Hormonal Treatments and Considerations for Adolescents with HS

This discussion focuses on hormonal treatments for adolescents with Hidradenitis Suppurativa (HS) and acne, emphasizing the significance of the menstrual cycle in HS exacerbation. It notes that while adult data indicates that around 62% of women experience HS worsening during menstruation, there is a lack of comprehensive data on adolescents. The talk highlights the benefits of hormonal therapies such as combined oral contraceptives (COCs) which, when containing appropriate estrogen and progestin levels, can help manage HS and acne symptoms. Spironolactone, an anti-androgen, is discussed as a reliable treatment, shown to be effective and safe for adolescents, with suggestions to combine it with COCs for better results. Monitoring for potential side effects, like hyperkalemia, is recommended when using these medications. The talk also addresses the prevalence of Polycystic Ovarian Syndrome (PCOS) among HS patients and advises careful assessment before starting hormonal treatments. Various treatment options, including finasteride and topical agents like classcoderone, are mentioned, although they are less commonly used. The overall conclusion is that more research is needed to assess the safety and efficacy of hormonal treatments in young patients with HS.