Surreal illustration of the battle between skin cells and bacteria in Hidradenitis Suppurativa.

HS and Staph: What You Need to Know About Skin Infections

Theo Raines in Health & Wellness December 2025 • 4 min read.

"Uncover the link between Hidradenitis Suppurativa (HS) and Staphylococcus epidermidis, including antibiotic resistance and biofilm formation."

Hidradenitis Suppurativa (HS) is a chronic skin condition characterized by painful lumps, boils, and scarring, primarily in areas where skin rubs together. While not considered a simple infection, bacteria play a significant role in its development. Understanding the interplay between bacteria and the immune system is crucial for managing this condition.

One common bacterium found on the skin is Staphylococcus epidermidis. While typically harmless, in HS patients, these bacteria can contribute to the problem, especially when they form biofilms, which are structured communities of bacteria that are more resistant to antibiotics and the body's defenses. This article examines how S. epidermidis behaves in HS lesions and how antibiotic choices can be impacted.

This article translates findings on S. epidermidis strains isolated from HS patients, focusing on their antibiotic susceptibility and biofilm-forming capabilities. Ultimately, the aim is to provide practical insights into managing HS in the context of bacterial involvement and antibiotic resistance.

How Does Staph. Epidermidis Impact HS?

Surreal illustration of the battle between skin cells and bacteria in Hidradenitis Suppurativa.

Researchers collected skin samples from HS lesions and nearby unaffected skin to study the S. epidermidis present. They looked at how well the bacteria grew, formed biofilms, and responded to common antibiotics. A key finding was that a significant number of S. epidermidis strains isolated from HS patients showed resistance to clindamycin, a frequently used antibiotic. Rifampicin, on the other hand, proved to be more effective at inhibiting bacterial growth and breaking down biofilms.

Several things stood out about the Staph strains:

Biofilm Formation: A large majority of the strains could form strong biofilms, making them tougher to treat.
Antibiotic Resistance: Many strains showed resistance or reduced sensitivity to clindamycin and tetracycline.
Rifampicin Effectiveness: This antibiotic was generally more effective at killing the bacteria and disrupting biofilms.

These findings suggest that S. epidermidis in HS patients may exhibit increased resistance to certain antibiotics and a strong ability to form biofilms, which could complicate treatment.

What This Means For HS Management

This research highlights the importance of considering antibiotic resistance and biofilm formation when treating HS. The reduced sensitivity to common antibiotics like tetracycline and clindamycin is concerning, as these are often used in HS management. The fact that Rifampicin may have better results shows that there are still options.

It's important to note that HS treatment is not only about killing bacteria. Managing inflammation and supporting the immune system are also key. However, understanding the specific characteristics of the bacteria involved can help tailor treatment strategies.

Future studies should focus on further understanding the relationship between the skin's immune response and S. epidermidis in HS patients. People with HS can help by openly discussing treatment history with their physicians, as this can help determine what antibiotics are most effective.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1111/jdv.15183, Alternate LINK

Title: Biofilm Production And Antibiotic Susceptibility Of Staphylococcus Epidermidis Strains From Hidradenitis Suppurativa Lesions

Subject: Infectious Diseases

Journal: Journal of the European Academy of Dermatology and Venereology

Publisher: Wiley

Authors: C.B. Ardon, E.P. Prens, K. Fuursted, R.N. Ejaz, J. Shailes, H. Jenssen, G.B.E. Jemec

Published: 2018-08-07

Everything You Need To Know

What is Hidradenitis Suppurativa (HS)?

Hidradenitis Suppurativa (HS) is a chronic skin condition that causes painful lumps, boils, and scarring, especially in areas where skin rubs together. It's not just a simple infection, but bacteria play a significant role in its development, and understanding this interplay is crucial for managing the condition.

What is the role of Staphylococcus epidermidis in the context of this condition?

Staphylococcus epidermidis is a common bacterium found on the skin. Typically harmless, it can contribute to the problems associated with Hidradenitis Suppurativa (HS), particularly when it forms biofilms. These structured communities of bacteria are more resistant to antibiotics and the body's defenses, complicating treatment.

What were the key findings about Staphylococcus epidermidis in those with the condition?

Researchers studied the strains of Staphylococcus epidermidis in Hidradenitis Suppurativa (HS) patients and found significant resistance to clindamycin, a common antibiotic used in HS management. The strains also demonstrated the ability to form strong biofilms. In contrast, Rifampicin was generally more effective at killing the bacteria and disrupting the biofilms.

Why is biofilm formation significant in this context?

Biofilms are structured communities of bacteria that are more resistant to antibiotics and the body's defenses. The formation of biofilms by Staphylococcus epidermidis in Hidradenitis Suppurativa (HS) lesions complicates treatment because it makes the bacteria harder to kill with antibiotics. This is a key factor in the management challenges of HS.

What does this research mean for managing the condition?

The findings indicate that in the treatment of Hidradenitis Suppurativa (HS), it's crucial to consider antibiotic resistance and biofilm formation. The reduced effectiveness of common antibiotics like clindamycin and tetracycline highlights the need to find alternative treatment options, such as Rifampicin, which has shown better results in studies. This also underscores the complexity of managing HS and the importance of tailoring treatment based on the specific bacterial characteristics involved.