Health Equity in Hidradenitis Suppurativa: Addressing Care Disparities

EP: 1.Recognizing Hidradenitis Suppurativa: From First Signs to an Accurate Diagnosis

EP: 2.Hidden in Plain Sight: Strategies to Improve Early Identification of Hidradenitis Suppurativa

EP: 3.The Pharmacist Advantage: Bridging Gaps in Hidradenitis Suppurativa Care

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EP: 4.Health Equity in Hidradenitis Suppurativa: Addressing Care Disparities

Disparities in the diagnosis and management of hidradenitis suppurativa (HS) are heavily influenced by factors such as race, gender, geography, and socioeconomic status. Patients living in urban areas with access to specialists are far more likely to be diagnosed early and receive effective treatment. In contrast, those in rural areas or under-resourced communities often face significant barriers—including lack of transportation, limited specialist availability, and insurance challenges. Individuals from historically marginalized populations, particularly those on Medicaid or uninsured, frequently delay care due to cost concerns or difficulty navigating the health care system. These disparities contribute to prolonged suffering and delayed access to effective interventions.

HS disproportionately affects women, with a female-to-male ratio of approximately 3:1, especially in early and moderate stages. However, the disease appears to progress more severely in male patients, narrowing that gender gap over time. Racial disparities are also notable, with African American individuals experiencing a significantly higher prevalence and often more severe disease progression. Cultural perceptions, mistrust of the health care system, and generational normalization of symptoms—such as viewing recurrent boils as hereditary or inevitable—further compound delayed diagnosis. For many immigrant families or people of color, financial constraints and a fear of medical costs often prevent them from seeking timely evaluation and treatment.

Efforts to reduce these disparities must include expanding access through telehealth, patient assistance programs, and culturally competent education. Community engagement is also vital—pharmacists, nurses, and primary care providers can serve as trusted first points of contact, helping to empower patients and dispel misconceptions about the disease. Highlighting that HS is treatable and not something one must endure is a key message. Encouraging early medical attention not only benefits individual patients but can create ripple effects through families and communities, improving awareness, early detection, and health outcomes across generations.