant or biologic treatment will reduce its effectiveness. Some early clinical trials suggest that being on an immunosuppressant medication impairs vaccine-induced immunity.

A small 2021 study showed that patients on immunosuppressive therapy still developed immunity after the COVID-19 vaccine and had no considerable side effects. With trials and data collection still in the early stages, research is ongoing in this area.

If you take immunosuppressants, systemic, or biologic medication for your HS, speak to your healthcare professional about how it might affect your COVID-19 risk and vaccine response.

Frequently Asked Questions

Should I stop taking my biological medication if I want to have the COVID-19 vaccine?

You should never stop any medication without the advice and guidance of your medical team. Stopping your medication without advice can put you at risk of HS flares and worsening symptoms.

You may need to stop certain medications when having the COVID-19 vaccine. But if this is the case, you will be informed by your clinical team and monitored at every stage, and they may alter your treatment regimen at the same time.

My HS medical team offered me a video consultation rather than a face-to-face appointment. Is it worth attending?

Yes. The COVID-19 pandemic has led to an increase in telecare rather than face-to-face appointments. In many cases, your HS team can still examine specific problems, check suspicious areas on the skin, manage your ongoing HS treatment, and prescribe new medication required. 

To help manage your HS through the COVID-19 pandemic, you can speak to your healthcare professionals to develop an HS action plan. This will mean you have a plan in place explaining when your HS team is available, how to contact them, and what to do if you have an HS exacerbation.

What can I do at home to help manage my HS?

Try to maintain a healthy diet and lifestyle. If you smoke, try to stop, and if you are overweight, then make some changes to try and lose weight. Also, ensure you look after your mental health as well as your physical health. 

If you are worried that your HS requires medical attention, do not hesitate to reach out to your healthcare professional. 

How to Stay Safe

There are lifestyle changes and public health guidance that will help in managing both HS and the risk of contracting COVID-19:

• If you are obese or overweight, try to lose weight and get weight management support if you need it.
• Stop smoking if you are still smoking.
• Continue your HS medication as prescribed.
• Try to avoid HS flare-ups where possible. Wear loose-fitting clothing, avoid shaving affected skin, and avoid wearing scented products in the affected areas to help prevent flare-ups. 
• Wash your hands regularly, avoid close contact with others, and socially distance where possible. When washing your hands, wash with soap and water for at least 20 seconds. 
• If you use an antiseptic skin wash or antiseptic soap, continue to use this. 
• If soap and water are not available, use a hand sanitizer containing 60% alcohol.  
• Use a warm compress to encourage the pus to drain from the abscesses. 
• Wear a face mask as advised by the CDC and your local health authorities.
• Avoid crowded situations, unnecessary travel, and contact with unwell people.
• Practice self-monitoring.
• If someone in your home becomes unwell, follow medical advice to reduce the risk of spreading the virus both inside and outside your home.

Summary

Having hidradenitis suppurativa does not place you at greater risk of contracting COVID-19 or having a more severe course, but you may have other conditions that are of concern. There are still questions about whether biologic medications and corticosteroids can reduce the effectiveness of the COVID-19 vaccines.

A Word From Verywell

Having a condition like HS may make you feel worried during the pandemic. Follow your HS action plan and try to reduce the risk of flare-ups where possible.

If you have concerns that your HS is getting worse, contact your healthcare provider immediately for advice and support. You can also speak to them about getting the COVID-19 vaccine if you have any concerns about its interaction with your current medication. 

The information in this article is current as of the date listed. As new research becomes available, we'll update this article. For the latest on COVID-19, visit our coronavirus news page.