Pain Self-Management Strategies for Hidradenitis Suppurativa Patients: An In-Person Survey Study.

Background: Pain is an undermanaged symptom of hidradenitis suppurativa (HS). Relatively few studies have investigated at-home pain management measures HS patients use, the efficacy of these measures, and how they may correlate with disease severity.

Objectives: The objective of this study is to survey pain management strategies used by HS patients and evaluate their efficacy.

Methods: We conducted a survey study on patients with HS from April 2023 to April 2024 at the Hidradenitis Suppurativa Clinic at Thomas Jefferson University Hospital (Philadelphia, PA). We measured the usage of certain pain management options in the past year for HS patients and asked patients to rank their pain relief from each measure on a Likert scale. We also recorded the clinically determined Hurley stage for HS severity to study correlations between the Hurley stage and pain management methods used/efficacy.

Results: Surveyed patients (n = 63) indicated a preference for over-the-counter (OTC) and topical pain management measures. For higher Hurley stages, rates of cannabis or prescription pain management usage were higher. Patients with Hurley stage III reported significantly greater relief from prescription opioid and non-opioid medications when compared to oral OTC medications; however, the degree of relief was considerably less than that obtained by patients with milder disease.

Conclusion: Pain management can be challenging for HS patients, especially among those with higher disease severity. Of note, altered pain pathways in HS could contribute to the reduced effect of pain relief methods in more severe stages.