Androgens in women
June 2019
in “Journal of The American Academy of Dermatology”
TLDR Hormone treatments can help with women's skin and hair disorders, but they need careful monitoring and more research.
The document from June 2019 reviews hormone-modulating therapies for androgen-mediated cutaneous disorders (AMCDs) in women, such as acne, hirsutism, and female pattern hair loss (FPHL). It discusses the efficacy, safety, and mechanisms of various treatments, including combined oral contraceptives (COCs), spironolactone, finasteride, dutasteride, and flutamide. COCs are FDA-approved for acne and are as effective as antibiotics after 6 months, while spironolactone is used off-label for acne and hirsutism but lacks high-quality evidence. Flutamide is effective for hirsutism but carries a risk of hepatotoxicity and is not recommended as first-line therapy. For FPHL, minoxidil is the only FDA-approved treatment, with other drugs used off-label. The document notes that flutamide is the most effective for hirsutism but not first-line due to hepatotoxicity, and while dutasteride is superior to finasteride in men, it lacks RCTs in women for FPHL. The importance of a 6-month trial, periodic monitoring, and contraception for women of child-bearing age on these treatments is emphasized, along with the need for more rigorous studies to evaluate these therapies for AMCDs.
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