In 2015 the FDA approved Humira (adalimumab) for the treatment of hidradenitis suppurativa. This condition usually presents in adolescence as painful draining boils in the armpits and inner thigh. Doctors are not certain what causes hidradenitis, but the condition may result from a problem with the apocrine glands, which are concentrated under the skin of the armpits and inner thigh area.
Adalimumab is the only FDA approved treatment for hidradenitis. It works by suppressing the immune reaction taking place within the painful boils. Adalimumab is administered at home by subcutaneous injection once a week. It takes a few weeks to kick in, but is not fully functional for six months. Patients may stay on adalimumab for years if they tolerate it.
Adalimumab works by suppressing the immune system, thereby increasing your risk for infections. You therefore need a test before starting treatment to make sure tuberculosis is not hiding anywhere inside your body. The immunosuppressive nature of adalimumab also makes it unsafe to receive live vaccines during therapy. Before you start treatment, your doctor should administer any live vaccines you may need in the foreseeable future.
Patients have other treatment options for hidradenitis. For example, painful areas are often drained and cultured to rule out an infection. Early lesions are injected with a corticosteroid called triamcinalone to reduce redness, swelling, and pain, and to decrease the likelihood that they will drain out. Other treatments available for hidradenitis include oral antibiotics (clindamycin and rifampin), infliximab infusions, and monthly treatments with an ND-YAG laser. Finally, excising the affected skin can afford long-lasting relief in some patients.