It is generally used as a third-line treatment, especially because of the risk of resistance, as rescue therapy for rapid improvement of the disease, or during surgical planning.51,54 Dapsone is a sulfone with antimicrobial, bacteriostatic and anti-inflammatory properties, which may represent a useful alternative in the long-term treatment of mild to moderate forms of the disease.57 Regarding hormonal treatment, the combination of ethinylestradiol/cyproterone acetate or ethinylestradiol/norgestrel, and spironolactone, can be considered in the treatment of certain patients, either as monotherapy in mild or moderate cases, or in combination with other treatments for more severe conditions.12,51,52,54 In general, hormonal treatments are considered to be a good therapeutic option for women with worsening HS during menstruation or with features of PCOS.54 On the other hand, metformin is an anti-diabetic agent that improves IR and may also exert some anti-androgen effect and has been shown to contribute to the control of HS as an adjuvant to other treatments.51 With regard to systemic retinoids, the beneficial effects in HS would be related to the reduction of keratinocyte proliferation, preventing occlusion of the pilosebaceous unit, together with their anti-inflammatory properties
Iron depletion
Some people struggle to maintain their weight loss once they stop using the program
The ferric iron is then bound to transferrin for onward distribution throughout the body through plasma circulation [56]
The suprachiasmatic nucleus, the brain master clock, coordinates the timing of neurotransmitter release, hormone secretion, body temperature, and cellular metabolism
While not hair-specific, their systemic regenerative effects may support overall follicle health, particularly following scalp trauma or procedures
