Antiandrogen therapy in hidradenitis suppurativa: finasteride for females

• Published in: Clinical and experimental dermatology Vol. 47; no. 1; pp. 86 - 92
• Main Authors: Babbush, K. M., Andriano, T. M., Cohen, S. R.
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.01.2022
• Subjects: Adult; Androgen Antagonists - therapeutic use; Androgens; Breast; Female; Females; Finasteride - therapeutic use; Hidradenitis Suppurativa - drug therapy; Humans; Intolerance; Menstruation; Middle Aged; Nausea; Patients; Quality of life; Retrospective Studies; Treatment Outcome; Young Adult
• ISSN: 0307-6938; 1365-2230
• DOI: 10.1111/ced.14847

Summary Background Given its widely accepted efficacy, androgen blockade therapy for hidradenitis suppurativa (HS) has become a standard of care. Although much less frequently used than spironolactone, a small number of HS studies have reported finasteride as an alternative treatment for women. In this study, we describe the response to and perception of finasteride therapy in a diverse cohort of women with HS. Aim To describe finasteride therapy in a diverse cohort of female patients with HS. Methods We conducted an institutional review board‐approved retrospective chart review and telephone survey of 20 female patients aged ≥ 18 years with a diagnosis of HS. Finasteride was prescribed by a single provider at a specialized HS centre. Results The mean age of the patients was 34.3 ± 13.5 years. Finasteride was initiated predominantly because of one or more contraindications or poor responsiveness to spironolactone. Most patients interviewed (90%; n = 18) were willing to take finasteride again or continue with therapy if indicated. Of the 20 patients, 10 (50%) reported overall satisfaction with finasteride, while 7 (35%) were neutral and 3 (15%) were dissatisfied. No patient reported worsening disease activity while on finasteride and only one (5%) reported decreased quality of life. When asked about adverse effects of finasteride, 80% (n = 16) reported none, while 20% (n = 4) experienced ≥ 1 of the following: headache, nausea, menstrual irregularities, breast tenderness or reduced libido/sexual function. Conclusions Our study suggests that androgen blockade therapy with finasteride is a safe and effective alternative for female patients with HS who have contraindication(s) or intolerance to spironolactone.