Hormonal Therapy for Acne

The 1996 document outlines the significance of androgens in the development of acne, noting their role in sebaceous gland maturation and sebum production, which can lead to inflammation when acted upon by Propionibacterium acnes. It highlights that androgens are produced equally by the ovaries and adrenals in women, and that persistent adult acne may suggest underlying conditions like PCOD or CAH. The document also discusses the inconsistency of higher androgen levels in males with acne and recommends laboratory tests for abnormal androgen production. Treatment options include adrenal suppression, oral contraceptives, and androgen antagonists, with specific medications such as dexamethasone, prednisone, spironolactone, CPA, and flutamide being mentioned. Furthermore, it emphasizes the potential of 5α-reductase inhibitors, particularly for type I isozyme, in reducing sebum production and treating acne, and suggests that androgen-receptor blockers combined with oral contraceptives may benefit adult females with acne unresponsive to conventional therapy.