Table IV.

Recommendations for hormonal agents

Hormonal agents, including estrogen-containing combined oral contraceptives, spironolactone, cyproterone acetate, metformin, and finasteride, should be considered in appropriate female patients, either as monotherapy for mild-to-moderate HS or in combination with other agents for more severe disease.

Anecdotal data suggest that progestogen-only contraceptives may worsen HS and should potentially be avoided.

Small samples sizes, variable outcome measures and methods, and reporting bias are major limitations in all described evidence of hormonal therapies.

HS, Hidradenitis suppurativa.