The use of cyproterone acetate/ethinyl estradiol in hyperandrogenic skin symptoms – a review

    Johannes Bitzer, Thomas Römer, Agnaldo Lopes da Silva Filho
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    TLDR Cyproterone acetate with ethinyl estradiol is effective for treating skin symptoms related to high androgen levels, like in PCOS.
    The 2017 review concluded that cyproterone acetate (CPA) 2 mg combined with ethinyl estradiol (EE) 35 µg is effective in treating hyperandrogenic skin symptoms such as hirsutism, acne, seborrhea, and alopecia, especially in women with polycystic ovary syndrome (PCOS). The review, which included 43 studies from a literature search of the PubMed database, found that CPA/EE significantly improved skin symptoms, with the greatest improvements in hirsutism observed at 12 months. It also provided benefits in menstrual cycle regularity and quality of life, while being generally well tolerated with a side effect profile similar to combined oral contraceptives (COCs). The review noted that CPA/EE could potentially be enhanced by combining it with other treatments, although more research is needed. It also highlighted the need for continuous re-evaluation of the benefit/risk ratio, particularly in patients with additional cardiovascular risk factors. The review did not specify the number of participants in the clinical trials it included.
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