Study: Laser Therapy Shows Success in HS Management for Skin of Color

Fractional ablative CO₂ laser therapy (AFCL) significantly improved hidradenitis suppurativa (HS) outcomes among patients with skin of color, according to a new retrospective study presented at the 2025 American Society for Laser Medicine and Surgery (ASLMS) Annual Meeting in Orlando. 

Researchers conducted a chart review of 24 patients treated at MedStar Washington Hospital Center between November 2017 and October 2024. The study population was predominantly Black (95.8%) with a mean age of 38.9 years. Patients had extensive histories of medical and surgical management for HS, including prior excision surgeries, incision and drainage procedures, and biologic therapy.

Patients were treated first with a Lumenis M22 IPL device, targeting bacterial bioburden, followed by AFCL using a deep FX handpiece. The average number of laser sessions per patient was 2.5, with a total of 60 procedures performed across common HS sites (groin, perineum, buttocks, and axillae).

Following treatment, 91.67% of patients reported decreased flareups and positive improvements in symptoms. Two patients did not experience benefits: one required surgical excision shortly after laser treatment, while another developed painful boils post-procedure. Overall, laser therapy was well-tolerated, even among patients with complex HS histories. Patients comorbidities included obesity (66.7%), psychiatric illness (54.17%), anemia (50%), and asthma (50%). Prior to laser therapy, most had received oral antibiotics such as doxycycline (54.17%) and clindamycin (29.17%), topical treatments, or biologic therapies including adalimumab (45.83%).

"The results of our study suggest a high prevalence of psychiatric illness like anxiety and depression amongst HS patients with advanced disease recalcitrant to pharmacologic therapy," the authors wrote. "This result emphasizes the need for implementing self-report PHQ-9 and GAD-7 depression and anxiety screening tools at medical office visits to better identify HS patients who may be in need of appropriate psychiatric services."

The authors also called for greater use of standardized outcome measures, including Scar Scale Scores and Dermatology Life Quality Index (DLQI) questionnaires, to objectively track treatment progress, as well as the need for additional research focusing on HS treatment among Black patients.

"HS is a complex and challenging condition that has many psychosocial implications. Laser therapy offers a promising, novel approach to HS," they concluded.

Source: Garg K, Carney B, Tejiram S, et al. FRACTIONAL Fractional CO2 laser therapy for hidradenitis suppurativa in patients with skin of color. Presented at: American Society for Laser Medicine and Surgery (ASLMS) Annual Meeting; April 24-26, 2025; Orlando.