Hidradenitis suppurativa (HS) is difficult to treat. Official guidelines have only recently been developed, and suggest that patients should be provided with both adjuvant, medical and surgical therapy. The guidelines are the result of resurgent interest in this disease, in which etiology and pathogenesis are only partially understood at present. Recent research has, however, identified possible targets for specific intervention using biologicals. In addition, classical clinically driven developments of new treatments continue to evolve, leading to several interesting new therapies for HS patients. In this article recent trends in medical treatments are described following a systematic review. Searches were conducted in MEDLINE(R), the Cochrane Library and Web of Science(TM) where specific treatments were combined with the search term 'hidradenitis suppurativa' and references from 2010 to March 2016 were included. A total of 365 papers were identified, 79 of which were retained for analysis following exclusions. The following treatments are discussed in detail: infliximab, adalimumab, ustekinumab, anakinra, alitretinoin, metformin and vitamin D. HS is a disease with a considerable morbidity and a great unmet need for treatment. A continued need for development of new treatments therefore exists for this otherwise often devastating disease.