Antiandrogen Therapy in Dermatology

November 1996 in “ International Journal of Dermatology ”

James C. Shaw

antiandrogens acne hirsutism androgenetic alopecia spironolactone cyproterone acetate flutamide corticosteroids oral contraceptives finasteride gonadotropin-releasing hormone agonists cimetidine ketoconazole androgen-secreting tumor Propecia

From the encyclopedia

Spironolactone →

powerful topical and oral anti-androgen used mostly by women

Cyproterone →

a synthetic anti-androgen and weak progestogen that inhibits DHT binding to androgen receptor

Finasteride →

Frontline, gold standard treatment for combatting androgenic alopecia

Studysummary This review discusses the use of antiandrogen therapy in dermatology, covering treatments for conditions like acne, hirsutism, and androgenic alopecia but reports no new clinical findings.

Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer

The 1996 document reviews the use of antiandrogens in dermatology, particularly for treating acne, hirsutism, and androgenetic alopecia in women. It details the effectiveness and potential risks of various treatments, including spironolactone, cyproterone acetate, flutamide, corticosteroids, oral contraceptives, finasteride, gonadotropin-releasing hormone agonists, cimetidine, and ketoconazole. Spironolactone and cyproterone acetate are noted for their benefits in treating acne and hirsutism, with the latter not available in the U.S. due to concerns about liver toxicity and tumor development. Flutamide is effective but carries a significant risk of hepatotoxicity. Corticosteroids are used empirically, and oral contraceptives are important for hormonal treatment, with newer formulations being safer. Finasteride shows potential for treating hirsutism and androgenetic alopecia, but more studies are needed. Ketoconazole has antiandrogenic effects but is limited by side effects at effective doses. The document concludes that antiandrogens can be valuable for treating women with androgen-mediated skin diseases, provided that an androgen-secreting tumor is excluded.

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Research cited in this study

20 / 20 results

research A Prospective Randomized Trial Comparing Finasteride to Spironolactone in the Treatment of Hirsute Women

34 citations , January 1995 in “The Journal of Clinical Endocrinology and Metabolism”

research Treatment of Hirsutism with Flutamide and a Low-Dosage Oral Contraceptive in Polycystic Ovarian Disease Patients

20 citations , December 1994 in “Fertility and sterility”

In this study, treatment with flutamide combined with a low-dose oral contraceptive significantly improved hirsutism in women with polycystic ovarian disease who did not respond to oral contraceptive treatment alone.

research Comparison of Flutamide and Spironolactone in the Treatment of Hirsutism: A Randomized Controlled Trial

165 citations , February 1994 in “Fertility and Sterility”

This study found that flutamide was more effective than spironolactone in reducing symptoms of hirsutism and related conditions in premenopausal women, with fewer discontinuations due to side effects.

research Finasteride

187 citations , January 1994 in “The New England Journal of Medicine”

Finasteride treats enlarged prostate and may help with baldness, but effects on sexual function and male fetuses are unclear.

research Hepatotoxicity Complicating Flutamide Treatment of Hirsutism

43 citations , December 1993 in “Annals of internal medicine”

This letter discusses the first reported case of serious liver damage linked to the use of flutamide for hirsutism in a woman, highlighting a potential risk for hepatotoxicity with this treatment.

research Azasteroids as Inhibitors of Testosterone 5α-Reductase in Mammalian Skin

34 citations , February 1993 in “Journal of steroid biochemistry and molecular biology/The Journal of steroid biochemistry and molecular biology”

This study found that 4-MA is a potent inhibitor of testosterone 5α-reductase in human tissues, promising potential for treating androgen-dependent skin conditions like male pattern baldness.

research The Effect of Finasteride in Men with Benign Prostatic Hyperplasia

1040 citations , October 1992 in “The New England Journal of Medicine”

In this study, 5 mg of finasteride per day significantly improved urinary symptoms and reduced prostate volume in men with benign prostatic hyperplasia, but increased the risk of sexual dysfunction.

research Incidence of Liver Toxicity Associated with the Use of Flutamide in Prostate Cancer Patients

116 citations , May 1992 in “The American Journal of Medicine”

This study found that flutamide-induced liver toxicity in prostate cancer patients was very rare, occurring in only 0.18% of cases with clinical manifestations, and symptoms resolved after discontinuing the drug.

research Hair Growth Effects of Oral Administration of Finasteride, a Steroid 5 Alpha-Reductase Inhibitor, Alone and in Combination with Topical Minoxidil in the Balding Stumptail Macaque

40 citations , February 1992 in “The Journal of Clinical Endocrinology and Metabolism”

Taking finasteride pills and using minoxidil lotion together can help grow hair.

research Flutamide in the Treatment of Hirsutism

27 citations , October 1991 in “International journal of gynaecology and obstetrics”

This study observed that flutamide treatment reduced hair growth and improved acne and seborrhea in hirsute women, with increased androstenedione levels and no side effects noted.

research Comparison of Sequential Cyproterone Acetate/Estrogen Versus Spironolactone/Oral Contraceptive in the Treatment of Hirsutism

68 citations , May 1991 in “The Journal of clinical endocrinology and metabolism/Journal of clinical endocrinology & metabolism”

This study found that both cyproterone acetate and spironolactone effectively reduced hair diameter and plasma testosterone levels in hirsute women, with no significant differences between the two treatments.

research Treatment of Hirsutism with the Pure Antiandrogen Flutamide

130 citations , September 1990 in “Journal of the American Academy of Dermatology”

This study found that combining flutamide with an oral contraceptive significantly reduced hirsutism, acne, and seborrhea in patients after seven months, without significant side effects.

research The Treatment of Hyperandrogenism with Oral Contraceptives

25 citations , August 1989 in “Seminars in reproductive medicine”

This article discusses the use of oral contraceptives for treating hyperandrogenism in women, reporting improvement in most patients, especially in reducing new hair growth, but presents no new clinical findings.

research Lack of Effect of Spironolactone on Hair Shaft Diameter in Hirsute Females

23 citations , July 1989 in “Postgraduate medical journal”

This study found that spironolactone 100 mg daily did not demonstrate objective benefits in managing idiopathic hirsutism, as it increased hair shaft diameter without reducing serum androgen levels.

research Treatment of Hirsutism With Cimetidine: A Prospective Randomized Controlled Trial

17 citations , February 1989 in “Fertility and sterility”

In this study, cimetidine at a daily dose of 1.5 gm for 3 months did not significantly affect hair growth in women with moderate to severe hirsutism.

research Clinical and Hormonal Effects of Chronic Gonadotropin-Releasing Hormone Agonist Treatment in Polycystic Ovarian Disease

96 citations , October 1987 in “The Journal of Clinical Endocrinology & Metabolism”

This study found that long-term GnRH agonist administration in premenopausal women with polycystic ovarian disease resulted in persistent suppression of ovarian steroid secretion, while adrenal steroid levels remained unchanged.

research The Treatment of Hirsutism with a Combination of Desogestrel and Ethinyl Estradiol

64 citations , January 1985 in “Clinical endocrinology”

In this study, treatment with the oral contraceptive containing 30 μg ethinyl oestradiol and 150 μg desogestrel significantly reduced androgen-dependent hair growth in hirsute women over one year.

research Effects of a Low-Dose Desogestrel-Ethinylestradiol Combination on Hirsutism, Androgens, and Sex Hormone Binding Globulin in Women with Polycystic Ovary Syndrome

53 citations , January 1985 in “Acta obstetricia et gynecologica Scandinavica”

This study found that an 8-month treatment with a low-dose oral contraceptive significantly reduced testosterone levels and hair growth in women with polycystic ovary syndrome and hirsutism, with minimal side effects.

research Oral Spironolactone Therapy for Female Patients with Acne, Hirsutism, or Androgenic Alopecia

101 citations , January 1985 in “British Journal of Dermatology”

This article discusses oral spironolactone therapy for female patients with acne, hirsutism, or androgenic alopecia and reports no new clinical results.

research Use of Cyproterone Acetate in the Treatment of Acne, Hirsutism, and Virilism

232 citations , June 1975 in “Journal of Steroid Biochemistry”

In this study, a treatment regimen combining cyproterone acetate and ethinyl estradiol significantly improved acne and seborrhoea in most women after three months, but had varied effects on hirsutism and alopecia.