Treating hidradenitis suppurativa with antibiotics and hormones

Understand how these therapies can improve your condition at different stages.

If you have the chronic skin condition hidradenitis suppurativa, your dermatologist will recommend treatment options to help heal your existing lesions and prevent new ones from forming. Antibiotic and hormone therapy can be effective components of your treatment, regardless of the stage of your condition. Here's help understanding when these treatments might help, how they work and the possible side effects.


These drugs treat any infection in your lesions, as well as unpleasant odors infections can cause. Antibiotics can also lessen inflammation, heal lesions and prevent new lesions from forming.

Antibiotics can be applied to your skin topically or taken by mouth. If your hidradenitis suppurativa is mild, your doctor might first recommend topical antibiotics, such as clindamycin. Applying the topical antibiotic twice daily might be enough to manage your lesions, though treatment duration varies.

Oral antibiotic therapy is usually recommended for moderate to severe hidradenitis suppurativa or milder cases that don't respond to lifestyle changes or topical antibiotics. A seven- to 10-day course of antibiotics might help soothe inflammation.

Oral antibiotics frequently prescribed to treat hidradenitis suppurativa include doxycycline monohydrate, minocycline, tetracycline, clindamycin, erythromycin, rifampin and amoxicillin/clavulanate. You might need antibiotic therapy for a few weeks or long-term to manage your condition.

Before recommending an antibiotic, your doctor will consider any allergies you might have, other medications you're taking and your history of success with the medication.

While rare, possible side effects include:

  • Diarrhea
  • Clostridium difficile bacterial infection
  • An orange discoloration of bodily fluids
  • Minor burning sensation from topical antibiotics

If you're pregnant, talk to your doctor about which antibiotics might be safe for you.

Hormone therapy

Because hormones called androgens are thought to trigger hidradenitis suppurativa, hormone therapy can be useful in controlling the condition. These might include oral contraceptives containing the hormones estrogen and norgestrel and finasteride (Propecia, Proscar).

Possible side effects of hormone therapy in women include:

  • Birth defects if taken during pregnancy
  • Blood clots

Possible side effects of finasteride in men include:

  • Decreased sex drive (libido)
  • Problems with ejaculation
  • Tender breasts
  • Breast tumors

Your doctor might recommend combining antibiotic and hormone therapies — in addition to making lifestyle changes, such as quitting smoking and managing your weight — for greater effectiveness. Before trying a new treatment, be sure to ask your doctor questions about the risks and benefits.

Dec. 29, 2018 See more In-depth

See also

  1. Acne
  2. Acne mistakes
  3. Acne scars: What's the best treatment?
  4. Acne treatments: Medical procedures may help clear skin
  5. Antidepressant withdrawal: Is there such a thing?
  6. Antidepressants and alcohol: What's the concern?
  7. Antidepressants and weight gain: What causes it?
  8. Antidepressants: Can they stop working?
  9. Antidepressants: Side effects
  10. Antidepressants: Selecting one that's right for you
  11. Antidepressants: Which cause the fewest sexual side effects?
  12. Atypical antidepressants
  13. Birth control pills for acne?
  14. Can zinc supplements help treat hidradenitis suppurativa?
  15. Hidradenitis suppurativa wound care
  16. Clinical depression: What does that mean?
  17. Clinical trials for hidradenitis suppurativa
  18. Coping with the stress of hidradenitis suppurativa
  19. Creating a hidradenitis suppurativa care team
  20. Depression and anxiety: Can I have both?
  21. Depression, anxiety and exercise
  22. Depression: Diagnosis is key
  23. Depression in women: Understanding the gender gap
  24. Depression (major depressive disorder)
  25. Depression: Provide support, encouragement
  26. Depression: Supporting a family member or friend
  27. Don't blame pizza, fries or dirt for acne
  28. Excessive sweating
  29. Hidradenitis suppurativa
  30. Hidradenitis suppurativa and biologics: Get the facts
  31. Hidradenitis suppurativa and diet: What's recommended?
  32. Hidradenitis suppurativa and sleep: How to get more zzz's
  33. Hidradenitis suppurativa: Tips for weight-loss success
  34. Hidradenitis suppurativa: What is it?
  35. Hidradenitis suppurativa: When does it appear?
  36. Hidradenitis suppurativa: Where can I find support?
  37. Living better with hidradenitis suppurativa
  38. Male depression: Understanding the issues
  39. Managing hidradenitis suppurativa: Early treatment is crucial
  40. Hidradenitis suppurativa-related health risks
  41. MAOIs and diet: Is it necessary to restrict tyramine?
  42. Marijuana and depression
  43. Monoamine oxidase inhibitors (MAOIs)
  44. Natural acne treatment: What's most effective?
  45. Natural remedies for depression: Are they effective?
  46. Nervous breakdown: What does it mean?
  47. Over-the-counter acne products: What works and why
  48. Pain and depression: Is there a link?
  49. Reducing the discomfort of hidradenitis suppurativa: Self-care tips
  50. Selective serotonin reuptake inhibitors (SSRIs)
  51. Serotonin and norepinephrine reuptake inhibitors (SNRIs)
  52. Staying active with hidradenitis suppurativa
  53. Surgery for hidradenitis suppurativa
  54. Take action against acne
  55. Treat acne-prone skin with care
  56. Treating hidradenitis suppurativa: Explore your options
  57. Treatment-resistant depression
  58. Tricyclic antidepressants and tetracyclic antidepressants
  59. Vitamin B-12 and depression
  60. What are the signs and symptoms of hidradenitis suppurativa?