
Christopher Sayed
Board-certified dermatologist and professor at UNC Chapel Hill, where he directs the hidradenitis suppurativa clinic and serves as VP of the Hidradenitis Suppurativa Foundation.
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Sep 8, 2026
Don’t Wait for the Tunnels
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1:03Matt ZirwasHOST
What do you like? How do you make the decision of making sure that you don't wait too long, you know, before somebody gets on an aggressive systemic therapy?

Christopher SayedGUEST
Yeah, this is a great question because I think the needle has moved a lot in the last several years because number one, the treatment landscape has changed.

Christopher SayedGUEST
We also understand a lot more about the impact that HS has on people, even at its earlier stages.

Christopher SayedGUEST
And this idea that as tunnels start to develop, there's irreversible damage that occurs so that even if you jump in at some point and start more advanced therapies, the ceiling becomes lower the further along they get in their disease.

Christopher SayedGUEST
So the more structural damage somebody has where tunnels have formed and scarring have formed, it's clear that to get them to like, you know, not just a high score 50 response, but like a 75%, 90%, 100% response, you have fewer patients who reach that the more advanced they get in their disease.

Christopher SayedGUEST
And so, yeah, this move is to treat earlier when that ceiling is still high, when you can really hopefully clear patients and keep that damage from occurring.

Laura FerrisHOST
And I guess adding to that, like, is it, does the trajectory matter as much as like the current state, right? So like, is the fact that, geez, I've seen this progress in six months different for you than the patient who, you know, kind of got to the same point over three years?