Advances in Laser Therapy for Hidradenitis Suppurativa: A Systematic Assessment of Current Evidence.

Background

Hidradenitis suppurativa (HS) is a chronic, recurrent skin disease that significantly impairs patients' quality of life both physically and mentally. It often requires a complex treatment process. Laser therapy, which is highly effective and well-tolerated, is an effective alternative to pharmacological treatment. This review aimed to synthesize information on laser therapy for HS, highlighting its clinical outcomes. In the current management guidelines for hidradenitis suppurativa, laser therapy is listed as one of the recommended procedural treatment options, applicable at different stages of disease severity (Hurley I-III). Methodology: This systematic review was conducted using the PubMed and Embase databases, regardless of publication year, in accordance with the PRISMA guidelines. Applied key search terms were: "laser AND (hidradenitis suppurativa OR acne inversa)". A total of 26 relevant studies were identified, and their data were extracted.

Results

The CO2 laser is mainly used in advanced stages of the disease (Hurley II-III). It allows effective removal of lesions with a minimal risk of relapse and a good aesthetic effect. The Nd:YAG (neodymium-doped yttrium aluminum garnet; Nd: Y3Al5O12) laser is effective at various stages of the disease (Hurley I-III) by reducing inflammation and destroying hair follicles, thereby reducing disease symptoms. IPL (intense-pulse light) therapy, or the combination of IPL with radiofrequency (RF), known as LAight®, delivers significant clinical improvement and enhanced quality of life, especially in less advanced cases. The diode laser works precisely and deeply, leading to the selective destruction of hair follicles and fistulas. The Alexandrite laser (755 nm) also limits hair follicle occlusion and is particularly effective in patients with lighter skin phototypes.

Conclusions

In modern dermatology, laser therapy is a reliable treatment for HS, contributing to effective regression of the disease at all stages. Combination strategies seem to improve clinical outcomes and enable a more personalized approach to HS, which is essential as various factors influence therapeutic efficacy. Further, larger-scale studies are needed to validate long-term outcomes and establish clinical guidelines.