QHow does topical resorcinol cream work and will it really help my patients with hidradenitis suppuritiva?

Medically reviewed on 12.1.2023 by Nicholas Brownstone, MD

I had never heard of 15% topical resorcinol cream until I attended a conference last year where Dr Joslyn Kirby (an expert in HS) mentioned it during one of her talks.

Now, I prescribe it to all of my HS patients and have found it to be a super helpful topical for them to apply whenever they get a new inflammatory nodule. The other day, one of my patients asked me during a follow-up visit, “Why didn’t any of my doctors tell me about this sooner? It works so well!”

So, if you haven’t started prescribing it yet, add it to your toolkit.

Resorcinol has keratolytic, antimicrobial, and anti-inflammatory properties. Boer and Jemec were the first to perform a study utilizing 15% resorcinol for HS. Twelve women with Hurley stage 1 or 2 HS were treated with topical 15% resorcinol and followed for at least one year. All patients experienced a significant decrease in pain and reported a reduction in the mean duration of the painful abscesses.

Adverse reactions were found to be mild and usually consisted of some desquamation (which was soothed by moisturizers) and self-resolving brown hyperpigmentation. Although, part of me wonders if this is just post-inflammatory hyperpigmentation from the abscess itself. My patients don’t seem to be bothered by it so far.

In another study of 134 patients with mild to moderate HS, Molinelli et al demonstrated that patients treated with resorcinol 15% showed a significant improvement in Hidradenitis Suppurativa Clinical Response, International Hidradenitis Suppurativa Severity Score System, and Pain Visual Analogue Scale score from baseline compared to patients treated with clindamycin 1% at the 12-week mark.

I have my patients use the topical 15% resorcinol cream BID on a new painful cyst/abscess until resolution. Currently, they can order a 60-gram tube for $38 from Smith Pharmacy, a mail-order compounding pharmacy in Little Chute, Wisconsin, and I find this will generally last them 3 to 4 months since they are only applying it to small areas PRN.

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References:

1. Boer J, Jemec GB. Resorcinol peels as a possible self-treatment of painful nodules in hidradenitis suppurativa. Clin Exp Dermatol. 2010;35(1):36-40. doi:10.1111/j.1365-2230.2009.03377.x
2. Molinelli E, Brisigotti V, Simonetti O, Sapigni C, D’Agostino GM, Rizzetto G, Giacchetti A, Offidani A. Efficacy and safety of topical resorcinol 15% versus topical clindamycin 1% in the management of mild-to-moderate hidradenitis suppurativa: A retrospective study. Dermatol Ther. 2022;35(6):e15439. doi: 10.1111/dth.15439