Measurement and Comparison of Various Androgen Levels in Women with Severe Acne, Hirsutism, and Androgenic Alopecia

In a study conducted 37 years ago, researchers measured and compared various androgen levels in a group of 126 women with severe acne, hirsutism, and androgenic alopecia. The mean ages of the groups were 23.9, 23.5, and 30.8 respectively. The study found that plasma androgen levels were elevated in nearly half of the women with androgenic signs. DHEA-S was the most commonly elevated steroid, with incidences of elevation being 42% in cystic acne, 48.7% in hirsutism, and 31% in androgenic alopecia. Elevation of androstenedione was more frequent in hirsutism (18%) than in acne and alopecia (5.9% and 5.7% respectively), while elevation of free testosterone was more frequently seen in patients with severe acne (18%). A small number of patients with alopecia (15%) and hirsutism (9%) had elevations of 17-hydroxyprogesterone suggestive of late onset adrenal hyperplasia. The study concluded that identification of steroid abnormalities in androgenized women requires appropriate laboratory studies, as the nature of the steroid pattern cannot be predicted on clinical grounds.