- Plastic Surgery
Morpheus8 and Hidradenitis Suppurativa: Promising Alternative or Just Experimental?
- December 5, 2025
- By Fernando Amato
An aesthetic technology that is starting to gain ground in clinical dermatology — but does Morpheus really help with hidradenitis suppurativa?
Morpheus8 for Hidradenitis Suppurativa: Evidence, Limitations, and When to Consider
Hidradenitis suppurativa (HS) is a chronic and recurrent inflammatory disease, which often causes pain, abscesses, fistulae, and deep scars. Although drug and surgical treatments are the pillars of management, new technologies have been studied as complementary options. In this context, interest in Morpheus for hidradenitis suppurativa is growing, especially in mild to moderate stages.
However, before detailing its role in treatment, it is essential to understand that the use of Morpheus8 in HS is still experimental, with few studies and without formal inclusion in international guidelines.
- 🔬 Morpheus in hidradenitis suppurativa is therefore not yet part of the official protocols.
- 📉 Initial evidence thus shows improvement in inflammatory lesions and scars.
- ⚠️ Risks exist, including burns, dyschromia, and scarring.
- 🧪 Available studies are small, with no standardization of parameters.
- 🩺 Only specialists experienced in HS and energy-based technologies should recommend it.
What is Morpheus8 and how does it work?
Morpheus8 combines microneedling with fractionated radiofrequency (RF), delivering thermal energy to different depths of the skin. This combination promotes:
- Collagen and elastin remodeling
- Subcutaneous tissue contraction
- Improvement of texture and scars
- Reduction of excess skin in some areas
For this reason, the equipment is widely used in aesthetic procedures, such as the treatment of sagging skin, rejuvenation, and acne scars. Thus, only in recent years has it begun to be studied in inflammatory dermatological diseases, including hidradenitis suppurativa.
Morpheus for hidradenitis suppurativa: what do studies show?
Evidence is limited. However, the most relevant study is a pilot with only 10 patients, which evaluated fractionated radiofrequency with microneedling in a controlled split-body scheme (half of the body treated; half serving as control).
Main findings of the study:
- Significant reduction of inflammatory lesions in the treated area
- Decrease in HS severity scores
- Improvement in cutaneous inflammatory markers
- Application performed in 3 sessions, at bi-weekly intervals
Although promising, the study has important limitations:
- Small sample size
- Short follow-up time
- Lack of standardization of parameters (energy, number of sessions, needle depth)
- Absence of comparison with standard treatments
Therefore, despite initial results suggesting benefit for mild to moderate HS, there is still insufficient evidence to recommend routine use.
Why is Morpheus not in HS treatment guidelines?
Brazilian and international guidelines continue to prioritize treatments with robust clinical evidence. These include:
- Control of risk factors (such as smoking — see: http://plastico.pro/riscos-tabagismo)
- Topical and systemic antibiotics
- Retinoids in selected cases
- Biological therapies (mainly adalimumab)
- Surgical procedures such as deroofing or wide excision
- Metabolic control and body weight assessment
- Adequate preparation with pre-operative exams (http://plastico.pro/exames-preop)
Energy-based therapies, such as diode laser, Nd:YAG, and intense pulsed light, already have a higher level of evidence in HS, with a focus on hair removal. However, in contrast, fractionated radiofrequency with microneedling has not yet been validated in large, multicenter studies.
Potential benefits of Morpheus in hidradenitis suppurativa
The use of Morpheus for hidradenitis suppurativa may therefore bring some theoretical benefits and those observed in initial studies:
1. Scar remodeling
HS often leaves depressed and fibrous scars. Microneedling with RF stimulates collagen and can thus improve texture and irregularities.
2. Reduction of local inflammation
Thermal energy can thus modulate inflammatory mediators, reducing active nodules.
3. Possible treatment of superficial scar tunnels
In mild cases, tissue contraction can reduce irregularities and fibrosis.
4. Complement after clinical control
Patients who have already stabilized the inflammatory condition can, however, benefit in residual areas.
Important limitations and risks of Morpheus
Despite the potential benefits, the limitations are significant:
1. Still limited evidence
There are no large, multicenter, or comparative clinical trials with standard therapies.
2. High cost and need for specialized technology
The equipment is, however, expensive and restricted to specialized clinics.
3. Possible risks and complications
Include:
- Burns
- Dyschromia (spots)
- Hypertrophic scars
- Infections
- Significant pain
- Therapeutic failure
Furthermore, the FDA recently issued an alert about serious complications related to microneedling RF devices, reinforcing the need for specialized supervision.
4. Does not replace standard treatment
HS is a chronic and complex disease that requires a multidisciplinary approach — Morpheus is only an adjuvant.
When to consider Morpheus for hidradenitis suppurativa?
Morpheus should not be used alone in disease control. It can be considered as a complement when:
- HS is mild to moderate, without deep fistulae
- The inflammatory condition is controlled with drug treatments
- There are residual scars or fibrous areas
- The patient has been duly informed that the use is off-label
- The procedure will be performed by a dermatologist or plastic surgeon with experience in HS and energy-based technologies
In cases of advanced HS, with fistulous tracts, recurrent abscesses, and extensive scarring, surgical treatment — such as cruroplasty (http://plastico.pro/cruroplastia) or other forms of excision — remains the standard.
Integration with other treatments and patient preparation
Morpheus should be part of a broader therapeutic plan, which includes:
- Smoking cessation management
- Weight control
- Balanced diet
- Treatment of comorbidities such as lipedema
- Adequate anesthetic evaluation when necessary (http://plastico.pro/anestesia-em-plastica)
- Procedures performed in appropriate environments, such as day hospital
Conclusion: Is it worth using Morpheus in hidradenitis suppurativa?
Morpheus for hidradenitis suppurativa represents an interesting possibility, especially for mild to moderate cases. However, the approach is still experimental, lacks large studies, and does not replace proven treatments.
It can be useful as an adjuvant, especially for improving scars and residual inflammation reduction, provided that:
- There is a careful indication
- The patient is informed about limitations
- The procedure is performed by a qualified professional
If you live with HS and want to evaluate complementary options, schedule an appointment with an experienced dermatologist or plastic surgeon. An individualized assessment is essential to determine if this technology can be part of your therapeutic plan.
Video related to HS and complementary technologies:
🎥 Liposuction and Abdominoplasty: Differences and Risks
(Chosen for its correlation with energy-based technologies and surgical approach in chronic skin and subcutaneous diseases.)
Questions and Answers
1. Does Morpheus treat the cause of hidradenitis suppurativa?
No. Morpheus does not act on the systemic inflammation that causes hidradenitis suppurativa. It can only help as a complement, especially in mild or controlled cases.
2. Is Morpheus indicated for severe hidradenitis suppurativa?
No. Patients with severe HS, with deep fistulae and extensive abscesses, usually require surgery and biological therapies. Morpheus does not replace these approaches.
3. Is the use of Morpheus in HS approved by medical guidelines?
Not yet. National and international guidelines do not include Morpheus as a standard treatment for hidradenitis suppurativa, classifying it as experimental.
4. How many Morpheus sessions are needed for HS?
The few studies suggest three bi-weekly sessions, but there is no standardized protocol. The amount may vary according to severity, area, and individual response.
5. Does the Morpheus procedure hurt?
Yes, it can cause moderate pain. Topical anesthesia or local infiltration is usually used for greater comfort during application.
6. Can I do Morpheus if the area is inflamed?
Ideally not. The treatment is usually indicated when inflammation is more controlled, reducing the risk of complications and increasing efficacy.
7. Can Morpheus cause skin discoloration?
Yes. There is a risk of hyperpigmentation or hypopigmentation, especially in darker skin or skin prone to scarring.
8. Does Morpheus replace antibiotics or biological medications?
No. It acts only as complementary therapy and does not replace proven treatments, such as antibiotics, retinoids, or biologics.
9. Can Morpheus be used after surgery for HS?
Yes. In some patients, it can be used after initial healing to improve texture and residual irregularities, provided it is indicated by a specialist.
10. Who can perform Morpheus treatment in patients with HS?
Dermatologists or plastic surgeons trained in microneedling radiofrequency and with experience in the management of hidradenitis suppurativa. The technique therefore requires specific knowledge to minimize risks.
Related articles
Agendar consulta
Precisa de orientação personalizada?
Marque uma avaliação com o Dr. Fernando Amato e tire as suas dúvidas sobre cirurgia plástica.
Falar no WhatsApp