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Can GLP-1 medications be a helpful hidradenitis suppurativa HS treatment? These medications are best known for GLP1 weight loss and more balanced blood sugar—but their benefits may extend to help calm relentless inflammation common in chronic health conditions like HS skin boils.
Recent studies suggest that GLP-1s might impact key inflammatory pathways by reducing cytokines like TNF-alpha and IL-17—some of the same targets that popular biologic drugs aim to control.
What’s even more fascinating? Improvements in HS symptoms were observed even when significant weight loss didn’t occur.
Yet there are many valid questions that we need answers to, such as do GLP-1s play well with HS treatment meds, what types of doctor would prescribe the medication, and what happens when you stop the GLP-1 (and could that cause a flare)?
Returning to the show is Dr. Steven Daveluy who is a board-certified dermatologist and leading HS expert known for his empathy and innovation. He’s an associate professor and program director at Wayne State University in Detroit, Michigan, having special interests in teledermatology, noninvasive skin imaging, skin of color, integrative dermatology, and complex medical dermatology, including hidradenitis suppurativa HS treatment. Dr. Daveluy also serves on the board of the Hidradenitis Suppurativa Foundation, and the editorial board for the Journal of the American Academy of Dermatology (JAAD).
If you or someone you love is living with HS, this is an essential conversation that you won’t want to miss. Dive in now!
Or, listen on your favorite app: iTunes (Apple Podcasts) | Spotify | Stitcher | TuneIn | Subscribe on Android
In This Episode:
- How GLP-1s can reduce systemic inflammation found in Hidradenitis Suppurativa (HS)
- Fascinating connection between GLP-1s and inflammatory cytokines like TNF-alpha, IL-17 (often present in HS)
- How GLP1 weight loss impacts HS (based on current research)
- Why diagnosis of HS skin boils EARLY is crucial (this is a big deal for successful HS treatment)
- What happens when you stop a GLP-1? (and what we still don’t know)
- Can you take GLP-1s and Hidradenitis Suppurativa HS treatment medications together?
- What to ask before starting GLP-1 treatment if you have HS skin boils
Quotes
“Once you start to get those tunnels, the inflammation around them is almost like its own inflammation factory after that, and medications don't work as well.”
“The good news is there aren't many interactions between the GLP-1s and the things that we use to treat HS.”
Links
Find Dr. Daveluy on Instagram | Twitter
Healthy Skin Show ep. 103: Hidradenitis Suppurativa: The Tip That Stopped My Flares
Semaglutide Improves Hidradenitis Suppurativa in Patients With Obesity
The anti-inflammatory and immunological properties of GLP-1 Receptor Agonists
392: Improving Hidradenitis Suppurativa HS Treatment With GLP1 Weight Loss Meds (NEW RESEARCH) w/ Dr. Steven Daveluy {FULL TRANSCRIPT}
Jennifer Fugo (00:14.585)
Dr. Daveluy, thank you so much for joining us again today to talk about hidradenitis suppurativa HS treatment.
Steve Daveluy (00:18.591)
Oh, it's my pleasure, thanks for having me. Always happy to talk.
Jennifer Fugo (00:22.069)
Always happy to talk about HS skin boils and how to treat hidradenitis suppurativa.
Steve Daveluy (00:24.47)
Right?
Jennifer Fugo (00:47.105)
I love the fact that you are so willing to not only talk about hidradenitis suppurativa (HS skin boils) and how to treat hidradenitis suppurativa, I think one of the most, and I'll make sure to link up your other episodes, because you've been on the show a number of times now, but I think you've provided so many people, too, with the opportunity to be able to advocate for themselves better at the doctors for hidradenitis suppurativa treatment. So I appreciate you so much for always making the time and space to speak to those who either have HS and know that they have it because they got diagnosed, or maybe even those who are kind of at the beginning of their journey, they think they might have this, but aren't quite sure, don't have a diagnosis yet. I just really appreciate you for that.
Steve Daveluy (01:05.55)
My pleasure, my pleasure. And thank you for creating a space where we can do this. Because like you said, it just is such an interesting disease in the sense that there are a lot of undiagnosed people, and you can actually pretty accurately diagnose it yourself. It's not a hard diagnosis to make. It's just finding a doctor or a healthcare provider who's heard of it and knows what it is. So I say these platforms are great for those people who are like, oh my gosh, I've been seeing someone for this, and I don't know what I have. It's really, really important to get the message out any way we can because there's just such a lack of awareness.
Jennifer Fugo (01:37.913)
There is, and I thought your suggestion of what we should talk about today is so timely because everybody has been talking about GLP1 weight loss medications like Ozempic, and I did not know that this has actually been looked at as a potential helper. I don't know if HS treatment is the right way to describe it, but maybe a helper in hidradenitis suppurativa treatment or management. So do you wanna talk a little bit about maybe how this came to be, why it might be a good idea, just like kind of a general overview of like, why would you want to consider using a GLP-1 if you're struggling with HS?
Steve Daveluy (02:23.905)
I would love to. And like you said, I'm glad we actually have some data and some people have taken that step to look at HS and GLP-1s, and kind of start to figure out the role they play. It makes sense because we know that, when we look at the population, HS is often associated with being overweight or obese. But I say when we look at the population, because we both know not everyone with HS is obese, not everyone is overweight. And it can actually be kind of alienating to people or stigmatizing if they aren't, and then everyone talks about it being this disease of people who are overweight, and I don't fit that picture.
Jennifer Fugo (03:01.805)
Yeah, and that was me. I was not overweight at all, and I had HS skin boils.
Steve Daveluy (03:06.349)
Right? And all of a sudden, you start trying to learn things and read things and like, well, I'm not fitting this picture, am I sure I have this? But it's just sometimes the messaging of these things gets mixed up, where it's like, well, yeah, the two do go together more often than they don't, but that doesn't mean it's a rule. That doesn't mean it's everybody. And then there's other studies that show for people who are obese or overweight, weight loss can sometimes help the HS. Now, it's not always super reliable, but it can help, which kind of makes sense because we know that obesity is sort of a pro-inflammatory state, so anything to bring the inflammation down. But what's really cool with the GLP-1s is that we're actually learning that it's not just the effect that they have on weight loss, they actually do impact those inflammatory pathways. So they might be sort of directly treating the HS, not just through the weight loss.
Jennifer Fugo (03:57.401)
Well, was fascinated when, so first of all, you suggested this, because I did not suggest this. And I was like, I don't know, let me look this up. And what I discovered, which I did actually not know, because we had, for those of you who watched the show, we had Nathalie Niddam come on, talking about GLP-1s, peptides, bioregulators, just kind of a 101-type podcast about it, because I do find this whole area fascinating. And as I'm looking things up, one of the papers, which I'll link in the references for this episode, said that the GLP-1s seem to reduce certain inflammatory mediators like tumor necrosis factor alpha or TNF-alpha, IL-17, which I believe, if I remember correctly, is the biologics that are used to treat HS actually target IL-17 and whatnot. So I thought that was fascinating because I didn't actually know that that was one, I thought that it was more on the weight loss side, and making you less hungry, and all of those things. But I didn't realize it could reduce these inflammatory reactions happening under the surface.
Steve Daveluy (05:12.211)
Same here. I thought the exact same thing when I started looking into this topic, because it kind of started coming up. Patients are like, should I go on a GLP-1, would that help my HS? And I thought the same thing, like, oh yeah, weight loss. But then you're right. There's this data that shows it doesn't just affect your stomach and your GI tract and your brain, making you feel less hungry and slowing down transportation, but it actually affects the immune system, which is fascinating and really interesting and kind of opens up these new doors. Because like you said, those are the targets of our biologics, TNF and IL-17. So if these GLP-1s can reduce them too, that's really fascinating.
Jennifer Fugo (05:52.129)
It also, and this is just me kind of like noodling in my head as we're talking, it makes me also wonder then, is, let's just say the picture of being overweight or obese. Is that potentially, like I think a lot of times we go, oh, well, we've just, I think there's that simplistic view of we've overeaten and it's excess calories being stored. And okay, on one hand, yes, there is truth to that. But most things are not black and white. There can be multiple things true at the same time. Is it also possible that the extra weight that someone is carrying around could be symptomatic of an underlying inflammatory picture? Or maybe it's that those extra adipose cells are contributing to inflammation. I don't know. There could be a chicken and egg, I don't know. I'm not in that enough, I'm not an immunologist.
Steve Daveluy (06:46.306)
Right.
Jennifer Fugo (06:49.805)
But it is really fascinating that it actually helps reduce. So have you, any thoughts on, with that being said, you, I guess, have experience now using some of these biologic meds, right, to help treat HS. Do you think that it would potentially make you need the medication less? Like say, do you guys use Humira and some of these other types of medications?
Steve Daveluy (07:17.835)
Yep. Humira, Cosentyx, Bimzelx. And it's interesting you bring it up because there's evidence from both HS literature and psoriasis literature that these meds may not work as well with increasing body weight. So in patients who are more obese, because like you said, we think that those fat cells can sort of promote inflammation. So the medications may, the disease is more resistant to treatment with obesity because it's sort of another thing sort of feeding into the disease and the inflammation.
What else is really interesting is, I think you're totally right, it's like a two-way communication of the inflammation influencing the fat cells, the fat cells influencing the inflammation. The TNF inhibitors, which is like Humira and Remicade, they found that when patients first start them, they can initially gain some weight for the first couple of months, and then it kind of flattens off. And they found that the body uses the TNF-alpha that it blocks to catabolize and break down fat. So it's actually a little harder to break down fat when you're blocking that TNF-alpha. And like I said, it's not like a steady progressive one, it kind of goes up a little and stabilizes. So then these really great researchers did a study on psoriasis where they put people on the drug, but they also put them on the Mediterranean diet. And they didn't gain weight, their cholesterol improved, their BMI improved, their waist circumference improved, and their psoriasis responded better to the treatments. Because again, it's that idea of like, all right, well maybe that weight loss, or inhibiting, or just healthier diet is gonna help everything work better.
Jennifer Fugo (08:55.019)
It is fascinating how this specifically, I think all skin conditions could benefit for the most part from having a more integrated approach to how you address things. I understand, that being said, that not everybody wants to do that. I'm a big fan of look, you do you, just understand the consequences of the choices we all make individually.
Steve Daveluy (09:17.965)
Yup.
Jennifer Fugo (09:21.303)
But I think with HS, we were talking about this earlier, just how devastating of a condition this is because once you get to like the Hurley stage 2, Hurley stage 3, so more advanced stages, you can't really come back from the damage. Can you speak a little bit, just to that? Because I think sometimes I find people are well-meaning, they really want to try natural things, or they kind of feel like, well, this is just, I get these flare-ups every so many weeks. Maybe it's every six weeks, maybe it's every eight weeks, or whatever. But the problem is, what we don't see is the inch forward of progression of disease. So can you just speak a little bit to that? Because I think that that helps underscore why this could be a helpful option to prevent that with HS.
Steve Daveluy (10:17.813)
Yes, and I'm glad you asked because that's such a big, important topic in HS right now. And when we speak to dermatologists who take care of it, other physicians, other healthcare providers, we are really saying, we call it sort of this window of opportunity. We need to start treatment earlier because like you said, it leads to permanent damage, tunnels, scarring. And we know that the actual disease sort of changes. Once you start to get those tunnels, the inflammation around them is almost like its own inflammation factory after that, and medications don't work as well. A lot of times you need surgery for that. So we're really saying we need to diagnose it early and get it under control before that happens.
Sometimes we compare it to acne, where as soon as I see scars from your acne, I'm like, we need Accutane, isotretinoin, we need to turn this off, it's causing damage. And so we need to really be more thoughtful of that with HS. We need to shut this down as soon as possible so that it doesn't progress and get worse. It may still, even in spite of treatment, but that's our best opportunity to really turn it off, is intervening early. Which is why it's so important to get the diagnosis early, get effective treatments on board early, which is a big push that I think is going to have huge benefits for patients. I dream of the day when no one needs HS surgery because we get it under control before any tunnels form. That would be ideal.
Jennifer Fugo (11:40.759)
I don't think any patient, I mean, I can't speak to it because I was just stage 1, and long story short, I'll link up to it, but I had laser hair removal and that stopped it in its tracks. And I'm so deeply grateful to the person who told me about that because my doctor never gave me that option. And I wish I knew about it early. But if you progress, that's no longer an option for you.
Steve Daveluy (12:03.306)
Right, right.
Jennifer Fugo (12:08.301)
And if you look at photos, it's hard to look at photos. And I would imagine that the patients who are in Hurley stage 2 or Hurley stage 3 wish that they were not there, and they didn't have to have all these surgeries and procedures. I would imagine it's really hard on quality of life for a number of levels.
Steve Daveluy (12:23.917)
Huge.
Jennifer Fugo (12:34.353)
So being that GLP-1s could possibly maybe be an option, what have you seen in the research or just in your experience, if you've had any? Because again, I think we should also be very clear, GLP1 weight loss meds are a little tricky to get covered by insurance at this point in time because they're not an HS treatment option. So we can talk a little bit about that. But how have you seen GLP-1s maybe tangentially help HS treatment?
Steve Daveluy (13:02.349)
Yes, and that's a very good way to phrase it, because so far we have two studies, they're small. One had 14 patients, one had 30 patients. And in both studies, in one, the one with 30, all the patients were on HS treatment, and then they added on a GLP-1. In the one with 14, almost all of them, like 78%, were on treatment for their HS. So it was definitely not like a study looking at it for HS. It was more like, let's give it to some patients with HS and see what happens. They both did see improvements.
In the study with 14 patients, they looked at sort of their HS severity got better, and their quality of life that they measured through one of the tools got better. And that one was interesting because when they looked, they do this, you know, their fancy statistical analysis, when they looked at the improvement in the HS and compared it to the weight loss, the two weren't necessarily dependent on each other. So some people's HS got better even without the weight loss, which like we were saying, speaks to this anti-inflammatory effect that the medications are probably having. And then in the one with 30 patients, they also saw improvements in quality of life, and they saw a decrease in the frequency of their flares from about every eight weeks to every 12 weeks. And that one didn't reach statistical significance, probably because it was a small number of patients. But it's kind of this proof of concept that these may be beneficial, and it might not even be the weight loss.
Jennifer Fugo (14:26.201)
Hmm.
Steve Daveluy (14:27.211)
Like you said, coverage is a little tricky. There's sort of, now that we know it can help the HS, there's sort of this idea that maybe if you don't qualify for one based on having diabetes or being obese, but maybe you're close, like you're overweight but not obese, then maybe having HS in addition could be something to tell the insurance to try to get it covered. Having said that, it's gonna vary state to state and all those things.
My patients who I've seen treated with a GLP-1 have all had an indication for it, like diabetes or obesity that they got it for, and most of them have improved. Now again, they're all with me, so we're treating the HS at the same time, but even when their HS treatments were stable, when they added the GLP-1, it did seem to kind of lead to some improvement, and it's a mixed bag. A lot of them did experience weight loss, so I don't know how much has contributed from the weight loss and how much from the anti-inflammatory effect, but it's one of those, like in the real world, you're like, okay, great, both.
Jennifer Fugo (15:24.931)
That is true. It's like, okay, well, at least we got there. How we got there might not quite, at least for the patient, matter quite as much. Obviously for us, we're like, how did that happen? What exactly did it do to get us that?
Steve Daveluy (15:39.02)
Right?
Jennifer Fugo (15:54.617)
But I'm curious because with that being said, you have patients that have HS, but they were able, for example, to go onto one of a GLP-1, who prescribes that? Like would a derm, I mean, you're a derm, so like would you be the person to prescribe it, or do you sort of find that it's better to have like a primary care doctor, or somebody else? Because I was trying to think about that. I'm like, that's probably a little gray area.
Steve Daveluy (16:11.862)
Right. And it's tricky because some insurances will have certain restrictions on medications. Like there are some for psoriasis that primary care or the insurance won't cover it. They have to see a specialist, and they're just kind of thinking like, all right, if we're going to go with a serious med, you should probably be seeing a specialist for it. Or they'll limit this one to this specialty or this one to this specialty, because they're sort of the experts in how to use it and everything. With the GLP-1s, it's kind of interesting because there is sort of this push because there's also some evidence in psoriasis that they can be helpful, either with the weight loss or with the anti-inflammatory pathways because 17 and TNF are also involved in psoriasis.
And so there is sort of this question of like, should derms be writing these? I mean, I write for things like metformin for patients with HS. Having said that, I've written it for it once so far because a patient was like, I really want to go on one, would you do it? And I was like, OK. I was not looking forward to the headache of the prior authorization, but we're pretty used to it in derm. And it kind of ended up, we were trying to get it authorized, in the meantime, she saw her primary care doctor, they prescribed it. It went through a little easier for them.
So I think it is a space where maybe derms are gonna get kind of comfortable and start using them. But I think that initially, when they first came out and there were the shortages and all those headaches, people were kind of like, all right, maybe I'm not gonna jump on board yet. Like, let's let the dust settle a little bit before I jump into this area where I'm gonna prescribe something, and it's not gonna get covered, and the patient's gonna be calling the office. But definitely primary care doctors, endocrinologists who treat diabetes, they're writing the drugs and that's where most of my patients have gotten them. It's from their primary care doctor or their endocrinologist and then they just kind of come back and tell me, hey, I started this.
Jennifer Fugo (17:59.479)
Now, should an HS patient, if they are currently taking any medications for HS treatment right now, should they have any concern that there could be a conflict potentially between a GLP-1 and whatever medication they're on?
Steve Daveluy (18:17.665)
The good news is there aren't many interactions between the GLP-1s and the things that we use to treat HS. So that's pretty good. I mean, it's always good to make sure anybody prescribing you anything knows all the meds you're on, all the supplements you're on, anything that you're on, to make sure there's no interactions. But it seems like they do sort of play well together, which is good. A lot of times our biologics don't really have much in the way of interactions, which is a great thing.
The one you would want be careful, and this probably isn't going to be prescribed for your HS specifically, but if you're on diabetes treatments you’ve got to make sure to follow up with the doctors because as your body loses weight and undergoes changes, your blood sugars might kind of change. But luckily in terms of our HS things we don't see a lot of overlap, but always good to do that check, we run a check every time we're prescribing anything.
Jennifer Fugo (19:08.889)
Absolutely, because I always think as people start stacking more things on, you can look outside of dermatology to see the catastrophe that can sometimes happen, especially with more elderly, sicker patients. Because my dad was a surgeon, he was an ophthalmologist, an eye doctor. He did a lot of cataract surgery, so most of his patients were in their 60s, 70s, 80s, 90s, maybe a few in the hundreds.
Steve Daveluy (19:38.048)
Right.
Jennifer Fugo (19:38.217)
And a lot of times they had so much medication that now all of sudden certain things were conflicting with one another and they're starting to have issues. So I always think that's an important thing to consider. Is there any possible thing that somebody needs to ask about? Because they ask me, they write in to my support team and they're like, have you heard of this medication? Is there anything I should worry about? And I'm like, that's a good conversation to have with your doctor, because it's important to really talk through these things.
Steve Daveluy (20:06.603)
Yes. Absolutely. There's even been some studies that show in elderly patients, each time you add a medication, it increases the risk of death. Because like you said, there's interactions, there's complications, it can add to the confusion and they might not take their pills the right way because they're like, oh, was this one twice a day or once a day? Once a week?Which makes sense. Sometimes I send people home with a few creams and I'm very clear to put on the labels what goes where because as soon as you get home you're like, okay, I know he told me, but I don't remember anything that he said.
Jennifer Fugo (20:43.319)
Yeah, it's really important, and if you're not clear, call your doctor or put a message through the portal because it is very easy, like you said, to get home and go, wait, did he say this or that? I'm not quite sure. And then you're either taking a medication too much, or too little, or there's an issue.
Steve Daveluy (20:51.467)
Yes.
Jennifer Fugo (21:12.941)
I wanted to ask you also too, because I think this is an important conversation. When we did the kind of GLP 101 podcast, we talked a lot about the need for finding balance with these. That they shouldn't necessarily be looked at as like, they're kind of interestingly, I hate to use this term, but they're kind of similar to like a silver bullet-ish.
Steve Daveluy (21:35.201)
Right.
Jennifer Fugo (21:40.003)
I mean, they have some downsides. There's definitely some problems with them and side effects that can be serious enough that you would have to stop the medication, and medical complications that can be quite serious. But that being said, in the ideal world, so if you're talking to an HS patient who's like, hey look, my disease seems to be progressing, I'm getting into maybe Hurley stage 2, we're having flare-ups happen more frequently and more severely. Ideally, if they came to you and possibly wanted to add on a GLP-1. What would you recommend from a more, like what would be an ideal path forward for them that might look at different facets to help them with their overall health that would also help the HS?
Steve Daveluy (22:27.361)
That's a great question, and I think it presents a really good opportunity to have a conversation with patients about diet and nutrition and exercise. And it sort of is a good conversation whether or not they end up going on a GLP-1, but it gives you that opportunity to say, okay, here's how the GLP-1 is going to influence you. It's going to slow down your GI tract. It's going to tell your brain that you feel full, so you'll be eating less. So nutrition is more important than ever because you got to make sure you're getting enough protein, enough fiber. It's a lot harder to have a healthy diet when you're reducing your intake because you've got to make sure you're getting your vitamins, your nutrients, and high quality nutrients. Now all of a sudden, having a donut for breakfast is a lot bigger deal than it might have been before where you're like, well, I had a donut, but I also had some oatmeal with it. And so I think it's a good way to talk about that and how a GLP-1 might affect your body. And like we know, we've seen it can lead to decreases in muscle mass because people aren't getting adequate nutrition, they aren't exercising enough on it, and your body is going to get energy from somewhere, so it's going to burn your muscle.
One thing I also talk to patients about is I'm generally like, I always talk about safety with medications, but I'm not nervous about medications. If someone needs something and it's a good fit for them, we're going to talk about safety, but we're going to put it into context, especially in a disease like HS, where there are side effects from not treating it. Like you said, it'll progress if we go untreated, so it's not totally harmless to just do nothing. But with the GLP-1s, I'm optimistic but a little cautious. I am a little nervous to see what are the long-term side effects. And there's even this question of, are you on this forever? Do you ever come off these medications, and what happens when you do? And we still need to learn more about that. Like, does it lead to behavior change that helps you to maintain the weight that you've lost? Or, without the medication, like you said, if it is sort of a silver bullet, when you get rid of the silver bullet, things go right back to normal.
So I think we still have a lot to learn, but I'm cautiously excited. We're seeing benefits. And in something like HS, it's interesting because there might even be more of a case for sort of using it on and off. If you're going for diabetes or for weight loss, there may still be a case that, all right, let's taper off and see how you do without it. But with HS especially, it's like, well, if your HS improves, then maybe when we stop it, the other medications you're on will keep it under control.
Jennifer Fugo (24:53.965)
Yeah.
Steve Daveluy (25:07.605)
So there's still a lot to know about it. But yeah, I like to use that as sort of a conversation with patients about what does your diet and nutrition look like now, what does it need to be on a GLP-1? Which then kind of makes the connection of, I guess I should also just be eating healthy no matter what, I should be worried about my intake no matter whether I go on this medication or not.
Jennifer Fugo (25:16.013)
Yeah, because what we don't ideally want, and I think you had had shared this with me earlier, was that no one wants to make a devil's bargain, where you did one thing, but you don't realize down the road that either you're not going to be able to stop something, you're not going to be able to get off of something. I mean, even patients worry, what happens if I wanna get off of this medication? It's not specific to GLP-1s, you had told me, they even ask you that question before they start a more serious, like a biologic medication. And that is a very reasonable question to ask.
And so I don't know if anybody cares, I would think they do, because they're watching the Healthy Skin Show and they've invested a significant amount of time in watching, but my personal thought would be that if you're going to say yes to a GLP-1, you should also on the other hand, right, it's a scale, you should also be willing to say yes to the diet and lifestyle changes that would help you overall maintain a much better quality of life. And that if you want to get off of it, that hopefully it will set you up for success.
Steve Daveluy (26:30.657)
Yes, and an interesting parallel is bariatric surgery, right? Like if you're thinking about bariatric surgery, you meet with the surgeon, and typically they make you show progress in healthy eating habits and exercise, and actually require you to lose some weight. Because they know it's not just like magically we're gonna do bariatric surgery and you'll never have to think about these things again, and your behaviors will all of a sudden, just like, you'll just not be hungry.
Jennifer Fugo (26:34.073)
Mm-hmm. Right.
Steve Daveluy (27:00.591)
It's like no, you have to also have that behavioral change and that healthy lifestyle habit change. And we don't really see that with the GLP-1s. It's not like, okay, well you need to make some changes first and then we can add it on. So it's interesting, sort of the differences between the two, where you go, all right, for this one, we kind of make you get ready for it so that after the surgery, you've got the skills and you've already practiced. But with GLP-1s, we don't. We just kind of give it to you and say, here you go.
Jennifer Fugo (27:25.059)
Yeah, and I did try and find research to see what would happen in those with HS if they came off. There is nothing about what happens if you then stop the GLP-1. Does the severity of HS increase? Do the lesions flare up in a shorter period of time? There's no research on that right now. There might be some in the works, I don't know.
Steve Daveluy (27:35.981)
Nothing. Yeah, I hope so.
Jennifer Fugo (27:56.889)
But I do wanna be very honest with people about that, so that you should ask that question, you might get an I don't know right now, and that would be honest. The one thing I thought was fascinating about the one study that we were discussing, and I'll put the link into the show notes, was that the 30 people who had HS, I don't know if this helps anybody, because again, the studies are all small. So we do have to take it with a grain of salt, because they're small,
Steve Daveluy (28:21.047)
Yep.
Jennifer Fugo (28:26.507)
But they were mostly women who were in that study. And most of them had, they were in Hurley stages 2 and 3. So I think that's good feedback to just consider that that's who the research has basically been done on.
Steve Daveluy (28:38.668)
Yeah.
Jennifer Fugo (28:47.467)
And I would also, for those of you who, maybe you aren't necessarily considered overweight, maybe there's an option, and this is just throwing an idea out there, of possibly microdosing a GLP-1. I've had a lot of clients where they've started on very low doses, and maybe that, even if you're not overweight, maybe that could be of benefit. It's just ideas. I don't honestly know. I can't, I don't prescribe anything, I'm not a doctor. But I do think that, like you shared Dr. Daveluy over and over again, because you have so much empathy for these patients and these people who are struggling, that anything we can do to prevent them from ending up really, really progressing and requiring surgery and all this stuff is probably something worthwhile to at least consider and have the conversation about.
Steve Daveluy (29:30.541)
Exactly. We do not have a super duper effective medication for HS right now, so every bit helps, you know, anything that has, and it's funny you see it in the people who are like nerding into HS and everything and the HS patients, that anything that has a potential is like, oh my gosh, let's look at it further. That's exciting, oh my gosh, let's try that out, let's figure this out. And it's exciting because, since there isn't something super great, there's a lot of research going on, a lot of people thinking creatively, trying to come up with new things, new surgical techniques, new medications, new lifestyle things. There's a study going on in Miami right now about exercise because exercise can be tough with HS. You know, is the friction gonna flare you up? If you have it in the groin, you certainly can't like go ride a bicycle. And so it's exciting. It's tough but it's also exciting. I keep saying there's never a good time to have HS, but there's never been a better time than now also.
Jennifer Fugo (30:31.907)
Yeah. Well, thank you so much for coming and joining us today. I'm so glad that we got a chance to talk about this so that hopefully if this is something that maybe somebody listening, even if it's just one person was thinking about it, maybe now this is an opportunity for them to have a conversation with their doctor about this and consider it as an option. And it's exciting. It really truly is. But thank you so much for being here. We'll put all your contact information in the show notes for anybody who's looking for a doctor because you actively treat patients. My goodness, I wish that you were my doctor when I had HS skin boils.
Steve Daveluy (31:05.453)
Yes, we need more experts. We're working on it.
Jennifer Fugo (31:08.907)
I know. I know. But thank you so much for all that you do, and for sharing your knowledge and enthusiasm for helping people who are living with this every single day.
Steve Daveluy (31:21.485)
And thank you for having me, and for helping get this word out to people who may need to hear it.
