Comparison of the efficacy on serum androgenic hormone levels between isotretinoin, cyproterone acetate/ethynil estradiol and combination therapies in females with acne vulgaris

Objective: Acne vulgaris is one of the most common skin disorders, and is a multifactorial disease characterized by androgenic stimulation of sebaceous glands. This study aimed to further understand the antiandrogenic effects of isotretinoin by using isotretinoin, cyproterone acetate/ethynil estradiol (CTA/EE) and isotretinoin+CTA/EE combination treatments with analyzing their effects on serum androgenic hormon levels. Materials and methods: 60 females that were clinically evaluated as grade 4-8 on Allen-Smith scale were selected from our patient population for whom isotretinoin, CTA/EE and isotretinoin+CTA/EE combination treatment was planned. Fasting androgenic hormone levels (androstenedion, luteinizing hormone (LH), follicle stimulating hormone (FSH), dehidroepiandrosteron sulfate (DHEAS), free and total testosterone) were detected in venous blood before treatment and on the third and the sixth month of study. Results: The statistical analysis showed that similar to the CTA/EE treatment; the decrease of the serum androstenedion and free testosterone levels with isotretinoin treatment in females with acne vulgaris were found to be statistically significant (p<0,001) but such significance could not be shown for total testosterone and DHEAS levels (p>0,0056). There is no statistically significant change in LH/FSH ratio in isotretinoin monotherapy, so as in CTA/EE treatment (p>0,0056). Conclusion: Our study demonstrates isotretinoin monotherapy made us to think that antiandrogenic effect may be one of the pathways of antiacne effect of isotretinoin. No statistically significant correlation was found between the severity of acne vulgaris and the androgenic hormone levels.