Ketoconazole Therapy for Women with Acne and/or Hirsutism

In a study from 1990, 42 women with acne and/or hirsutism were treated with 400 mg/day of ketoconazole for 3-6 months. The treatment resulted in a decrease in androstenedione, total and free testosterone, 5 alpha dihydrotestosterone, and dehydroepiandrosterone levels, while 17 alpha hydroxyprogesterone, estradiol, ACTH, cortisol, LH, and FSH levels increased. Hair growth rate and diameter also decreased significantly. After 6 months, 14 subjects showed evident improvement in hirsutism, while 22 women who did not complete the therapy showed no significant change. Acne improved in all cases. However, side effects such as headache, nausea, hair loss, hepatitis, and biochemical changes were reported, indicating that ketoconazole treatment requires careful patient selection and monitoring.