GLP-1 Medications and HS: What the 2026 Systematic Review Actually Found

If you have HS and have heard people talking about OzempicSemaglutide: 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, Wegovy or MounjaroTirzepatide: 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, you’ve probably wondered whether these medications actually do anything for hidradenitis suppurativa itself, or whether the buzz is just about weight loss. In June 2026, the strongest piece of evidence yet on this question was published: a systematic review pooling 19 studies and 67,568 patients.

This article walks through what that review actually found, in plain language, including the parts that are genuinely encouraging and the parts that are still very uncertain. It is not a recommendation to start, stop or change any medication.

Educational content only. This article summarizes published research. It is not medical advice and does not recommend for or against any specific medication. Decisions about GLP-1 medications and HS treatment should be made with your own healthcare team.

Key takeaways

• 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 pooled 19 studies covering 67,568 people with HS who were also using 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 (the drug class that includes semaglutide and tirzepatide).
• Across the pooled evidence, 60% of patients showed improvement in 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, quality-of-life scores (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) improved by an average of 3.83 points, and inflammatory and metabolic markers improved too.
• This is a summary of mostly observational and real-world data, not a large randomized controlled trial — the review’s authors describe the evidence itself as heterogeneous.
• The review could not determine how much of the improvement came from weight loss versus a possible direct effect of the drugs on inflammation.
• GLP-1 medications are not currently authorized specifically to treat HS in Europe; their approved uses are for type 2 diabetes and weight management.

What the review actually did

A systematic review doesn’t run a new experiment. It searches the published literature for every relevant study on a topic, checks each one against quality criteria, and then combines the results to look for an overall pattern.

For this review, the authors (Visan and colleagues) searched for studies on GLP-1 receptor agonists — a class of medications that includes semaglutide (the active ingredient in Ozempic and Wegovy) and tirzepatide (Mounjaro) — in people with hidradenitis suppurativa. They identified 19 studies, together covering 67,568 patients, and pooled the results.

That’s a large number of patients on paper. It’s worth remembering what “pooled” means here: those 19 studies used different designs, different patient groups, different follow-up lengths and different ways of measuring HS. Combining them gives a useful overall signal, but it is a different kind of evidence than one large trial run the same way for everyone.

What the review found

Four results stand out from the pooled analysis.

HS severity. 60% of patients were reported as improving by Hurley stage, with a 95% confidence interval of 52% to 67%. Hurley staging is the standard way dermatologists classify how advanced HS is, from isolated 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 (stage I) to widespread interconnected tracts and scarring (stage III).

Quality of life. The average DLQI (Dermatology Life Quality Index) score improved by 3.83 points. DLQI is a widely used questionnaire that captures how much a skin condition affects daily life — work, relationships, sleep, and more.

Inflammation and metabolic markers. C-reactive protein (CRP), a common blood marker of inflammation, fell by an average of about 1.35 mg/L. HbA1c, a marker of blood sugar control, also improved — which is expected, since these are metabolic medications.

Healthcare use. Some of the larger real-world datasets included in the review reported lower rates of antibiotic use, corticosteroid use and hospitalization among patients on GLP-1 medications. 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 across the included studies.

Why “60% improved” needs a caveat

It’s tempting to read “60% improved” as “GLP-1 drugs work in 6 out of 10 people with HS.” That’s not quite what the number means.

A pooled figure from 19 different observational studies is not the same as a response rate measured in one controlled trial where a treatment group is compared directly against 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 group. The 19 studies combined here differ in who was studied, how long they were followed, which GLP-1 drug they used, and how “improvement” was defined. The review’s own authors describe the overall evidence base as heterogeneous — meaning genuinely mixed and not fully comparable study to study.

So the accurate statement is: “60% improvement was reported across the pooled published evidence so far.” The less accurate statement — and the one this article is deliberately avoiding — is: “GLP-1 medications have a 60% response rate for HS.” The second version implies a level of certainty the current evidence doesn’t yet support.

The open question: weight loss, or something more direct?

This is the part of the story researchers care about most, because it decides what happens next.

GLP-1 medications produce substantial weight loss in many people. Obesity and HS frequently occur together, and weight reduction is already known to help HS in some patients — through less friction and moisture in skin folds, and through reduced systemic inflammation associated with excess adipose tissue. So it’s entirely plausible that GLP-1 drugs help HS simply by helping people lose weight.

But there’s a second possibility. GLP-1 receptor signaling has effects on the body that go beyond appetite and weight — including some effects on inflammatory pathways. A separate, smaller prospective study of 20 adults with HS and obesity, published earlier in 2026, found that several improvements (in pain, quality of life and inflammatory markers) remained statistically significant even after researchers adjusted for how much weight participants had lost. That keeps the idea of a direct, weight-independent effect plausible.

The June 2026 systematic review looked at this question directly and concluded that, with the evidence available so far, it cannot reliably separate weight-dependent effects from weight-independent ones. Both of these findings can be true at once: there is a credible signal that something beyond weight loss might be happening, and there still isn’t enough evidence to prove it.

What this doesn’t tell us

A few things worth being explicit about, because they’re easy to assume by accident:

• It doesn’t prove that GLP-1 drugs are an approved or standard HS treatment. They aren’t. In Europe, Wegovy is authorized for weight management, Ozempic for type 2 diabetes, and Mounjaro for diabetes and weight management — none currently lists HS as an indication.
• It doesn’t tell us that everyone with HS would benefit. Most of the underlying studies involved people who had obesity, diabetes, or both — not the full range of people who live with HS, including those at a normal weight.
• It doesn’t establish that tirzepatide (Mounjaro) works the same way as semaglutide for HS. The evidence base is not equally developed across every drug in this class.
• It doesn’t mean GLP-1 medication can replace biologics or other established HS therapy. Nothing in the review supports delaying or stopping effective HS treatment in favor of a GLP-1 medication.

What this could mean for you

If you already take a GLP-1 medication for an approved reason — type 2 diabetes or weight management — and you also have HS, it’s reasonable to keep an eye on how your HS behaves and mention it at your next appointment. Useful things to notice include flareFlare: 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 frequency, pain, drainage, and how many new lesions appear, alongside whatever else changed around the same time (a new biologic, an antibiotic course, a change in weight).

If you don’t currently have a medical reason to take a GLP-1 medication, this review isn’t evidence for starting one specifically to treat HS. That’s a different, much less well-supported question than the one the study actually answers.

Either way, this is a conversation for your dermatologist or GP, not something to decide from a research summary alone.

What we don’t know / limitations

• Most of the 19 pooled studies were observational (real-world data, retrospective chart reviews, cohort studies) rather than randomized controlled trials.
• The review cannot separate the contribution of weight loss from a possible direct effect on inflammation.
• Results for surgery, biologic use, and cardiovascular outcomes were inconsistent across the included studies.
• The evidence is concentrated in people who already had obesity or type 2 diabetes; it says much less about people with HS at a normal weight.
• This article is a summary of one review’s publicly available abstract, methods and results — not a full independent re-analysis of the underlying data.

Important: decisions belong in clinician conversations

This article is an editorial summary of published research and is not a personalized treatment recommendation. If this raises questions for you, bring them to your dermatologist or GP — this is exactly the kind of finding worth discussing at your next appointment rather than acting on alone.

Sources

• Visan MA et al. A Systematic Review of the Clinical Impact of GLP-1 Receptor Agonists in Hidradenitis Suppurativa. American Journal of Clinical Dermatology, published 15 June 2026. PubMed, PMID 42295612 · full text
• Nicolau J et al. Semaglutide in patients with hidradenitis suppurativa and obesity. Medicina Clínica, 2026;166(5):107405. PubMed, PMID 41832804
• American Academy of Dermatology. GLP-1 drugs and skin.
• European Medicines Agency. Wegovy — EPAR; Ozempic — EPAR.