Spironolactone May Benefit Women With HS


Spironolactone may benefit women of childbearing age with mild hidradenitis suppurativa (HS), especially if initiated early, according to the results of a single center retrospective study.


  • This retrospective study included 157 women aged 12-50 years (median age, 36.5 years) with HS who received spironolactone for at least 3 months between 2000 and 2021 at Michigan Medicine outpatient dermatology clinics. The majority of patients were White (59%) or Black (37%) individuals.
  • The median prescribed dose was 100 mg/d, the most common dose was 50-100 mg/d, and the median time spironolactone was initiated was 8.8 years after HS was diagnosed.
  • Improvement status was classified on the basis of objective clinician assessments, including documented reductions in the lesion count, pain, and symptoms.


  • Overall, 31 patients (20%) showed improvements with spironolactone treatment.
  • A shorter duration between the diagnosis of HS and the initiation of spironolactone was associated with improvement (P = .047).
  • Axillary involvement (P = .003), the use of intralesional steroids (P = .015), previous treatments (P = .023), and previous treatment failures (P = .030) were linked to a lack of improvement with spironolactone.
  • Patients with Hurley stage III were 85% less likely to experience improvement with spironolactone (P = .036).


Spironolactone, which has antiandrogenic properties, “may be beneficial for patients with mild HS, notably those at Hurley stage I if implemented early as a primary or ancillary treatment,” the authors concluded, adding that prospective, multicenter studies are needed to “elucidate further the safety and efficacy of spironolactone for treating HS.”


The study was led by Suma V. Gangidi, BS, Carle Illinois College of Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois, and was published online on July 1, 2024, in the International Journal of Women’s Dermatology.


Retrospective design can introduce inherent biases, including the potential for missing or misclassified data. Additionally, study was conducted at a single center, which may limit the generalizability, and findings were also limited by lack of standardized objective measures for assessing treatment improvement, presence of confounding variables from concomitant treatments, small sample size, and potential multicollinearity.


This study did not receive any funding. One author declared ties with various pharmaceutical companies. The other authors declared no conflicts of interest. 

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

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