GLP-1 Medications and Hidradenitis Suppurativa: What the Evidence Actually Shows

GLP-1 medications have changed the treatment of obesity and type 2 diabetes. Now they are attracting serious attention in hidradenitis suppurativa (HS) research. Studies involving semaglutideSemaglutide: A GLP-1 receptor agonist marketed as Ozempic® (approved for type 2 diabetes) and as Wegovy® (approved for weight management in defined patient groups) — the same active molecule, different approved uses. Observational studies and a small 2026 prospective study report Acne Inversa improvement during semaglutide treatment; neither approval covers Acne Inversa as an indication.SemaglutideA GLP-1 receptor agonist marketed as Ozempic® (approved for type 2 diabetes) and as Wegovy® (approved for weight management in defined patient groups) — the same active molecule, different approved uses. Observational studies and a small 2026 prospective study report Acne Inversa improvement during semaglutide treatment; neither approval covers Acne Inversa as an indication.Read more in the glossary and related GLP-1 receptor agonistsGLP-1 Receptor Agonist: A drug class (including semaglutide and tirzepatide) that mimics or amplifies signaling through the glucagon-like peptide-1 receptor, affecting appetite, insulin secretion, blood glucose, and body weight. Approved for type 2 diabetes and, for some products, weight management. A June 2026 systematic review found a positive but still heterogeneous signal for Acne Inversa improvement associated with this drug class; no HS indication exists.GLP-1 Receptor AgonistA drug class (including semaglutide and tirzepatide) that mimics or amplifies signaling through the glucagon-like peptide-1 receptor, affecting appetite, insulin secretion, blood glucose, and body weight. Approved for type 2 diabetes and, for some products, weight management. A June 2026 systematic review found a positive but still heterogeneous signal for Acne Inversa improvement associated with this drug class; no HS indication exists.Read more in the glossary have reported improvements in HS lesions, pain, quality of life and inflammatory markers, and a large systematic review published in June 2026 pulled that evidence together for the first time.

That does not mean Ozempic, Wegovy or another GLP-1 medicine is now a proven treatment for HS. This guide explains what changed in 2026, what the studies actually show, and what people with HS should know before treating GLP-1 medications as a new HS therapy. It sits alongside our article on weight reduction and realistic expectations, which answers a related but different question — whether losing weight helps HS. This guide is about the medications themselves.

Educational content only. This article summarizes published research. It does not recommend starting, stopping or changing any medication, and it is not a substitute for advice from your own healthcare team.

Key takeaways

• GLP-1 receptor agonists are established medicines for conditions such as type 2 diabetes and, for some products, weight management — not for HS.
• A June 2026 systematic review of 19 studies covering 67,568 patients found a consistent signal of HS improvement associated with GLP-1 treatment.
• A smaller, prospective 2026 study of 20 people with HS and obesity found several improvements that persisted after adjusting for weight change — a possible weight-independent effect.
• The evidence remains heterogeneous, mostly observational, and cannot yet separate weight-dependent from weight-independent effects.
• GLP-1 drugs are not currently authorized in the EU specifically to treat HS.

What are GLP-1 receptor agonists?

GLP-1 stands for glucagon-like peptide-1. GLP-1 receptor agonists mimic or amplify signaling through this pathway, affecting appetite, insulin secretion, blood glucose and body weight.

Semaglutide is the active ingredient in both Ozempic and Wegovy, but the two brands have different authorized uses in Europe: Ozempic is authorized for type 2 diabetes, and Wegovy for weight management in defined patient groups. TirzepatideTirzepatide: A dual GIP and GLP-1 receptor agonist, marketed as Mounjaro®, approved for type 2 diabetes and weight management under defined conditions. Early reports suggest a possible Acne Inversa benefit, but the HS-specific evidence base is smaller and less developed than for semaglutide. No HS indication.TirzepatideA dual GIP and GLP-1 receptor agonist, marketed as Mounjaro®, approved for type 2 diabetes and weight management under defined conditions. Early reports suggest a possible Acne Inversa benefit, but the HS-specific evidence base is smaller and less developed than for semaglutide. No HS indication.Read more in the glossary, sold as Mounjaro, acts on both the GIP and GLP-1 pathways and is authorized for diabetes and weight management under specified conditions. None of these medicines is currently authorized by the EMA specifically for hidradenitis suppurativa.

Because Ozempic and Wegovy share the same active ingredient but different labels, this guide generally uses the generic name semaglutide when discussing research, and specifies the brand only when a particular study evaluated that specific product.

Why are researchers interested in GLP-1 drugs for HS?

Three overlapping reasons drive the research interest.

Obesity is common in HS. Obesity and metabolic dysfunction occur frequently in HS populations and are linked to greater disease burden in observational studies. Weight reduction can improve HS in some people, though responses vary and HS occurs at every body weight — a medicine that produces substantial weight loss could plausibly improve HS indirectly through that route.

Reduced friction may help in some areas. Where weight loss reduces skin-fold friction or mechanical stress, that may ease management of particular HS-affected areas. This mechanism cannot explain all HS improvement, since HS also occurs in people without overweight or obesity.

GLP-1 signaling may influence inflammation directly. GLP-1 receptor agonists have metabolic and immunological effects that extend beyond weight loss. Researchers are investigating whether they might modify inflammatory signaling relevant to HS — a hypothesis that has become more credible through 2026, though it remains a hypothesis rather than an established mechanism.

What did the 2026 systematic review find?

A systematic review published 15 June 2026 in the American Journal of Clinical DermatologyDermatology: The medical specialty concerned with diagnosing and treating skin conditions. Acne Inversa is often managed by dermatologists, although surgery and other specialties may also be involved.DermatologyThe medical specialty concerned with diagnosing and treating skin conditions. Acne Inversa is often managed by dermatologists, although surgery and other specialties may also be involved.Read more in the glossary searched the HS literature on GLP-1 receptor agonists and pooled 19 studies covering 67,568 patients.

• HS severity: 60% of patients were reported as improving by Hurley stageHurley Stage: A clinical classification system for assessing the severity of Acne Inversa in three stages: Stage I (single abscesses without sinus tracts), Stage II (recurrent abscesses with isolated sinus tracts), Stage III (extensive sinus tracts and scarring across an entire region). Named after Dr. Helen Hurley.Hurley StageA clinical classification system for assessing the severity of Acne Inversa in three stages: Stage I (single abscesses without sinus tracts), Stage II (recurrent abscesses with isolated sinus tracts), Stage III (extensive sinus tracts and scarring across an entire region). Named after Dr. Helen Hurley.Read more in the glossary (95% CI 52–67%).
• Quality of life: the average DLQIDLQI (Dermatology Life Quality Index): A standardized ten-question questionnaire that measures how much a skin condition has affected a person's quality of life over the past seven days. Used in clinical trials and consultations to evaluate treatment outcomes.DLQI (Dermatology Life Quality Index)A standardized ten-question questionnaire that measures how much a skin condition has affected a person's quality of life over the past seven days. Used in clinical trials and consultations to evaluate treatment outcomes.Read more in the glossary score improved by 3.83 points.
• Inflammation: average CRP fell by roughly 1.35 mg/L.
• Metabolic health: HbA1c also improved, as expected for a metabolic medication.
• Healthcare use: some larger real-world datasets reported lower antibiotic use, corticosteroid use and hospitalization; results for surgery, biologicBiologic: A class of medications derived from living cells that target specific components of the inflammatory process. For Acne Inversa, biologics such as adalimumab and secukinumab are used when other treatments are insufficient.BiologicA class of medications derived from living cells that target specific components of the inflammatory process. For Acne Inversa, biologics such as adalimumab and secukinumab are used when other treatments are insufficient.Read more in the glossary use and cardiovascular outcomes were less consistent.

These are genuinely encouraging numbers. They come with an important caveat, explained below.

Why “60% improved” needs a caveat

A pooled figure from 19 different, mostly observational studies is not the same as a response rate from one randomized controlled trial with a placeboPlacebo: An inactive substance, usually identical in appearance to the real drug, used in clinical trials to control for the meaningful placebo response in Acne Inversa.PlaceboAn inactive substance, usually identical in appearance to the real drug, used in clinical trials to control for the meaningful placebo response in Acne Inversa.Read more in the glossary or standard-care comparison group. The 19 studies differ in who was studied, which GLP-1 drug was used, how long follow-up lasted, and how “improvement” was defined. The review’s own authors describe the evidence base as heterogeneous.

So the accurate statement is that 60% improvement was reported across the pooled published evidence so far — not that GLP-1 medications have a 60% response rate for HS. The second version implies a level of certainty the current evidence does not support.

What did the prospective semaglutide study show?

A separate prospective study published earlier in 2026 followed 20 adults with both HS and obesity through six months of semaglutide treatment. Researchers observed significant improvements in body weight, pain, quality of life, Hurley stage, depressive symptoms, and inflammatory and metabolic markers.

The notable part: several of these improvements remained statistically significant after adjusting for how much weight participants had lost — suggesting GLP-1 therapy might influence HS through mechanisms beyond weight reduction alone.

The limitations are just as important: only 20 participants, no control group, no placebo, everyone had obesity, and follow-up lasted six months. This study strengthens the weight-independent hypothesis. It does not prove it.

Weight loss, or something more direct?

Put together, these two pieces of evidence say something specific: there is now a credible signal that something beyond weight loss might be happening, and there still isn’t enough evidence to prove it. The systematic review explicitly states that current evidence cannot reliably separate weight-dependent effects from weight-independent ones — a conclusion that sits comfortably alongside the smaller study’s suggestive (not confirmatory) findings.

Earlier, smaller real-world data pointed the same direction. A retrospective chart review of 45 patients, summarized by the HS Foundation, found that more than half reported HS improvement while taking semaglutide for weight management — encouraging, but limited by its retrospective design. Current AAD patient guidance similarly notes that some people with HS taking GLP-1 medications report fewer flaresFlare: A period of acute worsening in a chronic condition. In Acne Inversa, a flare may be triggered by stress, hormonal changes, friction, or other factors and can manifest as new nodules, abscesses, or increased pain.FlareA period of acute worsening in a chronic condition. In Acne Inversa, a flare may be triggered by stress, hormonal changes, friction, or other factors and can manifest as new nodules, abscesses, or increased pain.Read more in the glossary, less drainage, less pain and improved quality of life, while stressing that the evidence remains early.

Are GLP-1 drugs approved for HS?

No. Current European authorizations rest on metabolic indications: Wegovy for weight management in defined populations, Ozempic for type 2 diabetes, and Mounjaro for diabetes and weight management under defined conditions. None lists hidradenitis suppurativa as an authorized indication. That means HS-specific use currently sits outside the approved label for every GLP-1 medicine on the market.

Should I ask for a GLP-1 medication because I have HS?

Current evidence is not strong enough to recommend starting a GLP-1 medication solely because someone has HS. The more evidence-based scenario is someone who already has an established metabolic indication — obesity or type 2 diabetes — and also has HS; there, the possibility of HS improvement may become a relevant additional factor to discuss, alongside the approved indication, individual history, expected benefits and risks.

Most of the current clinical evidence is also concentrated in people with obesity, diabetes or metabolic dysfunction. There is much less evidence for prescribing a GLP-1 medication specifically to someone with HS at a normal weight.

Can GLP-1 treatment replace biologics?

No evidence currently supports routinely replacing established HS treatment with a GLP-1 medication. For moderate-to-severe active HS, the priority remains treating the inflammatory disease directly while managing metabolic health in parallel — the same principle covered in our weight-reduction article. A GLP-1 medication may eventually prove to be a useful adjunct for selected patients; adjunct is not the same as replacement.

People in real-world practice may end up taking a GLP-1 medication and an HS biologic together when each is separately indicated. Whether a particular combination is appropriate depends on the specific drugs, the conditions being treated, medical history and other medicines — a decision for your treatment team, not something this article can settle in general terms. A useful question to raise: “If I start a GLP-1 medication for my metabolic indication, should we keep my HS therapy stable initially so we can see what changes?”

What about tirzepatide and Mounjaro?

Tirzepatide targets both the GIP and GLP-1 receptors. There are emerging HS reports involving tirzepatide, but the HS evidence base is less developed than the broader semaglutide literature included in the 2026 systematic review. Evidence for semaglutide should not be assumed to prove the same magnitude of HS effect for tirzepatide. Mounjaro is authorized in Europe for diabetes and weight management under defined circumstances, not specifically for HS.

What should I track if I already take a GLP-1 medication?

If the medication has already been prescribed for a medical indication, HS changes can be documented without turning the treatment into an experiment. Useful things to note:

• Are significant inflammatory flares becoming less frequent?
• Is pain meaningfully different?
• Do you need fewer dressings, or is there less drainage?
• Are fewer new nodulesNodule: A firm, palpable lump deep in tissue. Nodules can be painful and may progress to abscesses. They are among the typical early signs of Acne Inversa.NoduleA firm, palpable lump deep in tissue. Nodules can be painful and may progress to abscesses. They are among the typical early signs of Acne Inversa.Read more in the glossary or abscessesAbscess: An inflamed cavity or swelling containing pus or fluid. In hidradenitis suppurativa, abscesses can form as part of the inflammatory disease process and do not automatically mean that a bacterial infection is present. Secondary bacterial infection can occur and may require separate medical assessment. In Acne Inversa, abscesses occur mainly in the armpits, groin, and other skin folds.AbscessAn inflamed cavity or swelling containing pus or fluid. In hidradenitis suppurativa, abscesses can form as part of the inflammatory disease process and do not automatically mean that a bacterial infection is present. Secondary bacterial infection can occur and may require separate medical assessment. In Acne Inversa, abscesses occur mainly in the armpits, groin, and other skin folds.Read more in the glossary appearing?
• Has HS become easier to manage day to day — at work, during sleep, during exercise?
• Did any biologic, antibiotic or procedure change at the same time?

That last question matters most. If several treatments change together, it becomes difficult to know which one contributed to any improvement — or lack of one.

What this kind of tracking cannot do is establish mechanism. “I lost 15 kg and my HS improved, therefore semaglutide directly suppressed my inflammation” is a plausible-sounding conclusion that the evidence doesn’t yet support one way or the other. Nor does “my HS didn’t improve” disprove a population-level effect — individual response doesn’t establish (or rule out) efficacy on its own.

Side effects worth knowing about

Most GLP-1 side effects are not HS-specific, but some are practically relevant for someone who already manages a skin-fold disease. Current AAD guidance notes injection-site irritation, hair thinning, dry skin, excessive sweating, and skin-fold problems associated with loose skin after substantial weight loss as possible effects. Large weight loss can create new skin folds in some people — meaning weight loss is not mechanically simple for HS: fewer adipose-related factors may help in some areas, while new redundant skin folds may create friction or moisture problems in others. This article doesn’t attempt to reproduce a full safety label; check the official product information for whichever medication you are prescribed, and raise anything that concerns you with your prescriber.

What the evidence does not yet prove

To be explicit about the limits: current evidence does not establish that GLP-1 drugs are approved HS treatments, that everyone with HS should receive one, that HS improvement is independent of weight loss, that semaglutide works the way an HS biologic does, that GLP-1 treatment can replace biologic or surgical therapy, that normal-weight patients with HS benefit similarly, that tirzepatide has exactly the same HS effect as semaglutide, or that the pooled “60% improvement” figure represents a randomized-trial response rate.

The bottom line

GLP-1 receptor agonists have moved from an interesting HS hypothesis to a credible emerging clinical signal. The June 2026 systematic review found consistent enough improvement across published data to take the subject seriously, and the prospective semaglutide study strengthens the possibility that some benefit may extend beyond weight loss alone. Neither establishes GLP-1 medicines as standard HS treatment.

The strongest current, honest conclusion: for people with HS who already have an appropriate metabolic indication for a GLP-1 medication, improvement in HS may be an additional potential benefit worth monitoring. Whether GLP-1 drugs should eventually become HS treatments in their own right remains an open research question.

What we don’t know / limitations

• Most of the underlying evidence is observational rather than from randomized controlled trials designed to test HS outcomes.
• The relative contribution of weight loss versus a possible direct anti-inflammatory effect is not yet resolved.
• Evidence is concentrated in people with obesity or diabetes; there is little dedicated evidence for normal-weight HS patients.
• Tirzepatide-specific HS evidence lags behind semaglutide.
• Regulatory status can change; check current EMA product information for the medication you are considering.

Important: decisions belong in clinician conversations

This article is an editorial summary of published research, reviewed against current EMA product information as of August 2026, and is not a personalized treatment recommendation. Bring questions raised here to your dermatologist, GP or endocrinology team rather than acting on them alone.