Other Antiandrogens: Alternative Treatments for Acne and Hirsutism

January 1998 in “ Dermatology ”

J.B. Schmidt

antiandrogens cimetidine ketoconazole spironolactone hirsutism isotretinoin 5 alpha-reductase inhibitors androgen receptor enzyme inhibition type 1 5 alpha-reductase inhibitors Aldactone Accutane

TLDR Spironolactone works well for acne and hirsutism, isotretinoin is very effective for acne and may have antiandrogenic effects, and 5 alpha-reductase inhibitors should be considered antiandrogens.

The document from 1998 discusses alternative antiandrogenic treatments for acne, noting that while cimetidine and ketoconazole have weak antiandrogenic effects and are rarely used, spironolactone is an effective option with good results for hirsutism and acne, although it has dose-dependent side effects. Isotretinoin, known as the most effective acne treatment, has been debated for its potential antiandrogenic properties, with emerging evidence supporting this effect. The document also suggests expanding the definition of 'antiandrogen' to include 5 alpha-reductase inhibitors, which act on androgen receptor binding and enzyme inhibition, acknowledging their biological antiandrogenic effects. It hints that type 1 5 alpha-reductase inhibitors may become more significant in the future.

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