Antiandrogen Therapy in Dermatology

    November 1996 in “ International Journal of Dermatology ”
    James C. Shaw
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    TLDR Antiandrogens can help treat skin conditions like acne and excessive hair in women when used carefully.
    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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