The problem of chronic hydradenitis suppurativa (CHS) shifted to a new level throughout the world, accordingly to an increase in its prevalence and a search for new methods of treatment. The prolonged course of the disease, often torpid to traditional anti-inflammatory therapy, a variety of clinical forms and localization of CHS, requires the development of classifications and evaluation scales. The results of histological studies of specimens from the lesions are heterogeneous; follicular occlusion is not always determined, while there is a greater involvement of apocrine glands in the inflammatory process in the axillary areas than in the inguinal ones. Currently, there are several scales to assess the severity of CHS, trigger factors are identified and so are comorbid conditions in patients (diabetes, smoking, obesity). The choice of treatment method is based on the severity and prevalence of clinical manifestations. Until now, there is no consensus on the tactics of management of patients with CHS. There are European clinical guidelines that determine the stage approach and the choice of drugs depending on the degree of damage by Hurley. However, even abroad there is no consensus on the optimal method of treatment: many researchers note the greatest effectiveness and duration of remission after surgical radical excision of the affected foci, others point to the positive effect of traditional anti-inflammatory therapy or treatment with tumor necrosis factor inhibitors-α (adalimumab). In our country, special attention is paid to conservative treatment of patients with CHS in order to reduce the microbial burden on the organism and achieve prolonged remission. For these purposes, actinomycete lysate is successfully used in the pre- and postoperative periods.