Anti-androgens in Acne Treatment

An antiandrogen, or androgen antagonist, is some of a group of hormone receptor antagonist compounds that are able of preventing or inhibiting the biologic effects of androgens, male sex hormones, on normally responsive tissues in the body. Antiandrogens typically work by blocking the appropriate receptors, contending for binding sites on the cell's surface, obstructing the androgens' pathway.



There are newer 3 alpha reductase inhibitors.


1) Topical inocoterone acetate: Inocoterone is a non-steroidal antiandrogen. It has been shown to formed a small but significant reduction of inflamed acne. It however does not decrease the number of comedonal acne lesions and the rate of sebum secretion.


2) Spironolactone: This is a synthetic steroid that blocks the androgen receptor and inhibits the enzyme 5 alpha reductase in the skin. It decreases sebum secretion by 30 to 50%. Recommended doses are 50-100mg daily; however women with inflammatory acne lesions have been know to respond to a 25mg. dose. Common side effects include inducement of high potassium levels, breast tenderness, menstrual irregularities, testicular atrophy and erectile dysfunction. Pregnancy during spironolactone therapy should be avoided.


3) Cyproterone acetate: This synthetic steroidal antiandrogen acts by inhibiting ovulation and topically by blocking the androgen receptors on cells in sebaceous gland. Thus it serves both as an oral contraceptive and as anti-acne therapy. Given in doses of 2mg. to 100mg per day it has shown improvement in 75 - 90% women with acne. It has a similar effects topically as compared to oral dosing after three months of therapy. However the levels achieve by topical application are naturally lower than oral medication. The most serious potential side effect is liver toxicity. Patients should be regularly monitored for changes in liver functions, especially if they are taking high doses.


Disadvantages of anti-androgens


The main drawback of

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Keywords:

acne, acne lesions, acne treatment, acne however, acne similar, treatment acne, inflammatory acne, comedonal acne, inflamed acne, women acne