Oral Contraceptives and Cyproterone Acetate in Female Acne Treatment

The 1998 document outlines the use of hormonal treatments for female acne, particularly in cases related to hormonal imbalances and hyperandrogenism. It suggests that oral contraceptives, especially those with low androgenic progestins or containing cyproterone acetate, can be effective for women who also require contraception. For severe acne or pronounced hyperandrogenism, higher doses of cyproterone acetate may be prescribed, and other treatments like isotretinoin, dexamethasone, prednisolone, or spironolactone may be used in specific cases. Spironolactone is an alternative at doses of 100-200 mg/day, but may cause menstrual disturbances. Hormonal treatments are recommended for at least 12 months and may be lifelong in certain conditions. Side effects are generally milder than those of Roaccutane, but acne relapse is more common after discontinuation of hormonal treatments. The document also notes that future treatments may involve topical antiandrogens, although current options have been ineffective, and emphasizes the importance of systemic hormonal treatment for acne due to ovarian or adrenal hyperandrogenism.