Rifampicin and Clindamycin

I posted this about 6 months ago. Has anybody tried this combination?

Hi Alun Evans,

What does the Rifampicin and Clindamycin treatments actually do? what sort of results have you seen. Could you tell me how much it costs.

Also, I was thinking of getting laser hair removal in my underarms, because I find that my HS gets better when I remove the hair. I asked my dermatologist about this and he seemed to think it could be a good idea, the only downside he mentioned was the significant potential scaring.

Thanks

Hi Alun,

Yes I have tried it but didn't get very far as i couldn't tolerate it. Kept getting stomach upsets and terrible cramps. Tried about 3 times. I have just had both armpits done and touch wood not too bad since the wounds actually healed but it has only been about 6 weeks. I have tried just about every type of anti biotic and they either don't have any effect or I can't tolerate them. Have an derm doc who does not appear to give up on me so there is still hope. I will have a go with anything that might help.

The best thing I have tried so far is isotretinoin but after about 9 months of treatment I had a really bad outbreak so it got stopped plus the fact I was by then really struggling with the side effects.

Hope this helps

fiona

Hello

In reply to the above questions

Rifampicin and Clindamycin treatment acts as a powerful anti inflammatory combination in HS. I find it works in almost everyone [see original post below]. New evidence is coming out in the form of clinical trials. It is free on the NHS and even privately the drugs are quite cheap.

Laser hair removal may be of some benefit. I wouldn't say it was first line though. The risk of scarring as a result of laser hair removal should be very low if done properly.

Most other antibiotics have relatively little effect. I tend to try and manage stomach cramps etc by reducing the dose or making it intermittent. I've only had one or two patients who really couldn't take it.

Isotretinoin is quite good but not as effective as the above.

It won't be right for everyone but I want to make sure all HS sufferers at least know of the possibility.

Kind regards

Alun Evans

Hi I have just completed a 12 week course of clindamycin and rifampicin and had no remission although did feel some relief between 8 and 10 as symptoms got less severe. Less than three weeks after completing course and I am having a major flare up in a different location from the normal loci although relatively nearby. I hope this information helps someone. Lolo

Hello

Very sorry to hear that R+C didn't work for you. I would move onto infliximab [Remicade] next.

Alun Evans

I am starting a course 10 week course of R & C today, after none of the other antibiotics working. Has anyone managed to complete the course? I am really worried about all the side effects, esp the visible discoloured sweat. I am trying to lose weight as advised and am now worried that this will hinder my exersize at the gym (more than it usually does due to the pain it causes).

Any information on using these medications will be greatfully received.

Kaz

hello Alun nice to know that there are dermatologists reading boards such as this one. hs in itself is bad enough but to go to a doctor and be told you have bad acne why dont you clean yourself properly is beyond words acceptable on these boards.

anyway.......

hopefully work collegues of yours are also reading and taking notes.

the description of hs as a skin disease seems strange. hs is visible on the skin but surely does not start there. isnt it a disease of the sweat glands/hormone related/allergic reaction to dairy/throid related/genetic/pores too large at the base of hair follicles so allowing infection into the skin/the body producing leakage to cleanse its self of toxic material in an abnormal way/liver misfunction?......just a few of the theorys i've read ..... so yeah i can understand that untill more is knowm it is just as well to call it a skin disease but include other experts in the mix just to cover all bases. for example a dermatologist asking for a food intolerance/liver/hormone check.

hs is not caused by lack of hygiene or every homeless person would have hs.

anyway nioce that your here hope we can all continue to learn from each other.

Hi Alun i am willing to give this a go ,as ive tried everthing else but i need someone like yourself or someone that has the knowledge to tell me your thoughts or anyones views, i am 55yrs of age and not in very good health. i suffer from diabeties insulin controlled [excuse the spelling ]and have had h.s. for 20+years ive had a lot of surgery done all over my body, my h.s. is sometimes out of control. what i need to ask you? I have read a few times between the lines[ liver misfunction ] Ihave scrosis of the liver in the advanced stages a side affect from my diabeties, i dont drink tea total can there be any link from [diabeties] liver damage] h.s.] is it worth while researching, can any one give me there thoughts., views on this could there be a connection? [excuse my spelling ] :? THANKYOU, MARGARETANN

Hi Alun. I know you posted over a year ago but still hope people read this. I find it reassuring that dermatologist like yourself are reading forums. I have suffered from HD for 2years, it's safe to say I have been to hell and back with this disease. I have tried every antibiotic known to man and they had very little or no effect, they very very quickly stopped working. I have recently been on the combination treatment Clindamycin and Rifampicin. 300mg of each. This for me has been the Best Treatment Ever!! From having flare up after flare up for the past two years I was giving up on doctors and dermatologist. Since they referred me back to the hospital to see yet another dermatologist who gave me this treatment I haven't looked back since. I was on this treatment for 12weeks and ended the course of tablets on Jan 29th. Now to date... 7th April I have had NOT ONE FLARE UP!! For those who have suffered with this condition for years will know that just them 2 months of not flaring up has done wonders for me. The depression I was experiencing and the pain I was going through month after month. This is the longest I have been without any flare up in my groin area. Not having to worry, if I move this or that way will I flare up? If I do that... Will I flare up? I haven't had to worry about it. Although I know this isn't a cure and has simply put me into remission for X amount of time it's promising to know that I can go back on this treatment after a break obviously cos the tablets are so powerful and can cause last damage if breaks aren't taken in between. For those worrying about side effects... I had non. The only side effect I had was my urine went a kind of red colour and that was only for the first time I urinated each time after taking the tablets.. So it wasn't like it was permanently that colour. My sweat did not turn red and I also had no other side effect. My dermatologist said that they can't and won't stick me on the TNF inhibitors because they cost £13000 per year and simply I am not severe enough. To which I replied "so I have to be on deaths door with a leg dropping off to receive this treatment?" he said "yes". Lol. In his opinion TNF inhibitors aren't all they are cracked up to be, he said the people he has treated it hadn't helped much. He mentioned one person who he has treated with TNF's and that was a 10year old boy with HS, psoriasis and crohns disease. He said his crohns and psoriasis have improved but not his HS. I have psoriasis as well but I can live with that and it isn't severe. It's the HS that's the problem. I am a little nervous as now in April we are approaching the dreaded summer time! To which my condition is worst. Last year during the heat wave I spent most of the time in the most dreadful pain and depression and discomfort. I'm hoping this summer I may be able to spend all my time in work and hopefully after this break I can go back on the tablets and get through the first summer without pain or worrying. Fingers crossed! I am also in the process of applying for funding from the NHS for laser treatment on my groin and for my pilonidal cyst (top of my bum crack). I'm hoping this will help somehow for the HS in my groin. Other forums I have read have actually said it made there HS worse... I'm hoping this isn't the case. If anyone has info on if laser treatment can actually make HS worse after having it is much appreciated. Thanks very much Alun for your original post and I hope many read this and it helps. Like Alun has said... Of all the forums I have read there is very little mention or knowledge of the Clindamycin and Rifampicin treatment. Nearly forgot to mention whilst taking these tablets I WAS and STILL AM using Clindamycin Gel in affected areas (groin and top of bum crack) once a day. I think this helps very much as well. Simply rub in areas only once a day. I think this is key to helping and prevention of HS flare up. I shower every night after work and every morning before work and use hibiscrub wash before applying Clindamycin Gel in the morning. Although this has been a change to my routine in the morning and had to get up earlier... I feel it has helped me. Help this helps someone... Thanks again Alun for your post.