Which common findings in women with hidradenitis suppurativa (HS) may be due to hormonal effects?

Updated: Nov 20, 2020
  • Author: Marina Jovanovic, MD, PhD; Chief Editor: William D James, MD  more...
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Hirsutism and obesity are common findings among women with hidradenitis suppurativa. [47]  Obesity can alter sex hormone metabolism, leading to an androgen-excess state. Excessive androgens can enhance keratin production and coarsening of the hair shaft, promoting follicular occlusion. [26]  Although hirsutism, obesity, and acne among women with hidradenitis suppurativa are more common than expected, [42] the incidences are not significantly different from those in the general population. [39, 40, 48] However, neither evidence for biochemical hyperandrogenism nor suppression of SHBG has been shown in women with hidradenitis suppurativa when compared with age-, body weight-, and hirsuties-matched controls. [42]  In one study, obesity and oral contraceptive use were not common or pronounced among patients; this observation suggested that, while these parameters may influence preexisting disease, they are unlikely to be pathogenically important. [49]  In obesity, increased skin-to-skin contact may promote follicular hyperkeratosis. [26]

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