Anti-androgen treatment in women with acne: a controlled trial

Abstract

Ninety female patients with acne were allocated randomly to one of three groups and treated either with Diane, a high dose cyproterone acetate (CPA) regime with ethinyloestradiol, or Minovlar. The same dose of oestrogen was common to all three treatment groups. Patients were assessed every 2 months for 6 months, by grading for severity of the acne, lesion counts and photography, and subjectively using a visual analogue scale. In addition, bacteriological sampling and sebum excretion rate (SER) measurements were performed. The results showed a clinical improvement in all three treatment groups, but a more rapid and complete response was seen in those groups who received CPA. There was also a consistent trend suggesting a more favourable response in those in the high dose CPA group. Although there was a marked reduction in SER in the groups treated with CPA, there was no correlation between reduction in SER and clinical improvement in individuals, nor could a reduction in the surface bacterial population be shown to be a primary event in the success of anti-androgen therapy. We have shown that the addition of CPA to oestrogen adds significantly to the therapeutic effect in acne and that anti-androgen and oestrogen combinations are more effective than standard oestrogen and progestagen contraceptive pills.

Guidelines of care for acne vulgaris management

“…132,133 Cyproterone acetate Cyproterone combined with ethinyl estradiol (in the form of an oral contraceptive) has been found to be effective in the treatment of acne in females. [134][135][136] Higher doses have been found to be more effective than lower doses. Cyproterone/estrogen-containing oral contraceptives are not approved for use in the United States.…”

Novel Drug Delivery Systems: Potential in Improving Topical Delivery of Antiacne Agents

“…Cyproterone acetate (CPA) has been used since the early 1960s and represents the fi rst specifi c antiandrogen of clinical interest [44,45] . It has been shown that acne and hirsutism can be successfully treated with orally delivered CPA [46][47][48] . However, oral administration of CPA is associated with side effects like lassitude, breast tenderness, loss of libido and nausea [44] .…”

Gestagen versus oral contraceptive pills to induce withdrawal bleeding before induction of ovulation by clomiphene citrate in polycystic ovary syndrome

“…It acts mainly by competitively binding the androgen receptor. In mild to moderate cases, cyproterone acetate in a dose of 2 mg/day combined with 35 mg of ethinyl estradiol generally improves the symptoms (21)(22)(23)(24)(25). The recently approved ethinyl estradiol and drospirenone combination has also been used for the treatment of PCOS.…”