A case series of 20 women with hidradenitis suppurativa treated with spironolactone

    Andrew Lee, Gayle Fischer
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    TLDR Spironolactone is an effective and well-tolerated first-line treatment for hidradenitis suppurativa in women.
    In a retrospective case series from 2015, 20 women with hidradenitis suppurativa were treated with spironolactone. The patients had a mean age of 31.7 years and disease onset at 24.6 years. At a 3-month follow-up, 85% showed improvement, with 55% achieving complete disease suppression. The treatment was well-tolerated, and the study concluded that spironolactone is a useful and low-cost first-line treatment for HS in women. The study also found no added benefit from combining spironolactone with tetracycline or oral contraceptives, and suggested that 2 mg of cyproterone acetate may be less effective than 100 mg of spironolactone. Despite its limitations, such as the small sample size, the study supported the use of anti-androgen therapy for HS.
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