Topical and oral corticosteroids are sometimes prescribed to treat pain and inflammation from hidradenitis suppurativa (HS). But steroid use comes with side effects and is typically only recommended for short-term use.
HS is a chronic disorder that can cause painful lesions particularly where the skin rubs together, like under the armpits. Though there’s not yet a cure for HS, there are several ways to help manage the condition.
Here’s what to know about using steroids to treat HS, including potential side effects and insurance coverage options.
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The main types of steroids used to treat HS include:
- Topical: There are several creams, ointments, or gels that may be applied directly to lesions, including clobetasol and betamethasone. These are usually intended for short-term use.
- Oral: Prednisolone, methylprednisolone, and other oral steroids may also be prescribed.
- Injections: Steroids like triamcinolone, acetonide, and betamethasone can be injected directly into the affected regions. In one trial from 2017, participants experienced reduced pain after 1 day and reduced inflammation within a week of triamcinolone injections. In a 2022 review of several studies, researchers concluded that steroid injections effectively reduced lesion count, inflammation, and symptoms in most patients.
Corticosteroids for HS are generally considered to be safe in the short term. But both topical and oral steroids can cause side effects.
Some potential side effect of oral steroids include:
- weight gain
- poor sleep quality
- mood swings
risk of infection
- steroid tolerance
Topical steroid side effects may include:
- skin irritation
- thinning skin (when high concentrations are used)
Since the skin can develop tolerance to steroids over time, these treatments may become less effective over time and therefore may not be recommended for long-term use. Undesirable side effects may also rule out regular steroid use for some patients.
Cost and coverage for steroid treatments for HS may vary widely. Topical steroids tend to cost less, even out of pocket. Oral and injectables will generally be more expensive.
Most insurance plans in the United States will partially or fully cover corticosteroids when medically necessary, especially generic varieties.
For those who lack insurance and can’t afford their medications in the United States, RxAssist has options. You can also find out if you obtain Medicaid or other support in your state at benefits.gov.
Since every case is distinct and research is still ongoing, experts still remain unsure about the best treatment for HS.
However, doctors typically recommend only using antibiotics and steroids in the short term to avoid unwanted side effects. Oral antibiotics like prednisone are specifically only recommended
There’s also some less concrete evidence to support light therapy for HS, especially when combined with steroids.
In very severe HS cases, surgery may be the most effective option to remove painful lesions. Talking with your doctor can help you determine the most ideal treatment for your specific condition.
Steroids may be recommended in the short term to reduce pain and inflammation caused by HS. However, side effects and steroid resistance may prevent long-term use.
Other treatment options for HS include antibiotics, light therapy, and surgery. Although there’s not yet a cure for HS, you and your doctor can find a treatment plan to help you live more fully and well. If you lack access to medical care, you have options.