Hidradenitis suppurativa (HS) is a skin condition that can be treated and is not contagious. It causes painful bumps to form under your skin, often in places where skin rubs together, like your armpits or groin.
If you have moderate to severe HS, one of the biologic medications approved to treat it is Humira® (adalimumab). Humira was the first biologic drug approved for HS, in 2015. That means doctors have been using it to treat HS longer than two other recently approved biologics, Cosentyx and Bimzelx.
Biologics are medicines that target specific parts of your immune system to reduce inflammation. Humira targets a protein called tumor necrosis factor (TNF), so it’s known as a TNF inhibitor. You take it as a shot under your skin.
Learning about this treatment can be especially important for Black patients. HS is three times more common in Black people than in white people, and Black patients are more likely to have severe HS. In this guide, we’ll explain how Humira works, what to consider when thinking about it as a treatment for your — or your loved one’s — HS, and how to advocate for the best care so you can find relief.
Biologics are medicines made from living cells, and are used for many different health conditions. One of the most well-known biologics is insulin, which is used to treat diabetes. The biologics used for HS are called monoclonal antibodies, and they target specific parts of your immune system.
Humira, for example, goes after a protein called tumor necrosis factor, or TNF. TNF is part of your immune system and normally helps manage inflammation. But in HS, TNF can drive the ongoing inflammation that causes symptoms. Humira works by latching onto TNF and blocking it from sending the signals that tell your body to make inflammation.
Because Humira blocks TNF, it’s called a “TNF inhibitor.”
Medication is an important part of HS treatment. Medications include antibiotics that can help lower inflammation, drugs that help manage hormones that might contribute to HS, and medications called biologics that work with your immune system. Humira is a biologic.
If your HS is moderate to severe, biologics can reduce the active inflammation that causes your symptoms. Sometimes, they’re used alongside surgery, especially if HS has already caused lasting skin damage like tunnels or scars that medicine alone can’t fix.
Right now, there are three biologics approved for moderate to severe HS: Humira (adalimumab), Cosentyx (secukinumab), and Bimzelx (bimekizumab). Each of these medicines tackles inflammation in a slightly different way. Humira targets a protein called TNF. Cosentyx blocks IL-17A. And Bimzelx blocks both IL-17A and IL-17F.
Humira is approved by the FDA to treat HS that’s moderate to severe. It’s for adults and adolescents ages 12 and older. Adolescents and teens need to weigh at least 66 pounds (30 kg) to take Humira.
You don’t need to try another biologic before using Humira. It’s important to speak up for your health and make sure your doctor looks at all possible treatments. So, if your doctor doesn’t mention Humira, ask if it might be a good option for you. They’ll think about how bad your HS is, if other treatments have worked, your overall health, and any other medicines you’re currently taking.
Humira is an injection given under the skin. If you’re an adult with HS, you’ll start with a 160 mg dose. It can be taken all at once or split over two days. Two weeks later, you’ll take 80 mg. Then, two weeks after that, you’ll begin your regular dose of either 40 mg every week or 80 mg every other week. For kids aged 12 and up, the dose depends on how much they weigh. Your doctor will figure out the right amount.
Humira comes in prefilled injection pens and syringes. Someone in your provider’s office should show you how to give the injection before you do it on your own at home. A caregiver can also be trained to give injections for adults or teens.
Humira was studied in two large clinical trials called PIONEER I and PIONEER II. A total of 633 adults with moderate to severe HS participated. For the first 12 weeks, about half got Humira and the other half received a placebo (a shot that looked real but didn’t contain the drug).
After 12 weeks, in PIONEER I, about 42% of people on Humira saw a big difference: their abscesses and inflamed bumps dropped by at least half, without an increase in abscesses or draining tunnels. Only 26% of those on the placebo saw the same improvement. In PIONEER II, about 59% of people on Humira saw this kind of improvement, while only about 28% of those on the placebo did.
People taking Humira also felt less skin pain, though the results weren’t exactly the same in both studies. Longer studies showed that people who kept taking Humira weekly kept their HS symptoms under control for up to three years.
Possible side effects include:
Because Humira lowers the activity of your immune system, it can make it harder for your body to fight infections. Some people taking Humira have developed serious infections that required hospitalization or were life-threatening, including tuberculosis (TB), fungal infections, and bacterial infections.
If you notice signs of an infection, call your doctor right away. These can include:
Humira and similar medicines (called TNF inhibitors) have also been connected to a higher chance of certain cancers, such as lymphoma. Some cancers have occurred in children and adolescents taking TNF inhibitors. These cancers are rare, but they can be serious, so talk with your doctor about what this means for you or your child.
Get emergency help right away if you have signs of a serious allergic reaction, such as trouble breathing or swelling in your face, lips, tongue, or throat.
Humira can cause other serious issues. This includes liver problems if you’ve had hepatitis B before, new or worsening heart failure, certain nervous-system disorders, low levels of some blood cells, and autoimmune reactions. If you notice any new or unusual symptoms while on Humira, tell your doctor right away.
Before you and your doctor decide on Humira, let them if:
You have an infection or tend to get sick often. It’s important not to start Humira if you currently have an infection. Since Humira can make it harder for your body to fight infections, your doctor will want to know about infections that keep coming back or other health issues that might make you more prone to getting sick.
You’ve ever had tuberculosis (TB) or been exposed to someone with it. Your doctor will need to test you for TB before you begin Humira and keep an eye out for any signs of it while you’re on the medication.
You’ve had hepatitis B. Humira can sometimes reactivate the hepatitis B virus, which could lead to serious liver problems.
You have heart failure. Humira and similar medications (called TNF inhibitors) have been known to cause new cases of heart failure or worsen existing ones.
You have a condition that affects your nervous system, such as multiple sclerosis. In rare cases, TNF inhibitors have been linked to new or worsening nerve-related disorders.
You need any vaccinations. You should not get live vaccines while taking Humira. Ask your doctor if you need any shots before you start the medication.
You’re pregnant, thinking about getting pregnant, or breastfeeding. Of the biologics approved to treat HS, Humira has been the most extensively studied during pregnancy and breastfeeding. Studies of Humira use during pregnancy haven’t found a clear link to major birth defects. Humira can cross the placenta, especially later in pregnancy. Only small amounts of Humira seem to get into breast milk, and and no harmful effects in breastfed babies have been reported. Talk with your dermatologist and OB/GYN about the benefits and risks of taking Humira while you’re pregnant or breastfeeding.
Make sure your healthcare provider knows about all the medicines you’re taking, from prescriptions and over-the-counter medicines to any vitamins, supplements, or natural remedies.
You generally shouldn’t take Humira with another biologic medicine that also lowers your immune response, because it can increase your risk of serious infections. This includes drugs such as anakinra or abatacept. Also, while you’re on Humira, you should steer clear of live vaccines.
Humira might also change how your body handles certain medicines. This can matter with drugs that need to be kept at a specific range in your body, like warfarin, cyclosporine, or theophylline. If you’re on one of these, your doctor might need to keep a closer eye on you when you start or stop taking Humira.
HS affects Black patients more than others. It’s about three times more common in Black people than in white people. Black patients also tend to be diagnosed later, wait longer to see a dermatologist (the provider best trained to diagnose and treat HS), and are more likely to have more severe HS.
Humira has been used to treat HS longer than any other biologic, but there still isn’t enough research on whether it works differently for Black patients. Black patients were included in the main studies for Humira and HS, but the analysis didn’t look specifically at whether Humira was more or less safe or effective for them.
This doesn’t mean Humira is a bad choice for Black patients or that it works differently for us. It just means there isn’t enough evidence to properly answer those questions. This isn’t a new problem. Black patients have historically been underrepresented in medical studies, including those for HS. We need more research to understand why HS is more common in our community and whether the approved treatments work any differently for Black patients.
There are also some health conditions that might be especially important to think about. Humira can make existing heart failure worse, and one very large U.S. study found that Black patients with HS had about twice the odds of congestive heart failure as white patients. If you have heart failure or have had heart problems, make sure your doctor knows before you start Humira.
Black women seem to be especially affected by HS. Studies across the country have shown that HS is more common both in Black people and in women. One smaller U.S. study found that HS was about three times as common among Black women as among white women, but there is little large-scale research focused specifically on Black women. Scientists still don’t know exactly how many Black women in the U.S. have HS, why HS is more common in Black people, or why it is more common in women in general, although hormones appear to play a role.
Of the biologics approved to treat HS, Humira has been the most extensively studied during pregnancy and breastfeeding. Studies haven’t found a clear link between Humira use during pregnancy and major birth defects. Humira can cross the placenta, especially later in pregnancy, but only small amounts appear to pass into breast milk, and no harmful effects in breastfed babies have been reported. None of this means there are no risks, so if you’re pregnant, breastfeeding, or thinking about getting pregnant, talk with your dermatologist and OB/GYN about the pros and cons of continuing or starting Humira.
Your symptoms: Before your appointment, write down (or ask a loved one to write down) a few things: how long you have had bumps, abscesses, or tunnels, where they usually show up, and how often they come back. Since HS can get worse and then better before you see the doctor, snap some photos when your symptoms are at their worst and bring them along. If your doctor doesn’t suggest HS, ask them directly: “Could this be hidradenitis suppurativa?” If you feel like your concerns aren’t being heard or your treatment isn’t helping, it’s a good idea to get a second opinion from another doctor.
Past treatments: Let your doctor know what treatments — if any — you’ve tried before and if they made a difference or caused any side effects. You don’t have to have taken another biologic before trying Humira, so ask about all your options if what you’re currently doing isn’t enough.
Infections and TB: Because Humira works by calming down a part of your immune system, it can also make you more likely to get infections. Tell your provider about any infections you have now, infections that keep coming back, or if you’ve ever had TB or been around someone who has it. Your provider should test you for TB before you start Humira.
Your heart health: Tell your doctor if you have heart failure or other serious heart problems. Humira and other TNF inhibitors have sometimes caused new heart failure or made existing heart failure worse. This may be especially important for Black patients with HS: One large study in the U.S. found that Black patients with HS were about twice as likely to have heart failure compared to white patients with HS.
Hepatitis B: Let your doctor know if you’ve ever had hepatitis B. Humira can cause the virus to become active again, which can lead to serious liver issues.
Your pain level: Pain is a really important topic, especially for Black patients with HS. One study found that Black patients reported more severe HS pain and were less happy with how their doctors were handling it. If pain is a big part of living with HS, speak up and be specific: Is it making it hard to sleep? Does it stop you from working, moving your body, or doing what you need to do? Is it affecting your mood? How often do you notice it? Ask your doctor what you can do or take to manage your pain right now.
Medication interactions: Before you start Humira, tell your doctor about all the medicines you’re taking. You generally shouldn’t mix Humira with another strong immune-suppressing medicine, because it can raise your risk of serious infections. Humira can also change how your body handles certain medicines, like warfarin, cyclosporine, and theophylline, so your doctor might need to keep a closer eye on you.
Vaccines: Tell your doctor if you’re due for any vaccines. You shouldn’t get live vaccines while taking Humira, so your provider might suggest getting any you need before you start treatment.
Pregnancy and breastfeeding: Tell your doctor if you’re pregnant, breastfeeding, or thinking about getting pregnant. Among the biologics approved for HS, Humira has been studied the most during pregnancy and breastfeeding. Studies haven’t found a clear link between using Humira during pregnancy and major birth defects, and only small amounts seem to pass into breast milk. Talk with your dermatologist and OB/GYN about what’s best for you.
How to give the shot: Your provider should show you exactly how to give yourself Humira before you do it on your own at home. A caregiver can also be taught how to give the injections. Bring any caregivers who might be helping with injections to the appointment.
If you have private insurance, AbbVie (the company that makes Humira) has a Humira Savings Card. If you qualify, this card can really cut down how much you have to pay yourself. Some patients might even pay as little as $0 each month. This card cannot be used if you have Medicare, Medicaid, or other government-funded insurance.
AbbVie also offers a program called Humira Complete, which can help you understand your insurance coverage and find ways to pay less. If you have Medicare, you can talk with one of their insurance specialists about your plan and what other choices you might have.
Here’s an important update: AbbVie is removing Humira from its myAbbVie Assist program. This program provides free Humira to eligible patients. As of July 1, 2026, they stopped taking any new Humira patients. If you’re already in the program, you can keep getting Humira until your current eligibility period ends, but you won’t be able to sign up again after that.
If Humira is too expensive or your insurance won’t cover it, don’t assume you are out of options. Talk to your dermatologist and your insurance company. Ask them what’s covered and what financial help might be available. Learn more about savings and support for Humira
This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking any drug or commencing or discontinuing any course of treatment.
There aren't any known Humira side effects that are specific to Black patients. But there are some health conditions that may be especially important to discuss with your doctor. Humira can make existing heart failure worse. One large U.S. study found that Black patients with HS had about twice the odds of congestive heart failure as white patients with HS. If you have heart failure or other serious heart problems, make sure your doctor knows.
We don't have enough research to know if there are meaningful differences in how Humira works for Black patients. The two main studies for Humira included 633 people with HS, with 91 Black participants. However, researchers didn't share separate results showing how well Humira worked or what side effects happened specifically in Black patients. This doesn't mean Humira doesn't work as well for Black patients; it just means we need more research to truly answer that question.
One study found that Black patients with HS reported more severe pain and were less satisfied with how their doctors were managing it. Don't assume that pain is something you have to live with. Tell your doctor how much pain you're feeling and how it's affecting things like your sleep, work, movement, and mood. Ask what can be done to help manage your pain now and in the future.
Black women seem to be especially affected by HS, but there isn't a lot of research specifically focused on them. If you're pregnant, breastfeeding, or hoping to get pregnant, make sure your doctor knows. Among the biologic medicines approved for HS, Humira has been studied the most during pregnancy and breastfeeding. Studies haven't found a clear link between using Humira during pregnancy and major birth defects, and only small amounts of Humira seem to pass into breast milk. Talk with your dermatologist and OB/GYN about the benefits and possible risks when you're deciding on your HS treatment.
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