Serum levels of testosterone and dehydroepiandrosterone sulfate in females with acne and/or female pattern hair loss

Abstract

Objectives: The objectives of this study are as follows: (1) To study the levels of testosterone and dehydroepiandrosterone sulfate (DHEAS) in females with acne and/or female pattern hair loss (FPHL) and (2) to study the correlation of the severity of acne and/or FPHL with serum levels of testosterone and DHEAS. Materials and Methods: A cross-sectional study was carried out in the department of dermatology and venereology, of a tertiary care institution over a period of 1 year among patients who presented with acne and/or FPHL. Acne was graded using Leeds revised acne grading system and FPHL with Ludwig scale. Competitive immunoenzymatic colorimetric method for quantitative determination of testosterone and DHEAS concentrations in serum (“DiaMetra” kits) was performed. Correlation between quantitative variables was assessed by Pearson correlation and Spearman rank correlation. Results: A total of 84 patients with acne and/FPHL were studied over a period of 1 year. Fifty-one (60.7%) patients had acne, 21 (25%) had FPHL, and 12 (14.3%) patients had both. The mean levels of testosterone in acne, FPHL, and in patients with both were 1.14 ± 4.65 ng/ml, 0.51 ± 0.17 ng/ml, and 0.53 ± 0.24 ng/ml, respectively. The mean DHEAS in patients with acne, FPHL, and with both was 4.64 ± 4.96 μg/ml, 4.96 ± 5.34 μg/ml, and 6.34 ± 5.37 μg/ml, respectively. The Spearman rank correlation between the level of testosterone and the grades of inflammatory acne in face and FPHL was 0.193 and -0.16, respectively. The Spearman rank correlation of DHEAS with the grades of inflammatory acne in face and FPHL was 0.092 and 0.01, respectively. Limitations: The study carried out in a tertiary referral center, not reflecting the status of the condition in general population was the major limitation. Conclusion: This study in a localized population could not elicit a significant statistical correlation between serum levels of total testosterone and DHEAS with severity of acne or FPHL. However, a majority of patients with acne, FPHL, or both had low levels of total testosterone which were discordant with most of the previous studies. Half of the study population with coexisting acne and FPHL had high levels of DHEAS which suggests the need to study the role of DHES in patients with coexistence of acne and FPHL.