A prospective randomized controlled trial assessing the efficacy of adjunctive hyperbaric oxygen therapy in the treatment of hidradenitis suppurativa

Hyperbaric oxygen therapy ( HBOT ) appears to enhance wound healing, increase bactericidal activity, and act synergistically with a number of antibiotics. The aim of this study was to evaluate the efficacy of HBOT as an adjunctive therapy in patients with hidradenitis suppurativa ( HS ) treated with a combination of systemic rifampicin and clindamycin. The study was a prospective, single‐center, single‐dose, open‐label, randomized controlled clinical study of HBOT in patients with moderate to severe HS . Efficacy was measured by modified S artorius score ( SS ), HS S everity I ndex ( HSSI ), D ermatology L ife Q uality I ndex ( DLQI ), and a visual analog scale ( VAS ) before treatment and after the completion of 4 and 10 weeks of treatment. Erythrocyte sedimentation rate ( ESR ) and C ‐reactive protein ( CRP ) levels were also measured. Forty‐three patients were enrolled in the study. More patients in the HBOT than in the control group showed a decrease of ≥50% from baseline parameters at week 10 for SS (100%), HSSI (100%), DLQI (95.5%), VAS (100%), ESR (100%), and CRP (72.7%). Clinically and statistically significant improvements from baseline were observed at 4 and 10 weeks in HSSI ( P  = 0.009 at both), SS ( P  = 0.021 at both), and DLQI ( P  = 0.044 at week 4, P  = 0.009 at week 10). Adjunctive HBOT was considered to be effective in significantly improving antibiotic treatment of HS . The treatment was well tolerated, and no unexpected safety issues were identified.