The influence of hormonal combined contraceptive in the onset of hidradenitis suppurativa: a retrospective cohort study

Hidradenitis suppurativa (HS) is a chronic inflammatory cutaneous disease characterized by recurrent painful nodules, abscesses and sinus tracts on the apocrine gland-bearing skin. The role of sex hormones in the pathogenesis as well as the use of hormonal treatment in the management of HS is still debated. We performed a retrospective cohort study, including 183 patients, to assess the influence of the combined oral contraceptive (oestrogen-progesterone COC) on HS onset and disease severity. Univariable and multivariable analyses highlighted that the patients undergoing COC therapy had a later onset of HS, more precisely 9.81 years after the patients who have not received COC, independently of body mass index, family history, smoking, acne, age of menarche and concomitant gynaecological disorders. This study suggests that COC use could influence the development and the progression of HS and supports the key role of sex hormones in the pathogenesis of the disease.