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Hidradenitis Suppurativa (HS) is a chronic inflammatory skin disease marked by recurrent nodules, abscesses and sinus tracts, typically in the body folds. It is a very challenging disease and causes great distress. The mainstay of treatment is topical antibiotics, oral antibiotics, and more recently adalimumab. Apremilast may also be helpful in moderate hidradenitis suppurativa. Antiandrogen therapy has also been reported to be helpful in treating HS. This has recently been further supported by a recent study that reviewed the charts of 67 patients treated with spironolactone for HS. Spironolactone is an androgen antagonist and often used for the treatment of adult acne in women, hirsutism, and androgenetic alopecia. Significant improvement was noted in pain and inflammatory lesions over an average 7.1 month follow-up period.
Spironolactone is approved as a blood pressure medication; treatment for HS, acne, and other indications are off-label. Spironolactone is generally well-tolerated, but like all drugs there is a long list of possible adverse effects. Adverse effects more frequently seen in practice include dizziness, breast tenderness, and menstrual irregularities. Spironolactone should not be used during pregnancy. Consult with your dermatologist to see if spironolactone is a treatment possibility for hidradenitis suppurativa.