From the Guidelines
Clindamycin topical with benzoyl peroxide is not the first-line treatment for acute active hidradenitis suppurativa (HS), but it can be used for mild cases or as adjunctive therapy. For acute active HS, oral antibiotics like doxycycline (100mg twice daily) or a combination of clindamycin (300mg twice daily) with rifampin (300mg twice daily) for 10-12 weeks are more effective 1. Topical clindamycin 1% solution applied twice daily may help with mild cases or as adjunctive therapy, but the combination with benzoyl peroxide is more commonly used for acne rather than HS 1.
The treatment of HS should be based on the evaluation of the inflammatory components as well as the scarring and should be directed by evidence-based guidelines 1. The European Dermatology Forum guidelines for the management of HS recommend the use of topical clindamycin 1% solution/gel twice daily for 12 weeks for mild disease 1. However, for moderate to severe cases, systemic treatments are necessary to control inflammation and prevent disease progression.
Some key points to consider when treating HS include:
- The use of adjuvant therapy as needed, such as pain management, weight loss, tobacco cessation, treatment of superinfections, and application of appropriate dressings 1
- The routine use of patient-reported outcomes, including DLQI, itch and pain assessment (Visual Analogue Scale) 1
- The need for surgical intervention should be assessed in all patients depending upon type and extent of scarring, and an evidence-based surgical approach should be implemented 1
- The use of fixed-dose combination topical antibiotic with benzoyl peroxide is recommended for acne, but its use in HS is not well established 1
In terms of morbidity, mortality, and quality of life, the treatment of HS should aim to reduce the severity of symptoms, prevent disease progression, and improve patient outcomes. The use of topical clindamycin with benzoyl peroxide may be beneficial for mild cases or as adjunctive therapy, but its use should be guided by evidence-based guidelines and individual patient needs.
From the Research
Treatment of Hidradenitis Suppurativa
- The use of topical clindamycin with benzyl peroxide for the treatment of acute active hidradenitis suppurativa is not directly mentioned in the provided studies.
- However, the study 2 discusses the use of topical clindamycin 1% solution as a first-line treatment for Hurley stage I and II hidradenitis suppurativa, in combination with LAight® therapy.
- Another study 3 evaluates the efficacy of a combination of systemic clindamycin and rifampicin in the treatment of patients with severe hidradenitis suppurativa, showing a significant improvement in disease severity and quality of life.
- The study 4 mentions clindamycin as the most often used topical and systemic agent in the perioperative treatment of hidradenitis suppurativa, often in combination with rifampicin.
- The study 5 provides a comprehensive review of topical management and wound care for hidradenitis suppurativa, but does not specifically mention the use of clindamycin with benzyl peroxide.
Topical Treatments
- Topical clindamycin 1% solution is used as a first-line treatment for hidradenitis suppurativa, as shown in study 2.
- The combination of clindamycin and rifampicin is effective in the treatment of severe hidradenitis suppurativa, as shown in study 3.
- Clindamycin is the most often used topical and systemic agent in the perioperative treatment of hidradenitis suppurativa, as mentioned in study 4.
Combination Therapies
- The combination of LAight® therapy and topical clindamycin 1% solution resulted in a significantly higher decrease in disease severity and improvement of quality of life compared to topical clindamycin 1% solution monotherapy, as shown in study 2.
- The combination of clindamycin and rifampicin is effective in the treatment of severe hidradenitis suppurativa, as shown in study 3.