Hidradenitis suppurativa biologics need time to work — that is the message Jenny Hsiao, M.D., delivered at Fall Clinical Derm 2026, as reported by Managed Healthcare Executive. Her point sounds simple, but it addresses one of the most common failure points in HS management: abandoning therapy before it has had a fair chance to show benefit.

Hidradenitis suppurativa is a chronic inflammatory skin disease characterized by painful nodules, abscesses and tunnels, most often in the axillae and inguinal folds. Because flares are frequent and lesions are measured clinically rather than with a single blood marker, response to treatment can be slower to read than in conditions like psoriasis, where tools such as PASI scoring track change quickly. That slower read is precisely where Hsiao's caution lands.

What does this change for prescribing?

The practical question for dermatologists and payers is: what does this change at the prescription pad? Hsiao's message, delivered at the Fall Clinical Derm 2026 meeting, pushes clinicians toward patience before switching agents, and toward setting expectations with patients early — telling them upfront that improvement may take time.

For managed care, the framing matters too. If biologics are abandoned too soon, claims data can understate real-world effectiveness. Premature discontinuation can look like treatment failure when it is actually insufficient trial duration.

The counseling implication is straightforward:

• Set expectations at initiation: response takes time
• Do not rush to judge a biologic as ineffective early in the course
• Distinguish a slow responder from a true non-responder before changing therapy

Why the setting matters

Fall Clinical Derm is a continuing-education meeting that draws dermatology clinicians each year in Las Vegas, and its sessions routinely shape how community dermatologists translate trial data into daily practice. When a speaker tells that audience to slow down before switching biologics, the advice travels — into appointment conversations, prior authorization responses and follow-up scheduling.

Hsiao's expertise adds weight to the guidance. She speaks to the management of a disease where biologic therapy has expanded options for patients with moderate-to-severe disease, and where the temptation to cycle through agents quickly can leave patients bouncing between treatments without an adequate trial of any of them.

For patients, the takeaway is one they can act on: ask how long the trial period should be before deciding the drug is not working, and report changes honestly rather than stopping on their own.

As biologics for HS continue to move into broader use, expect time-to-response counseling to become a standard part of the initiation conversation — and expect payers to take a closer look at whether early discontinuation is skewing the effectiveness picture.