GLP-1 drugs and hidradenitis suppurativa

A September 2026 review in Expert Opinion on Therapeutic Targets asks whether GLP-1 receptor agonists, the drug class that includes semaglutide and tirzepatide, could work as an add-on therapy for hidradenitis suppurativa, a chronic and often painful inflammatory skin disease^[1]. The authors, a group of Danish dermatology researchers, are not proposing a new treatment. They are laying out a biological argument and calling for the randomized trials that would need to happen before anyone acts on it. This is early, exploratory science, not a recommendation to use a GLP-1 drug for hidradenitis suppurativa today.

Why a diabetes drug and a skin disease share researchers

Hidradenitis suppurativa causes recurring, painful nodules and abscesses, usually in the armpits, groin and under the breasts, and it behaves like a systemic inflammatory condition rather than a purely local skin problem. Obesity is one of its strongest known risk factors. A 2023 cross-sectional study found metabolic syndrome in 32.4% of people with hidradenitis suppurativa compared with 20.3% of people without it, a difference that held even after adjusting for other variables and appeared in lean patients too, not only in patients carrying excess weight^[2].

That overlap is the starting point for the new review. The authors describe hidradenitis suppurativa as an immunometabolic disease: dysregulated insulin signaling and abnormal adipokine (fat-tissue hormone) activity feed the same inflammatory pathways that drive the skin lesions. If obesity and inflammation are entangled that closely, a drug that treats both at once becomes a reasonable question to ask, even if the answer is not yet known^[1].

What the existing GLP-1 research on hidradenitis suppurativa shows

The new paper builds on a small but growing body of work. A 2024 systematic review found that liraglutide, an earlier GLP-1 drug, reduced lesion severity in hidradenitis suppurativa patients alongside weight loss, while cautioning that "further placebo-controlled trials are necessary to confirm its efficacy"^[3]. A larger 2026 systematic review pooled ten studies, most of them retrospective cohorts ranging from 6 to nearly 20,000 patients, and reported a mean Hurley-stage severity score (the standard clinical scale for hidradenitis suppurativa) falling from 2.6 to 1.1 among patients on a GLP-1 drug, alongside fewer flares and improved quality-of-life scores^[4].

Semaglutide was the drug used most often in that pooled data, appearing in eight of the ten studies, followed by liraglutide, dulaglutide and tirzepatide. Response rates in the 42% to 68% range were comparable to the roughly 50% response rate reported for biologic drugs already used to treat hidradenitis suppurativa. But the same review flagged that only one inflammatory marker, ultrasensitive C-reactive protein, moved in a statistically significant way, and it stated plainly that "whether patients' improvement is due to weight loss, or other mechanisms, i.e., GLP-1 agonists' anti-inflammatory properties, remains to be determined"^[4].

What this is not

GLP-1 drugs are not approved for hidradenitis suppurativa anywhere. Semaglutide's authorized indications, listed on its EMA approval documents, cover type-2 diabetes and chronic weight management in adults with obesity or overweight plus a related condition^[5]. Prescribing a GLP-1 drug specifically to treat hidradenitis suppurativa would be an off-label use, and the evidence behind it so far comes almost entirely from retrospective cohorts and small case series rather than the placebo-controlled trials that establish whether a drug actually works for a given condition, as opposed to correlating with improvement for other reasons. See our semaglutide regulation overview for how the approved indications are defined by country.

The September 2026 review's own conclusion is direct on this point: the authors write that "randomized controlled trials using well-defined dermatological and metabolic endpoints are needed before routine implementation"^[1]. That is a call for more research, not a green light. Established hidradenitis suppurativa treatments, including topical and systemic antibiotics and the biologic drugs referenced in the review above, remain the options a dermatologist would consider first.

What we don't yet know

Several open questions separate this from a settled finding. It is not clear whether any benefit comes from weight loss itself, from a direct anti-inflammatory effect of GLP-1 receptor activation, or from both acting together. Most of the supporting data are retrospective, which means the patients who received a GLP-1 drug were not randomly assigned and may differ from those who did not in ways researchers cannot fully control for. Sample sizes in the underlying case series are small, and the studies with the largest patient counts come from insurance-claims data that measures diagnosis codes rather than lesion severity directly.

If you have hidradenitis suppurativa and are also managing obesity or type-2 diabetes, this research is worth raising with your dermatologist or prescriber as a topic to watch, not a reason to seek out a GLP-1 drug on your own. The responsible next step, according to the researchers who wrote the review, is the same one that applies to most promising but early dermatology findings: run the trial before changing practice.