Evidence-Based Approach to Cutaneous Hyperandrogenism in Women

October 2015 in “ Journal of The American Academy of Dermatology ”

Timothy H. Schmidt, Kanade Shinkai

cutaneous hyperandrogenism hirsutism acne androgenetic alopecia polycystic ovary syndrome serum androgen levels pilosebaceous unit modified Ferriman-Gallwey score Ludwig scale Olsen scale oral contraceptive pills antiandrogens minoxidil COCs CHA PCOS OCPs Rogaine combined oral contraceptives

TLDR The conclusion is that oral contraceptives and antiandrogens can treat hirsutism and acne in women with cutaneous hyperandrogenism, but more research is needed for effective treatments, especially for hair loss.

The document from 2015 reviews the diagnosis and treatment of cutaneous hyperandrogenism (CHA) in women, which encompasses conditions such as hirsutism, acne, and androgenetic alopecia (AGA). It highlights that CHA can be indicative of systemic disorders like polycystic ovary syndrome (PCOS) and that many women with CHA have normal serum androgen levels, suggesting the involvement of local factors at the pilosebaceous unit. The modified Ferriman-Gallwey score is used to assess hirsutism, while the Ludwig or Olsen scales are used for alopecia. The review suggests that oral contraceptive pills (OCPs), with or without antiandrogens, are effective for hirsutism and acne, but options for AGA are limited. Minoxidil is mentioned as a treatment for AGA with a small effect size. The document calls for more research on CHA mechanisms and treatment efficacy and stresses the importance of a thorough history and skin examination in guiding diagnosis and treatment, which may include COCs and antiandrogens even in the absence of elevated androgen levels. The document does not specify the number of people in any referenced study.

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