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<p>Laser hair reduction (LHR) is an emerging therapeutic option for hidradenitis suppurativa (HS), though standardized guidelines for its use remain undefined. We conducted a national survey to characterize dermatologists’ perceptions of efficacy, patient selection, treatment approach, and barriers related to LHR for HS. A total of 25 U.S.-based dermatologists completed an anonymous online questionnaire. Among respondents, 80% reported recommending LHR for HS, with the highest likelihood of recommendation for patients with Hurley Stage 1 (mean 7.88/10) and Stage 2 (7.44/10) disease, but lower for Stage 3 (4.27/10). Regarding treatment course, 60% recommended 4–8 sessions, and 24% indicated they offer as many treatments as the patient desires. The most commonly used devices were the Nd: YAG laser (64%) and alexandrite laser (24%), with 44% of respondents adjusting laser type based on skin type. Most dermatologists (65%) perceived LHR to result in moderate improvement (30–50% reduction) in inflammatory lesions. Compared to biologic therapy (e.g., adalimumab), LHR was rated higher in terms of patient satisfaction (mean 5.76/10), cost-effectiveness (6.92/10), and safety (7.44/10), though biologics were favored for reducing draining tunnels. On a 0–10 scale of procedural complexity, LHR was rated as more complex than cosmetic hair reduction (4.83) but less so than ablative fractional resurfacing (6.63). Patients undergoing LHR were generally satisfied, with 47% rated as “very satisfied” and 31% as “somewhat satisfied.” Insurance coverage was cited as a key barrier; respondents reported an average success score of 4.84/10 in obtaining coverage. CPT code 17,999 (unspecified procedure) was most commonly used (61%), followed by 17,111 (destruction of benign lesions, &gt; 15) at 50%. Out-of-pocket charges per session varied, with the highest being $450 for all areas. This survey of dermatologists with diverse experience and practice settings suggests that LHR is already being widely used to manage HS, particularly in early-stage disease. While LHR is perceived to offer moderate efficacy and high patient satisfaction, logistical challenges—especially surrounding insurance reimbursement—remain significant obstacles to broader implementation.</p>

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Dermatologist perceptions and preferences of laser hair reduction for hidradenitis suppurativa

  • 期刊论文

  • 发表日期：

    2025年7月12日

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  • Teja Mallela,
  • Akhil Wadhera,
  • Christopher J. Sayed

摘要

Laser hair reduction (LHR) is an emerging therapeutic option for hidradenitis suppurativa (HS), though standardized guidelines for its use remain undefined. We conducted a national survey to characterize dermatologists’ perceptions of efficacy, patient selection, treatment approach, and barriers related to LHR for HS. A total of 25 U.S.-based dermatologists completed an anonymous online questionnaire. Among respondents, 80% reported recommending LHR for HS, with the highest likelihood of recommendation for patients with Hurley Stage 1 (mean 7.88/10) and Stage 2 (7.44/10) disease, but lower for Stage 3 (4.27/10). Regarding treatment course, 60% recommended 4–8 sessions, and 24% indicated they offer as many treatments as the patient desires. The most commonly used devices were the Nd: YAG laser (64%) and alexandrite laser (24%), with 44% of respondents adjusting laser type based on skin type. Most dermatologists (65%) perceived LHR to result in moderate improvement (30–50% reduction) in inflammatory lesions. Compared to biologic therapy (e.g., adalimumab), LHR was rated higher in terms of patient satisfaction (mean 5.76/10), cost-effectiveness (6.92/10), and safety (7.44/10), though biologics were favored for reducing draining tunnels. On a 0–10 scale of procedural complexity, LHR was rated as more complex than cosmetic hair reduction (4.83) but less so than ablative fractional resurfacing (6.63). Patients undergoing LHR were generally satisfied, with 47% rated as “very satisfied” and 31% as “somewhat satisfied.” Insurance coverage was cited as a key barrier; respondents reported an average success score of 4.84/10 in obtaining coverage. CPT code 17,999 (unspecified procedure) was most commonly used (61%), followed by 17,111 (destruction of benign lesions, > 15) at 50%. Out-of-pocket charges per session varied, with the highest being $450 for all areas. This survey of dermatologists with diverse experience and practice settings suggests that LHR is already being widely used to manage HS, particularly in early-stage disease. While LHR is perceived to offer moderate efficacy and high patient satisfaction, logistical challenges—especially surrounding insurance reimbursement—remain significant obstacles to broader implementation.