Treating Hidradenitis Suppurativa with GLP-1 Drugs (Ozempic, Wegovy): A Scientist’s Look at the Hope and the Hype

My name is Jaap, and I am a biomedical scientist that also used to live with severe Hidradenitis Suppurativa, the kind that takes over your life. Today, I am completely asymptomatic because I learned how to heal Hidradenitis Suppurativa from within. More importantly, I’ve had the privilege of helping many other individuals with HS get their lives back, too.

Introduction

If you’re living with Hidradenitis Suppurativa (HS), you know the heavy burden it carries. Beyond the painful lesions, there’s often a struggle with weight, metabolic health, and the feeling that your body is working against you. It’s no surprise, then, that the recent buzz around weight-loss medications like Ozempic, Wegovy, and Mounjaro, known scientifically as GLP-1 receptor agonists (GLP-1 RAs), has caught the attention of our community. Could these drugs, celebrated for their impact on diabetes and obesity, be a missing piece in the puzzle of how to treat Hidradenitis Suppurativa?

The connection makes sense on the surface. We know HS is deeply intertwined with obesity and metabolic dysfunction. As research by Vilarrasa and colleagues highlights, the chronic low-grade inflammation underlying both HS and obesity creates a vicious cycle, potentially making HS progress to more severe forms. So, if a drug can help manage weight and maybe even calm inflammation, could it offer real relief for HS?

Several recent studies and reports have started exploring this very question. Today, we’ll dive into the science together. We’ll look at what GLP-1 agonists are, the evidence for their use in HS, the potential risks and limitations, and how this all fits into the bigger picture of finding a true, lasting path to remission, the path we champion at HS Arma.

Understanding GLP-1 Receptor Agonists: More Than Just Weight Loss?

First, what exactly are these medications? GLP-1 is a natural hormone our gut releases after eating. It signals the pancreas to release insulin (helping control blood sugar), slows down how quickly the stomach empties (making you feel full longer), and tells your brain you’ve had enough to eat (reducing appetite). Drugs like liraglutide (Saxenda, Victoza), semaglutide (Ozempic, Wegovy, Rybelsus), dulaglutide (Trulicity), and tirzepatide (Mounjaro, Zepbound – which also targets GIP receptors) are synthetic versions designed to last longer in the body.

Their success in managing type 2 diabetes and promoting significant weight loss is well-documented. Research reviewed by Vilarrasa and colleagues shows weight loss of up to 15% or more, levels previously achievable mainly through surgery. They are generally approved for individuals with a BMI of 30+ or 27+ with weight-related comorbidities.

But the potential interest for HS goes beyond just weight reduction. Some research, like the systematic review by Persson and colleagues, suggests GLP-1 RAs might also have direct anti-inflammatory effects. Studies in psoriasis, another inflammatory skin disease linked to metabolic issues, show these drugs can sometimes improve skin lesions, possibly by reducing inflammatory signals like TNF-alpha and IL-17, even independent of weight loss. As Krajewski and colleagues note in their review, this suppression of key inflammatory pathways involved in HS (like TNF-α, IL-17, and NF-κB) is a major reason for investigating their potential in our condition.

The Emerging Evidence: GLP-1 Agonists and HS Symptoms

So, what does the research specifically looking at GLP-1 RAs and HS tell us? It’s still early days, mostly consisting of case reports, small observational studies, and patient surveys, but the initial findings are intriguing¹⁴.

• Patient-Reported Improvements: A recent survey study by Gupta and colleagues provides some of the most direct patient insights. They surveyed 22 HS patients using GLP-1 RAs (semaglutide, tirzepatide, dulaglutide, or liraglutide), mostly prescribed for weight loss or diabetes. While about 32% reported no change, a encouraging 68% saw improvement in their HS-specific health. Many reported fewer flares (62%), fewer new lesions (67%), less pain (52%), reduced drainage (62%), less itch (48%), and decreased odor (43%). Importantly, almost 60% felt HS impacted their daily activities less, and a similar number would recommend these drugs to other HS patients. Participants who lost weight reported losing an average of 31 pounds.

• Observational Studies & Case Reports: Several smaller studies echo these findings. Lyons and colleagues, in a retrospective study cited by Krajewski et al. and Strong & Driscoll, looked at 30 HS patients on semaglutide. They found significant improvements in quality of life (DLQI scores) and fewer patient-reported flares, alongside weight loss, even at doses lower than typically used for weight management. Similarly, a prospective study by Nicolau and colleagues on liraglutide (3mg) showed improvements in Hurley stage, DLQI, and depression scores in 14 HS patients. Case reports mentioned by various sources describe individuals experiencing reduced flares, decreased need for other medications, and significant lesion improvement with liraglutide, semaglutide, or tirzepatide.

• The Role of Dose: A recent letter by Posada Posada and colleagues described a retrospective study of 45 HS patients on semaglutide. While 60% (27 patients) improved, the amount of weight loss at 6 and 12 months wasn’t significantly different between those who improved and those who didn’t. However, they did find that higher doses of semaglutide at 3, 6, and 12 months were significantly associated with improvement.

This growing body of evidence, reviewed systematically by Krajewski and colleagues, suggests GLP-1 RAs like liraglutide and semaglutide can lead to significant reductions in weight and systemic inflammation, translating to improved lesion severity and quality of life for some HS patients.

The Smoke Alarm vs. The Fire: Limitations, Risks, and the Knowledge Gap

While these early results offer hope, we must approach them with scientific caution and a critical eye. This is where we encounter the “knowledge gap”, the difference between managing symptoms and addressing the root cause.

• Limited High-Quality Evidence: As Gu and Sebaratnam point out, the evidence supporting GLP-1 RAs specifically for HS is currently very limited, mainly relying on case reports and small studies without control groups. Many studies, like the one by Gupta et al., also involve patients on multiple other HS treatments, making it hard to isolate the effect of the GLP-1 RA itself. We desperately need larger, randomized controlled trials (RCTs) to confirm these findings.

• Significant Side Effects: These are potent medications with real side effects.
  • The most common are gastrointestinal issues like nausea, vomiting, diarrhea, and constipation, especially when starting or increasing the dose. While often transient, they can be severe enough for people to stop treatment.
  • More serious, though rarer, risks mentioned by Gu et al. and Persson et al. include pancreatitis, gallbladder disease, gastroparesis (stomach paralysis), and bowel obstruction.
  • Persson and colleagues also note potential links to immune-mediated skin reactions (like bullous pemphigoid) and aesthetic concerns like facial volume loss (“Ozempic Face”) due to rapid weight loss. And, rapid weight loss without attention to nutrition and exercise can also lead to muscle loss!

• Ethical Concerns: The surging popularity of these drugs for weight loss has led to significant shortages, impacting patients who rely on them for managing type 2 diabetes³⁸. Prescribing them off-label for HS, where the evidence is still emerging, could worsen this access issue.

• Silencing the Alarm, Not Extinguishing the Fire: This is the core of the HS Arma philosophy. GLP-1 RAs are a prime example of a powerful tool that addresses the consequences of an underlying imbalance but not necessarily the cause. They target the smoke (excess weight, maybe some inflammation) but not the fire (the root drivers of metabolic dysfunction and immune dysregulation). Taking these drugs might lead to eating less, but it doesn’t automatically mean eating healthier. You can lose weight on Ozempic while still consuming inflammatory foods that fuel the underlying HS fire and deprive your body of the nutrients needed for repair. This research suggests GLP-1 RAs might be a valuable adjunctive therapy, as proposed by Henry et al., Strong & Driscoll, and Krajewski et al., a helpful addition alongside foundational changes, but not a replacement for them.

---

Naturally Nudging GLP-1: Your Body’s Built-In Solution

While these GLP-1 RA drugs offer a potential tool by essentially mimicking a natural process, what if we could encourage our own bodies to optimize this system naturally, achieving similar benefits like better satiety and metabolic balance without the risks, costs, and potential side effects? This is where the HS Arma philosophy truly shines, moving beyond symptom management to address the root cause, empowering your body’s innate intelligence.

The exciting truth is that GLP-1 secretion isn’t just a random event; it’s directly influenced by the foods we eat and how we live. Think about it: GLP-1 is naturally released by your gut in response to nutrients. By making strategic choices, we can push this system back into balance.

---

Beyond Calories: The Nutrient Satiety Connection

This brings us to a critical point often missed in conventional weight-loss discussions: satiety isn’t just about feeling physically full or restricting calories. It’s profoundly linked to nutrient density. You can eat a large volume of processed, calorie-dense but nutrient-poor food and still feel unsatisfied an hour later. Why? Because your body isn’t just counting calories; it’s craving the essential vitamins, minerals, and other nutrients it needs to function and repair.

When you consistently feed your body nutrient-dense whole foods, the cornerstone of the HS Arma approach, you satisfy these deeper biological needs. This leads to a more natural and sustainable feeling of fullness and helps regulate appetite without relying on a drug to do it for you. Your body stops screaming for more because it’s finally getting what it truly needs.

---

The Superiority of the Natural Path

Choosing to support your body’s natural GLP-1 production and balance offers profound advantages over pharmaceutical intervention:

• No Side Effects: The gastrointestinal distress, potential pancreatitis risk, muscle loss concerns, or Ozempic face associated with GLP-1 RAs are completely bypassed. You’re working with your body, not overriding it.
• Sustainable Balance: When you achieve metabolic balance and weight management through foundational diet and lifestyle changes, it’s a real, sustainable state. Unlike stopping a drug, which can lead to rebound weight gain or symptom recurrence because the underlying imbalance was never fixed, the natural approach creates lasting health resilience.
• Holistic Healing: Eating nutrient-dense, anti-inflammatory foods doesn’t just influence GLP-1. It provides the essential building blocks for tissue repair, supports a healthy gut microbiome (which is crucial in HS!), reduces systemic inflammation (the “fire”!), and boosts overall vitality. You’re not just managing weight; you’re fundamentally healing your body from the inside out.

While GLP-1 RAs might offer a helpful temporary shield for some, especially to break cycles of severe metabolic dysfunction, they cannot replace the foundational work. The HS Arma approach empowers you to tap into your body’s own incredible systems for balance and healing, offering a path that is not only effective but also inherently safer and more sustainable in the long run.

---

The HS Arma Approach: Building Health from the Foundation Up

This brings us back to our core message. While the development of GLP-1 RAs and other targeted therapies is exciting and offers valuable tools (temporary shields), true, sustainable healing for HS comes from addressing the root cause.

At HS Arma, we reverse the conventional model. We don’t see lifestyle as an optional add-on; we see it as the primary, non-negotiable foundation. We focus on:

• Foundational Nutrition: Identifying your personal inflammatory food triggers and nourishing your body with nutrient-dense, anti-inflammatory foods. This naturally supports metabolic balance, helps manage weight sustainably, and provides the building blocks your body needs to heal.
• Strategic Lifestyle Changes: Mastering stress management, optimizing sleep, incorporating appropriate movement, and reducing environmental toxin exposure, all crucial for calming systemic inflammation.
• Natural Therapies & Skincare: Using targeted, science-backed natural compounds and supplements to support immune balance and skin health from the inside out and outside in.
• Community & Support: Recognizing that this journey requires support, guidance, and accountability.

This research on GLP-1 RAs doesn’t contradict our approach; it highlights why it’s so essential. When even powerful weight-loss drugs only help a portion of patients or come with significant trade-offs, it underscores the need to address the why behind the weight and inflammation. Building a strong foundation of health makes your body more resilient, potentially making these powerful drugs less necessary or even entirely unnecessary over time.

Key Takeaways

• Promising Potential: Early research suggests GLP-1 receptor agonists (like Ozempic, Wegovy, Saxenda, Mounjaro) may improve HS symptoms for some patients, likely through weight loss and possibly direct anti-inflammatory effects.
• Obesity Link: Given the strong association between HS, obesity, and metabolic syndrome, GLP-1 RAs are a logical area of investigation.
• Not a Magic Bullet: Evidence is still limited (mostly small studies, patient reports), improvement isn’t universal, and these drugs carry significant side effects and risks.
• Root Cause Matters Most: GLP-1 RAs address consequences (weight, some inflammation) but not the fundamental drivers. A natural, foundational approach focusing on diet, lifestyle, and targeted natural therapies remains key for lasting remission.
• Adjunctive Role: These drugs might best serve as a helpful tool alongside foundational changes for certain patients, rather than a standalone solution.

Conclusion: Empowering Your Healing Journey

The science around GLP-1 agonists and HS is evolving rapidly, offering potential new avenues for relief. It’s exciting to see research acknowledging the systemic nature of HS and exploring treatments that address related conditions like obesity.

However, let’s use this knowledge wisely. Instead of waiting for the next blockbuster drug, let’s focus on the incredible power we already have: the power to influence our health from the inside out. Understanding the limitations of even our best pharmaceuticals reinforces the critical importance of foundational healing.

Can you cure HS? We know that achieving deep, sustainable remission is absolutely possible. It requires looking beyond the smoke alarms and addressing the source of the fire. By building your HS Arma through targeted nutrition, lifestyle changes, and natural therapies, you give your body the best chance to find balance and heal for good.

Read here the difference between the pharmaceutical route and the natural route: Heal HS naturally!

References

1. Persson, C., Eaton, A., & Mayrovitz, H.N. (2025). A Closer Look at the Dermatological Profile of GLP-1 Agonists. Diseases, 13(5), 127. https://doi.org/10.3390/diseases13050127 [Source Document 5]
2. Posada Posada, M.I., Alora, M.B., & Lima, X.T.V. (2025). Impact of semaglutide use in obese and diabetic patients with hidradenitis suppurativa. Journal of the European Academy of Dermatology and Venereology, 39(8), e662-e664. https://doi.org/10.1111/jdv.20392 [Source Document 8]
3. Gu, Y., & Sebaratnam, D.F. (2024). GLP-1 receptor agonists for hidradenitis suppurativa: Navigating benefits, risks, and ethical considerations. International Journal of Dermatology, 63(5), e100-e101. https://doi.org/10.1111/ijd.17108 [Source Document 4]
4. Vilarrasa, E., Nicolau, J., de la Cueva, P., Goday, A., Gallardo, F., Martorell-Calatayud, A., & Carrascosa, J.M. (2024). Glucagon-Like Peptide-1 Agonists for Treating Obesity in Patients With Immune-Mediated Skin Diseases. Actas Dermo-Sifiliográficas, 115(1), T56-T65. https://doi.org/10.1016/j.ad.2023.10.019 [Source Document 3]
5. Strong, J., & Driscoll, M.S. (2025). Obesity in Hidradenitis Suppurativa: Are GLP-1 Receptor Agonists the New Frontier? American Journal of Clinical Dermatology, 26, 175-182. https://doi.org/10.1007/s40257-024-00911-x [Source Document 7]
6. Gupta, R., Cesar, L., Micheletti, R., & Fang, V. (2025). Patient-reported outcomes of glucagon-like peptide-1 agonists on hidradenitis suppurativa severity. JAAD International, 21, 40-43. https://doi.org/10.1016/j.jdin.2025.05.004 [Source Document 1]
7. Krajewski, P.K., Złotowska, A., & Szepietowski, J.C. (2024). The Therapeutic Potential of GLP-1 Receptor Agonists in the Management of Hidradenitis Suppurativa: A Systematic Review of Anti-Inflammatory and Metabolic Effects. Journal of Clinical Medicine, 13(21), 6292. https://doi.org/10.3390/jcm13216292 [Source Document 6]
8. Henry, T., Cahn, B., Haber, R., Landers, J.T., Berger-Fleishman, R., Alam, M., & Hoyer, S. (2023). Therapeutic potential of GLP-1 agonists for hidradenitis suppurativa. International Journal of Dermatology, 62(12), 1543-1544. https://doi.org/10.1111/ijd.16892 [Source Document 2]

Important Medical Disclaimer

1. Not Medical Advice: All content and information on this website is for informational and educational purposes only. It does not constitute medical advice and is not a substitute for professional diagnosis, treatment, or consultation with a qualified healthcare provider.

2. My Role and Qualifications: I am a biomedical scientist and PhD candidate and share information from that perspective, combined with my personal experience as a patient with Hidradenitis Suppurativa. However, I am not a medical doctor, physician, or registered healthcare professional. Do not consider our relationship a doctor-patient relationship.

3. Consult Your Doctor: Always seek the advice of your medical doctor or another qualified health professional with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay seeking it because of something you have read on this website. If you suspect you are experiencing a medical emergency, or a severe infection, do not rely on this website or the HS Arma community, please call your local emergency services or go to the nearest emergency room immediately.

4. A Critical Warning on Medication: Pharmaceutical drugs are a crucial tool in managing Hidradenitis Suppurativa for many people. Under absolutely no circumstances should you ever alter, reduce, or stop taking your prescribed medication without the explicit direction of the doctor who prescribed it. Doing so can be dangerous. Always consult with your doctor before doing anything related to your treatment plan.

5. No Liability: Your use of this website and reliance on any information provided is solely at your own risk.

6. Individual Results May Vary: Every patient’s biological baseline, genetics, and adherence to the protocol is different. Therefore, I cannot guarantee specific results, cures, or timelines for your Hidradenitis Suppurativa.

7. Scientific and Expressive Freedom: The articles published on this blog are distinct from formal peer-reviewed academic literature. They serve as an independent platform for my personal viewpoints, scientific hypotheses, and philosophical reflections as an independent scientist and HS patient. While grounded in biomedical research, I exercise a degree of expressive freedom to translate rigid academic data into insights from a patient perspective. These writings are my personal meditations on the science of HS and should be read as my individual perspective, not as universally accepted clinical consensus or formal peer-reviewed literature.