How you will know it is working
HS progress shows up in the interval between flares long before it shows up in the mirror. We track five markers from your first consultation and review them at every follow-up, so what changes is recorded rather than remembered.
Everything below is something you can check against your own experience — what we watch, the order it typically moves in, and when each one is realistic to judge. If a marker has not shifted by the point we said it should, that is worth a conversation, and we would rather have it than let things drift.
The five markers we track
- Flare frequency — how often
- Flare duration — how long each one lasts
- Drainage — volume and persistence
- Pain — severity and how much of your day it takes
- Medication load — dose and frequency of antibiotics, steroids, biologics
We deliberately do not lead on "clear skin". It is the last thing to move, and judging progress by it is precisely how patients abandon something that is working.
When we judge it
- Weeks 1–4 (Recovery Stage 1) — digestion, sleep and energy shift first. Skin often has not changed. That is expected.
- Weeks 3–6 — the Partial Improvement Plateau. Not failure.
- Months 2–4 (Recovery Stage 2) — this is when the disease should start to change.
- Months 4–8 (Recovery Stage 3) — same triggers, diminished response.
- Month 8+ (Recovery Stage 4) — stable remission is assessed. Not before.
Who responds well
Earlier-stage disease. Shorter duration. Preserved biological repair capacity. A clear, identifiable driver profile. Patients who begin while still on their current medication rather than after stopping it.
When this is not the right treatment
- Extensive EPOH-DSS Stage 4 disease with established tunnels and dense scarring. Scar is
structural and does not reverse with any internal treatment, ours included.
- Patients seeking a fast result. Recovery Stage 1 alone is 4–8 weeks of internal work before
surface change, and stable remission is assessed at month 8 and beyond.
- Patients who want to stop their medication on day one. That is not what we do, and we will
decline.
For patients with very advanced structural change, the realistic goal is a lower inflammatory burden and a lower medication load — not remission. We would rather turn away a patient we cannot help than take their money.
If real aggregate outcome data with a sample size ever exists, it will appear on this page — with its sample size and its method.
Medical disclaimer. This page is general clinical information, not personalised medical
advice. Individual response varies with disease duration, degree of involvement and remaining biological
repair capacity — not every patient reaches the same outcome. No medication should be started, stopped or
altered without consulting your treating physician.
