Efficacy of Laser Hair Removal Therapy in HS (HaLa)

The Efficacy of Laser Hair Removal Therapy in Patients With Mild to Moderate HS, a Randomized Controlled Trial.

Hidradenitis suppurativa (HS) is a chronic, recurrent and debilitating inflammatory skin disorder, characterized by painful inflamed nodules, abscesses and tunnels in the skin folds such as the axilla, inguinal region and gluteal area. The primary event in HS is occlusion of the hair follicle. HS is a notoriously difficult to treat disease, because treatment options are limited and evidence based treatments are scarce. Prevention of diseases is an important topic in medicine. However, current clinical trials in HS are focusing on anti-inflammatory drugs in patients with severe HS, whereas prevention and treatment of patients with more common mild HS is neglected. Laser hair removal therapy is a non-invasive procedure with minimal treatment discomfort for patients. Previous limited studies have suggested positive results in favor of laser hair removal therapy in HS. We therefore hypothesize that hair depilation using laser hair removal therapy may prevent the formation of new lesions and flares of the disease. The objective is to assess the efficacy of laser hair removal therapy in patients with mild to moderate HS.

Patients will undergo 6 monthly laser hair removal treatments with de Nd:YAG laser. After 6 months, a 6 follow up will start, using clindamycin 1% lotion if needed.

IHS4 will be calculated on a monthly bases. IHS4 will be added up per visit which makes it a cumulative outcome

Change in skin related pain of the axillae, on a numerical rating scale (NRS), between baseline and month 12, and between groups.

Change in skin related itch of the axillae, on a NRS, between baseline and month 12, and between groups.

Difference in number of self-reported flares (number of flares reported by the patients in the last 4 weeks), between the two groups during this study

Difference and change in quality of life measured with the Dermatologic Life Quality Index (DLQI) between baseline and month 12 and between groups.

Difference and change in quality of life measured with the Hidradenitis Suppurativa Quality of Life score (HiSQOL), between baseline and month 12 and between groups.

Difference of average duration of a flare, reported by the patient, over month 1 to 12 between groups.

Incidence and severity of all adverse events (according to medDRA) will be analysed throughout the study.

Measured at baseline (month 1), after laser hair removal therapy (month 7) and six months after laser hair removal therapy (month 12), for the intervention group

Measured at baseline (month 1), after laser hair removal therapy (month 7) and six months after laser hair removal therapy (month 12), for the intervention group

Measured at baseline (month 1), after laser hair removal therapy (month 7) and six months after laser hair removal therapy (month 12), for the intervention group

Measured at baseline (month 1), after laser hair removal therapy (month 7) and six months after laser hair removal therapy (month 12), for the intervention group

Inclusion Criteria: IHS4 mild to moderate, without tunnels in the axillae. HS activity in at least one axilla. Age 18 years and over. Exclusion Criteria: If the patient is not able or willing to provide informed consent. If the patient is allergic to clindamycin lotion. If the patient uses systemic therapy for HS such as antibiotics or biologicals. If a patient is pregnant.