What the New European HS Guideline (2026) Means for You: 6 Changes at a Glance Canonical URL: https://www.acneinversa.life/en/blog/hs-2026-guideline-overview/ Markdown URL: https://www.acneinversa.life/en/blog/hs-2026-guideline-overview.md Plain text URL: https://www.acneinversa.life/en/blog/hs-2026-guideline-overview.txt Language: en Category: Research Published: 2026-09-12 Last updated: 2026-09-12 Last editorially reviewed: 2026-09-12 Next scheduled review: 2027-09-12 Evidence strength: Moderate evidence — Backed by consistent observational studies or smaller trials. Author: Dr. rer. nat. Dennis Alexander Kwiatkowski (Biochemist, Scientific Writer and Pharma Expert) Scientific editor: Dr. rer. nat. Dennis Alexander Kwiatkowski Reviewer qualifications: Biochemist, Scientific Writer and Pharma Expert Review scope: Scientific literature, clinical guidelines, sources, and editorial clarity Clinical reviewer: No independent clinical review Tags: Acne Inversa, Hidradenitis Suppurativa, HS, Research, S2k guideline, guideline 2026, comorbidities, severity The European S2k guideline for HS/acne inversa (Part 1, 2026) substantially updates the predecessor guideline from 2015. An overview of six changes with direct relevance to patients, with links to the detailed article on each. Medical disclaimer: This website is for general educational information only and does not replace medical advice, diagnosis, or treatment. Please speak with qualified medical professionals about symptoms or treatment decisions. 60-second summary - The European S2k guideline for HS/acne inversa (Part 1, 2026) updates the predecessor guideline from 2015, substantially expanding diagnosis, severity assessment and comorbidities. - Six changes directly affect patients: severity scoring, comorbidity screening, heart health, the definition of a flare, care for teenagers, and what matters beyond lesion count. - This article briefly orients each change and links to the detailed article on it. - None of these points replaces an individual clinical assessment. What this means: You don't need to read the guideline yourself to benefit from it — this overview and the linked articles translate the relevant parts into something you can actually use at your next appointment. What we are less certain about: This overview focuses on the points with the most immediate relevance to patients and is not a complete summary of the entire guideline. What you can do next: Pick whichever point below matches your current situation and read the linked article for it. Article In August 2026, the European Hidradenitis Suppurativa Foundation published the first part of a new guideline for HS (acne inversa) — a substantial update to the predecessor guideline from 2015. According to PubMed, the authors describe the expansion themselves this way: "The expansion of the guideline is evident and signifies a major leap forward in HS management" (DOI (https://doi.org/10.1111/jdv.70638)). The biggest change isn't a single new test. It's a considerably broader view of what a good HS assessment should include — beyond lesion count alone. This article summarizes six changes with direct relevance to patients, and links to the detailed article on each one. It's deliberately not a full guideline excerpt — it's an orientation for where to read further if a point matches your situation. For information only. This overview explains a guideline update for patients. It does not diagnose anything and does not replace an individual clinical assessment. 01 — Hurley stage alone is no longer enough Classic Hurley staging describes structural changes (tunnels, scarring) in one body region — but not current inflammatory activity. The guideline update additionally recommends the IHS4 score, which counts nodules, abscesses and draining tunnels, because classic Hurley is too static for tracking treatment response. → Hurley Stages vs IHS4: What Your HS Severity Score Actually Means (/en/blog/hs-hurley-stages-ihs4/) 02 — HS is more than a skin disease The new guideline assigns several comorbidity areas — including mental health, cardiovascular risk, diabetes/metabolic health, joints, gut, and psoriasis — an explicit recommendation about assessment timing for the first time, rather than just naming them as associations. → HS Beyond the Skin: What Health Checks Should You Discuss With Your Doctor? (/en/blog/hs-comorbidity-screening-guide/) 03 — Heart health deserves a recurring check Within that broader comorbidity framework, cardiovascular risk gets an especially concrete recommendation: assessment at the first visit and then at least annually. → HS and Heart Health: Why the New European Guideline Recommends Cardiovascular Checks (/en/blog/hs-cardiovascular-checks-guide/) 04 — A flare now has a shared working definition "Flare" has been used very inconsistently in HS research for years. The new guideline sets out a working definition for the first time: a new or substantial worsening of signs or symptoms. → What Actually Counts as an HS Flare? (/en/blog/hs-flare-definition-guide/) 05 — Teenagers need their own diagnostic attention The guideline devotes a dedicated section to children and adolescents for the first time. HS can start during puberty and is often recognised later in this age group than in adults — not because it's rarer, but because it's more easily mistaken for ordinary puberty skin. → HS in Teenagers: Can Hidradenitis Suppurativa Start During Puberty? (/en/blog/hs-teens-recognizing-early-onset/) 06 — Your severity score isn't your whole disease Beyond any single score, the guideline explicitly refers to a broader, internationally agreed framework: six domains that together give a fuller picture than any single number — pain, physical signs, quality of life, global assessment, disease course, and symptoms beyond pain. → Your HS Is More Than a Lesion Count (/en/blog/hs-outcome-domains-guide/) What these six points have in common Each of these points makes the same underlying claim in its own way: a single number, a single test, or a single lesion only partially describes your disease. The new guideline gathers that into a considerably broader, multidimensional framework — severity, comorbidities, disease course, patient experience — instead of leaving it at a lesion count. In practice, that means an appointment focused entirely on lesions or a single score doesn't automatically cover everything that matters about your disease. The articles linked above give you concrete wording to raise what otherwise easily gets missed. The bottom line The new European S2k guideline is no substitute for your individual care, but it describes how good HS assessment has changed in 2026: broader, more multidimensional, and more explicit about what matters beyond the skin. Pick whichever of the six points above matches your current situation, and bring it to your next appointment. FAQ What's the difference between the 2015 S1 guideline and the new S2k guideline? Both are guidelines from the European Hidradenitis Suppurativa Foundation. The 2015 S1 level rested on a simpler expert consensus; the new S2k level (Part 1, 2026) rests on a structured consensus from a larger expert panel via a Delphi process, with substantially expanded chapters on diagnosis, severity assessment and comorbidities. The authors themselves describe the expansion as a significant step forward from 2015. Do I need to read the guideline myself? No. Guidelines like this are written primarily for clinicians and are correspondingly technical. This overview and the linked articles translate the parts with direct relevance to patients into a more accessible form, while pointing to the original source for anyone who wants to read it anyway. Does this guideline change my treatment immediately? Not automatically. Guidelines like this are aimed at clinicians and provide consensus-based orientation — how quickly and in what form that shows up in your individual care is decided by your clinician. This overview can help you raise the topic specifically, but it doesn't make a treatment decision for you. Does this article cover everything in the new guideline? No, deliberately not. The guideline covers many further topics for clinicians, including detailed diagnostic criteria, imaging procedures, and a full account of epidemiology. This overview deliberately focuses on the points with the most immediate practical relevance to patients. References 1. Jemec GBE, Villumsen B, van Straalen KR, et al. European S2k guidelines for hidradenitis suppurativa/acne inversa Part 1. Epidemiology, diagnosis and clinical assessment. - Journal of the European Academy of Dermatology and Venereology, 2026 - https://doi.org/10.1111/jdv.70638 2. Zouboulis CC, Desai N, Emtestam L, et al. European S1 guideline for the treatment of hidradenitis suppurativa/acne inversa. - Journal of the European Academy of Dermatology and Venereology, 2015 - https://doi.org/10.1111/jdv.12966