The Role of Hormones in Hidradenitis Suppurativa: A Systematic Review

Hidradenitis Suppurativa (HS), a chronic skin condition, is associated with hormonal dysregulation, according to a systematic review. The disease is linked with a dysregulated release of pro-inflammatory adipokines and insulin resistance, which is more common in HS patients regardless of BMI, age, and gender, potentially leading to cardiovascular disease. Anti-androgenic therapy, using drugs like finasteride, spironolactone, and cyproterone acetate, has shown effectiveness in treating HS, especially in female patients. Metabolic syndrome is present in 32.4% of HS patients, with a 1.69-fold higher risk of developing diabetes mellitus. Antidiabetic therapy with metformin resulted in clinical improvement in 50%–72% of HS patients. The prevalence of Polycystic Ovary Syndrome (PCOS) in HS is 9%, and HS symptoms can worsen around menstruation and improve during pregnancy. The review recommends screening HS patients for insulin resistance and PCOS.