Biologic drugs used to treat hidradenitis suppurativa (HS) can be safely and conveniently self-injected at home, but some people are afraid to try this method. Many myHSteam members have shared their self-injection experiences, as well as their fears.

“I hate needles,” one myHSteam member wrote. Another said, “I’ve heard great things about biologics. If it works for me, then I’m braving the needles for sure.”

When appropriate, self-injection is a popular alternative to clinically administered injections. If you’re afraid of giving yourself an injection, think about how it can cut down on doctor visits and offer more self-sufficiency with your treatment options. Once people get over the fear, many prefer the flexibility and comfort of self-injection.

Knowing what to expect can help you face your fears. Here’s what to know so you can be prepared to face your self-injections with confidence.

Biologic Treatments for HS

Biologic drugs are made from living cells and are used to treat autoimmune diseases and inflammatory conditions. Biologic therapy neutralizes the overactive immune response that creates inflammation. This helps reduce painful bumps (nodules, cysts, or lesions). Biologics can also decrease HS symptoms like discharge, inflammation, and swelling.

Adalimumab (Humira) and secukinumab (Cosentyx) are the only biologics approved by the U.S. Food and Drug Administration (FDA) to treat HS. However, two other biologics — ustekinumab (Stelara) and infliximab (Remicade) — are sometimes prescribed off-label for HS. This means they’re used for a purpose different from what they were originally approved for.

Do You Have To Inject Your Biologic Therapy?

Currently, biologics can only be given intravenously (into a vein) or by injection. That’s because they consist of large molecules that can’t be properly absorbed in the gastrointestinal tract if taken orally. There are three main types of self-injection devices for self-administering biologic drugs. They each have their advantages and disadvantages, depending on your preference. Talk to your doctor about the option you feel most comfortable using to make self-injection less scary.

Prefilled Syringe

A prefilled syringe is a syringe and needle that has been filled with the appropriate dose of a medication. The dose is administered manually (by hand), and the user can control the speed of the injection. However, self-injecting with a prefilled syringe can be hard for people with HS who have trouble using their hands.

Self-Injection Pen

A self-injection pen, also called an auto-injector, is prefilled with medication. It has a hidden spring-loaded needle, which is released by pressing a button when the device is pressed against the skin. Self-injection pens are easier to use for some people. However, they may cause more swelling, bruising, or pain than a slower injection with a standard syringe.

E-Devices

Electronic devices (e-devices) are reusable auto-injectors with advanced technology, offering more features than standard injection pens. E-devices can let users control the injection speed, keep a record of each injection, and have skin sensors that stop the injection if skin contact isn’t correct. However, some people might find e-devices too complicated.

Benefits of Self-Administering HS Treatments

Self-injection isn’t the best option for all HS medications or for everyone who takes them. Talk to your dermatologist to see if biologics and self-injection could be right for you. Benefits to self-injecting your biologics rather than getting them at the doctor’s office include:

• Every dose you give yourself is one less in-person doctor’s appointment you have to make, commute to, wait for, etc.
• Self-injection gives you the flexibility to take your meds where and when is best for you (as opposed to the dermatology provider’s office hours).
• Administering your self-injection from the comfort of your home, in a safe familiar space, may help you relax and cope better with the fear of needles.

How Fear of Injections Can Pose a Risk to Your Health

Missing a dose, an appointment, or a test due to a fear of injections could put your health at risk. Overcoming this fear can help you stay on track with your treatment and protect your health.

Poor Treatment Adherence

People with a deep fear of injections are more likely to refuse or delay necessary health care interventions. This fear can make it harder to stick to their biologic treatment for HS. The risks of poor HS treatment adherence include worse symptoms and treatment outcomes. Overcoming your fear of injections may help you take your medications more consistently, which could improve the way your treatment works and your quality of life.

Follow-Up Care

HS can be a treatment-intensive condition, often requiring many visits to doctors. If you’re living with this skin disease, chances are that blood will eventually be drawn (and needles involved). This is especially true if you’re on a biologic that requires regular follow-up testing and monitoring to make sure the treatment is working well.

Knowledge Is Power: Understanding Your Fear

If you have a fear of needles, you’re not alone. Around 25 percent of adults are afraid of needles, and the prevalence of needle fear is even higher in younger people. If your needle aversion is a barrier to your health and to adding a biologic to your HS regimen, it’s a good idea to overcome your fear of injections.

The good news is, for most people, overcoming the fear of injections is doable, even for those with trypanophobia, the extreme fear of medical procedures involving needles. You can find a wide array of tools and strategies to help you overcome your fear of injections. Knowledge can boost confidence, which can decrease fear. Maybe getting to the core of your fear and understanding it better can help you overcome it.

Tips for Administering Self-Injectable HS Meds

For many with moderate to severe HS, the benefits of self-injectable biologics far outweigh the fear of the needle and the pain of their condition. “At first I was scared, but I am glad I got over that,” shared a myHSteam member who overcame their fear and now uses biologics. “It is the best my skin’s been and the least amount of pain I have been in for months now.”

Education

Understanding how self-injection works may help you gain confidence and overcome your fears. Do your research and talk to health care professionals to learn all you need to know about self-injecting your HS treatment. Once you know the risk factors that trigger your fears, you can better avoid them.

If injection pain is a major concern, there are ways to reduce and manage the pain before, during, and after an injection. Bring your meds closer to room temperature from their refrigerated storage before you inject them. To reduce any pain or swelling, numb the injection site with an ice pack or a topical anesthetic cream like lidocaine before and after self-injecting.

Self-Injection Support

Self-injection may be better if you have support — from both doctors and peers. A study tracked more than 2,200 people taking adalimumab for an autoimmune condition, including skin conditions such as HS. Half of the participants joined a treatment-specific patient-support group (PSP). More PSP participants than nonparticipants took their adalimumab as directed in the first year, reported better management of their condition, and went to the hospital fewer times.

If you’re interested in finding a self-injection support group, talk to your health care providers for a referral.

Learning From myHSteam Members

Members of myHSteam share their tips for injecting biologics. For example, some people start the process by relaxing with their favorite cup of tea and calming music. Letting your biologic drug reach room temperature before injecting can help reduce pain and help you feel more confident that you won’t feel too much discomfort.

Sometimes, putting the injection in the context of the alternative helps people get over their hesitancy or anxiety. “The pain of the injection is nothing compared to the days or weeks waiting on one to drain or just go away,” a member commented. “I'll take the injections over not being able to walk, sit, or even comfortably lie down.”

Some members report that the injections get easier with time. “Injecting was a little bit of a psychological challenge for me at first, but now it’s becoming less and less of a big deal every time I do it,” another member shared.

Self-injecting biologics for HS can be intimidating, especially if you’re afraid to use needles. But with the right information, preparation, and support, it can become easier — and even help you feel more in control. Getting past the fear of injections can help you stick with your treatment and improve your health and quality of life.

Find Your Team

On myHSteam, the social network for people with hidradenitis suppurativa and their loved ones, more than 44,000 members come together to ask questions, give advice, and share their stories with others who understand life with HS.

How do you cope with your fear of injections? Do you have advice for getting used to self-injections? Join the conversation in the comments below, or post on your Activities page.