Hidradenitis Suppurativa Linked to Higher Risk of Self-Harm and Suicide: JAMA
Denmark: A large Danish registry-based study has found that patients with hidradenitis suppurativa had about twice the rate of self-harm, including suicide, compared with the general population. These patients also showed a higher prevalence of smoking, alcohol use, and preexisting mental health disorders. Among individuals who died by suicide, those with hidradenitis suppurativa were more likely to have a prior episode of self-harm, highlighting the need for closer psychological assessment and support in this population.
The findings come from a research letter published in JAMA Dermatology by Nikolaj Holgersen and colleagues from Copenhagen University Hospital, Denmark. Hidradenitis suppurativa (HS), a chronic inflammatory skin condition, has previously been linked to psychiatric comorbidities, but data exploring self-harm as a contributing factor to suicide risk have been limited. This study aimed to address that gap using large-scale national data.
For this purpose, the researchers conducted a nationwide cohort study using Danish health registries spanning from January 2003 to December 2020. The analysis included 9,566 individuals diagnosed with HS, with a mean age of 38.7 years, of whom nearly 69% were women. These patients were matched by age and sex with 47,827 individuals from the general population. The primary outcomes assessed were episodes of self-harm and deaths due to both violent and nonviolent suicide.
The following findings were reported:
- At baseline, individuals with hidradenitis suppurativa had higher rates of smoking, excessive alcohol use, and drug use compared to controls.
- Mental health disorders were more prevalent among patients with HS.
- Patients with HS were more likely to have a history of prior self-harm.
- Lower educational attainment was more commonly observed in the HS group.
- During follow-up, 3.3% of patients with HS experienced self-harm compared to 1.1% of controls.
- Suicide rates were higher in the HS group, with 0.2% deaths compared to 0.1% in the control population.
- HS was associated with more than a twofold increased risk of self-harm.
- A significantly higher risk of suicide was also observed among patients with HS.
- Individuals with HS without prior self-harm history showed particularly elevated risk.
- Even those with a prior history of self-harm remained at increased risk compared to controls.
- Among those who died by suicide, patients with HS were more likely to have a history of self-harm.
- Patients with HS were more likely to use nonviolent methods of suicide compared to controls.
These findings highlight the complex interplay between chronic skin disease and mental health. The authors emphasize that self-harm may act as an important intermediary step leading to suicide in this population. As such, early identification of psychological distress and proactive mental health support could play a critical role in reducing adverse outcomes.
Overall, the study highlights the importance of a multidisciplinary approach in managing patients with hidradenitis suppurativa, with greater attention to mental health screening and intervention as part of routine care.
Reference:
Holgersen N, Rosenø NAL, Nielsen VW, et al. Hidradenitis Suppurativa and Risk of Self-Harm and Suicide. JAMA Dermatol. Published online March 11, 2026. doi:10.1001/jamadermatol.2026.0037
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