Exploring the Off-label Use of Botulinum Toxin in Hidradenitis Suppurativa

Abstract

Hidradenitis suppurativa (HS) is a therapeutic challenge despite various treatment modalities. This review explores the potential of botulinum toxin, both type A (BTX-A) and type B (BTX-B), as an off-label intervention for hidradenitis suppurativa management. Hidradenitis suppurativa, characterized by inflammatory lesions and abscesses, often leads to chronic pain and poor quality of life. Conventional therapies offer limited sustained relief, prompting exploration into alternative treatments. Existing research, although primarily consisting of case reports and a limited randomized controlled trial, suggests potential benefits of botulinum toxin in alleviating HS symptoms. Observations include improvements in dermatology life quality index (DLQI), pain reduction, and lesion regression following botulinum toxin administration. However, these findings lack uniformity in dosing and demographic representation, necessitating further robust investigations encompassing diverse populations. While initial findings hint at the promise of botulinum toxin as a potential therapeutic avenue for HS, the current evidence base is mainly anecdotal. Large-scale controlled trials across diverse demographics are crucial to substantiate efficacy, establish standardized treatment protocols, and evaluate the safety profile for broader application in managing this challenging condition.