Female Acne Patients Research Articles

Influence of Social Media and Internet on Treatment Decisions in Adult Female Acne Patients: A Cross-Sectional Survey Study.

Adult female acne is a chronic condition that significantly impacts quality of life. The content on social media can influence patients perception of their disease and serve as a channel through which they may seek or obtain treatment options. This study aims to evaluate the impact of social media usage habits on treatment decisions among adult female acne patients. A cross-sectional, multicenter survey study involved 358 females aged 25 or above, diagnosed with acne. Sociodemographic data were collected, and social media behavior, treatment choices, outcomes, and motivation were explored. Among 358 participants, 95.3% used at least 1 social media platform; 72.1% sought acne information online. Top platforms used to seek acne information were Google (75.6%), Instagram (72.3%), YouTube (60%), and TikTok (29.4%). For advice, 67.4% consulted doctor accounts, 53.5% non-medical influencers, 53.5% patient accounts, and 36.1% product promotion accounts. Commonly followed advice included skincare products (88%), dietary changes (42.3%), home remedies (38.8%), exercise (30.3%), topical medications (25.2%), and dietary supplements (17.4%). Notably, 20.9% were willing to alter prescribed treatment by their physician for acne based on social media advice. Patient motivations included quick information access (84.1%) and difficulty in securing dermatologist appointments (54.3%). The study reveals widespread social media use among adult female acne patients, highlighting concerns about potentially misleading information. Dermatologists can enhance the impact of social media by providing reliable sources for patients.

Lipidomic analysis of facial skin surface lipids in acne in young women.

Alterations in the secretion and composition of skin surface lipids (SSL) are closely associated with the development of acne. Lipidomics is a useful tool to analyse the SSL of different types of acne. Our previous study found that phosphatidylserine and triacylglycerols dominate SSL changes in male acne and infantile acne, respectively. However, skin surface lipids as well as specific lipids in female acne patients remain to be investigated. To analyse and compare the SSL profile of acne women and healthy women and to discuss the involvement of differential lipids in acne development. Systematic lipidomics approach (high-throughput UPLC-QTOF-MS technology in combination with multivariate data analysis methods) was used to analyse the variations of SSL between acne and healthy groups. Analysis revealed significant differences in lipid content and composition between the two groups. Further analysis showed that levels of 13 individual lipids were significantly different and followed the same trend as the main class and subclasses. The largest individual contributor to the subgroup was triglycerides (TG) and phosphatidylinositol (PI). In addition, female acne patients exhibited reduced ceramide chain length (CCL) and increased levels of unsaturated fatty acids (UFAs), The changes of CCL in female acne are identical to male acne. There was a significantly higher level of TG and PI in the SSL of female acne patients. A reduction in CCL and an increase in UFAs content might contribute to the reduced skin barrier function in acne patients. The results suggest that female acne may have different pathogenesis than male acne.

Females May Have Less Severe Acne, but They Suffer More: A Prospective Cross-Sectional Study on Psychosocial Consequences in 104 Consecutive Polish Acne Patients.

Acne is a common skin condition affecting both adolescents and adults, and it can profoundly impact patients' quality of life and mental well-being. This prospective cross-sectional study aims to explore the differences in psychosocial aspects between male and female acne patients in Poland. A total of 104 consecutive acne patients were included in this study. Clinical severity, patients' quality of life, stigmatization levels, and psychiatric disturbances were evaluated using the following instruments: Investigator Global Assessment (IGA), Dermatology Life Quality Index (DLQI), Cardiff Acne Disability Index (CADI), 6-Item Stigmatization Scale (6-ISS), and Hospital Anxiety and Depression Scale (HADS). This study found that female patients exhibited significantly less severe acne and experienced significantly decreased quality of life and increased levels of stigmatization. Furthermore, anxiety levels among female patients exceeded those observed in their male counterparts. Notably, no disparities in the severity of depression were observed between the two gender groups. Correlations were discerned among all psychosocial parameters in the entire study cohort and in the female subgroup, while such correlations were not uniformly observed among male participants. This study underscores the importance of considering psychosocial aspects and implementing routine measurements in the management of acne to improve patients' well-being.

The Association of CAG Polymorphism in the Androgen Receptor Gene with Nodulocystic Acne in Egyptians

Abstract Acne vulgaris is a pilosebaceous inflammatory condition with several etiologies. Hormones have a crucial role in the development of acne. Hypersensitivity of the androgen receptor gene (ARG), which is the sole receptor for androgens, was reported to share in the pathogenesis of acne. At the 5'end of exon 1 of chromosome X, ARG has a polymorphism of CAG triple loop that codes for the polyglutamine pathway. Aim of the Study The aim of this study was to investigate CAG repeat polymorphism in the ARG in Egyptian nodulocystic acne patients to clarify its relevance to the pathogenesis of nodulocystic acne. Patients and Methods Twenty-five patients with severe and very severe nodulocystic acne and 25 apparently healthy control subjects were included in the current study. Full general, dermatological assessment and acne severity determination were performed through GAGS score before genetic analysis to determine CAG repeat number in included participants. Results Genetic analysis of CAG repeats number revealed that male and female acne patients had significantly lower number of CAG repeats compared to control subjects. Moreover, after gender correction, acne patients still had significantly lower number of CAG repeats compared to control subjects. Conclusion the current study revealed that acne patients had significantly lower number of CAG repeats compared to controls.

The association of cytosine-adenine-guanine repeat polymorphism in the androgen receptor gene with nodulocystic acne in Egyptian patients

Background: The role of androgens in acne pathophysiology has been supported by long-standing clinical and experimental observations. Methods: Genotyping for the androgen receptor gene was performed by PCR-based fragment length analysis, aiming to investigate cytosine-adenine-guanine (CAG) repeat polymorphism in Egyptian nodulocystic acne patients to clarify its relevance to the pathogenesis. Detailed frequency of CAG repeats number in patients and control groups, in 25 males and 25 females and Comparison of CAG repeat number regarding demographic and clinical characteristics was performed. Results: It was found that females had a higher frequency of longer CAG repeats compared to males, while in control group there was an even distribution of CAG number repeats in both females and males. Male and female acne patients had significantly lower number of CAG repeats compared to controls with statistically significant difference (p≤0.05). Comparison of CAG repeat number regarding demographic and clinical characteristics revealed no significant correlation or association with patients’ age, duration of acne, onset or course of the disease. Conclusions: These findings support the hypothesis that CAG repeats number affects AR activity, therefore, acne development and severity. Moreover, analysis of CAG repeats number in acne patients can be of considerable importance in the treatment strategy, indicating the role of antiandrogen therapy in acne patients.

Knowledge on the Use of Isotretinoin and Its Side Effects and Awareness towards Saudi FDA-Pregnancy Prevention Program among the Female Acne Patients: A Northern Saudi Study.

Background and Objectives: Acne vulgaris is one of the most common dermatological disorders among adolescents and adults in the Kingdom of Saudi Arabia (KSA). Isotretinoin is a cost-effective way of treating severe acne patients compared to other methods used for severe forms of acne management. The present study investigated the knowledge of the use of isotretinoin and its side effects among female acne patients of the reproductive age group who were on isotretinoin. This study also assessed participants' awareness of the Saudi FDA-Pregnancy Prevention Program (SFDA-PPP). Materials and Methods: The present population-based cross-sectional survey was conducted among 768 participants using a standard and validated Arabic version questionnaire. We have applied logistic regression analysis to determine the predictors for awareness of SFDA-PPP. A Chi-square test was applied to identify the factors associated with knowledge related to isotretinoin. Results: Regarding the side effects of isotretinoin, participated female acne patients were most commonly aware of dry mouth and lips (84.5%), teratogenicity (68.2%), and headache (44.8%). Nearly 60% of the participants belonged to the low knowledge category. The present study participants' knowledge was significantly associated with education status (p = 0.007), occupation (p = 0.01), and those participants who were aware of SFDA-PPP (p = 0.001). Furthermore, we explored that only 37.5% were aware of the SFDA-PPP program implemented in Saudi Arabia. The awareness of SFDA-PPP was significantly higher among those participants belonging to health sectors (Adjusted OR (95% CI) = 1.39 (1.01-1.92), p = 0.049). Conclusion: The present survey explored inadequate knowledge among reproductive age group female acne patients regarding isotretinoin uses, precautions to be followed, and side effects, especially teratogenic effects. This survey findings suggest that improving female acne patients' knowledge of isotretinoin through health promotion activities is crucial, especially by giving them precise instructions about the teratogenic effects.

Systemic isotretinoin for acne treatment: Ovarian reserve is safe with the low dose.

Isotretinoin is among the most frequently used medications in the dermatologic daily practice. With a Black box warning, teratogenicity is a major concern. Female fertility may be an issue to be investigated when it comes to its use in females. The aim of this work was to assess the effect of low dose isotretinoin on the ovarian reserve in female patients with moderate to severe acne. Sixty-sex female acne patients candidate for isotretinoin therapy and 66 controls were enrolled in this prospective controlled cohort study. Low dose isotretinoin (0.25-0.4mg/kg/day) was given to the patients group for 6 months. Serum anti-Mullarian hormone (AMH), ovarian volume (OV) and Antral follicle count (AFC) were evaluated at baseline and 6months after the last dose in the patients' group, and 1year after the baseline assessment for the control subjects. There was no significant difference in serum AMH between patients after isotretinoin treatment and control subjects (p=0.898). AMH failed to show any significant change in pre- and post- treatment levels in patients' group (p=0.747). Both OV and AFC showed no significant changes in patient group when comparing pre- post- treatment levels on both sides (p > 0.05) and in control group between baseline and 1-year-interval levels on both sides (p > 0.05). Low-dose isotretinoin in treatment of moderate to severe acne seems to be safer on ovarian reserve as indicated by non-significant change in AMH levels as a sensitive parameter of female fertility.

Association of serum zinc and vitamin E levels with Acne vulgarisin Bangladeshi acne patients

The serum level of zinc and vitamin E were measured to understand the association of various nutrients on acne pathogenesis. Both zinc and vitamin E are antioxidants used as a supplement in acne treatment. However, their effect and status in acne patients are not fully understood. This study included 48 acne patients and 48 sex- and age-matched healthy controls. The zinc and vitamin E concentration was measured in the serum by flame atomic absorption spectroscopy (AAS) and HPLC methods. Compared to the healthy control, a significant deficiency of serum vitamin E level in acne patients (p<0.001) was found, although the patients were not deficient in serum zinc level (p=0.22). In addition, female acne patients had a slightly lower zinc level than male patients (p=0.06). The low serum vitamin E level suggests that supplementation of vitamin E might be helpful in acne treatment. However, further studies are required to understand the dose and mechanism of vitamin E supplements in acne treatment.
 J. Bangladesh Acad. Sci. 45(1); 49-58: June 2021

Efficacy and safety of topical spironolactone 5% cream in the treatment of acne: A pilot study.

BackgroundSpironolactone is an effective treatment for female patients with acne vulgaris. However, topical spironolactone could be a valuable treatment option in both male and female acne patients due to the less possibility of systemic side effects with its topical formulation.ObjectiveTo evaluate the efficacy and safety of 5% spironolactone cream in the treatment of mild to moderate acne vulgaris.MethodsIn this pilot clinical trial, topical spironolactone 5% was evaluated to treat patients with mild to moderate acne twice a day for 8 weeks. The rate of improvement as any alterations in the number of open and closed comedones, facial inflammatory papules, and acne global grading scores were assessed. Moreover, skin biometric characteristics including skin hydration, erythema, transepidermal water loss (TEWL), pH, sebum, and Propionibacterium acnes bacteria activity were also assessed following the treatment.ResultsFifteen patients participated in our study with a mean age of 25 ± 4.87 years old. A total of 66.6% (n = 10) were female and 33.4% (n = 5) were male. The number of acne papules, open and closed comedones, and acne global grading score decreased significantly 4 and 8 weeks after the beginning of treatment (P < .05). No considerable side effect was reported. Moreover, there was no significant difference between the skin hydration, melanin, erythema, TEWL, pH index, sebum, and P acnes bacteria activity before, 4, and 8 weeks after the treatment with topical spironolactone cream (P > .05).ConclusionThe topical 5% spironolactone cream seems to be an effective and safe treatment of acne vulgaris in both male and female patients.

Cross-sectional study of quality of life impairment of adult female acne patients

The effect of acne vulgaris on the quality of life of adult females is not readily documented nor the factors that impair quality of life in these adult females. The aim of this study was to document quality of life impairment and the factors that affect this quality of life in adult female acne patients. The study was a prospective cross sectional study of 56 adult female acne patients aged 25 years and above. Socio-demographic data, clinical examination were documented with a study proforma. Quality of life was assessed using Cardiff Acne Disability Index (CADI). Data was analysed using SPSS version 22. Mean of independent groups were compared using Students ‘t’ test while Chi squared test was used to compare categorical variables. For all statistical tests, P value &lt;0.05 was adjudged to be significant. The mean age of the participants was 33.4± 8.2 and mean CADI was 6.6±3.8, minimum CADI was 2 and maximum was 15. Quality of life impairment was mild, moderate and severe in 35.7%, 37.5% and 26.8% respectively. The items affected in the CADI index were questions about “Perception of how bad pimples were,” “Feelings about appearance of skin,” and “Aggression, frustration and embarrassment.” Factors associated with quality of life impairment were age, post inflammatory hyperpigmentation, presence of scarring. Quality of life is impaired by acne in adult females. This impairment is made worse by age, presence of scarring and post-inflammatory hyperpigmentation and not marital status, level of education and a family history of acne.

Prevalence, clinical, and biochemical characteristics of the female acne patients with insulin resistance

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Resistin -420 C&gt;G Polymorphism in Female Patients of Acne in Pakistan

Acne vulgaris is an inflammatory skin disorder of pilosebaceaous units. The clinical characteristics are seborrhea, sebaceous glands, non inflammatory lesions, inflammatory lesions and severe scaring. Propionibacterium acnes are the main pathophysiological factor influencing the acne development. Resistin gene is a novel proinflammatory cytokine involved in the initiation of inflammatory disorders like cardiovascular diseases, obesity and atherosclerosis. Various SNPs have been discovered in human RETN gene which is involved in different inflammatory disorders. Purpose of this study was to analyze RETN -420 C&gt;G polymorphism in female acne patients of Pakistani population. About 58 control female subjects and 76 acne female patients were recruited for this study. In order to examine the RETN -420 C&gt;G polymorphism in the promoter region, PCR and RFLP techniques were used. Statistically significant P value &lt;0.05 for the RETN -420 C&gt;G polymorphism was obtained in genotype/alleles frequencies between acne patients and control female subjects. Significant association between genotype frequencies, disease severity and acne scars distribution among female patients was also observed. It is concluded that RETN -420 promoter polymorphism was not associated with family history and skin types; however it was significantly associated with acne pathopysiology

English

BACKGROUND Acne vulgaris is a chronic inflammatory condition of the pilosebaceous unit which occurs in adolescent age groups. Physical and psychological scars can create social issues in the family, school and workplace. The disorder is multifactorial. There are plenty of recovery choices but are not satisfactory. We wanted to investigate the serum zinc levels and the therapeutic utility of oral zinc supplementation in acne vulgaris patients. METHODS This is a prospective study conducted over a period of one and a half years among one hundred acne patients who reported to the outpatient clinic of the Department of Dermatology, Venereology and Leprology with untreated patients of acne vulgaris. RESULTS Males were 65 % and females were 35 % with male : female ratio of 6.5 : 3.5. Most of the patients were students occupying 71 % of the study. Family history was observed in 46 % of patients, either in the siblings or in the parents. Premenstrual flare-up of acne lesions was noted in 71.42 % of female patients indicating a pivotal role of hormones in the pathogenesis of acne. Aggravation of lesions in summer was noted in 45 % of patients. Aggravation of acne lesions with different types of diet like non-vegetarian food, oily food and chocolates was noticed in 69 % of the study. History of usage of different types of cosmetics available in the market was noted in 76 % of the patients. In the present study, 62 % had lower than normal serum zinc levels and 38 % had normal serum zinc levels. Thus, serum zinc levels were found to be lower in both male and female acne patients in the majority (62 %) of the study patients and also normal healthy controls. The fasting serum zinc levels in the 62 patients before and after oral zinc sulphate were estimated after completion of 3 months treatment. Normal serum zinc levels were observed in all 62 patients treated. CONCLUSIONS Oral zinc sulphate is an effective, safe and economic remedy in the treatment of acne vulgaris. The extra advantage with oral zinc sulphate is that it is devoid of many adverse reactions commonly seen after prolonged use of systemic antibiotics. KEYWORDS Oral Zinc Sulphate, Acne Vulgaris

Evaluation of hirsutism and hormonal parameters in acne vulgaris patients treated with isotretinoin.

Although the effect of isotretinoin use on hormonal changes in acne pathogenesis is not fully known, there are limited studies on its effects on the development of hirsutism. In this study, it was aimed to evaluate the effect of isotretinoin use on hirsutism and hormonal parameters in patients with acne vulgaris. In this study, 30 female acne patients and 30 healthy females were evaluated prospectively. Menstrual irregularity, LH, FSH, prolactin, progesterone, 17-OH progesterone, oestradiol, total testosterone, DHEA-S, insulin, glucose, TSH levels, Ferriman-Gallwey (FG) score and ultrasonography (USG) findings of control group and patient group were recorded. Pre-treatment progesterone (P=.007) and oestradiol (P=.001) levels of the patients were statistically lower than the control group. In the patient group, menstrual irregularity (P<001) and FG hirsutism score at the third month of treatment were significantly higher than before treatment. In 10% of the patients, there were abnormal findings on pelvic USG in the third month of treatment. In our study, it could not be revealed that isotretinoin has a significant effect on pituitary, adrenal hormones and insulin resistance. We found that 3months of isotretinoin treatment caused an increase in menstrual irregularity and FG hirsutism score.

Rosacea in acne vulgaris patients: Subtype distribution and triggers assessment-A cross-sectional study.

Recent studies have reported that the incidence of acne combined with rosacea is increasing. However, the clinical feature and inducing factor of these two diseases co-occurrence is remain unclear. This study aims to investigate the classification and severity of female patients combining with acne and rosacea. Female patients with facial acne combined with rosacea, 15-50years old, were included from dermatology outpatient department from January 2019 to December 2019. The severity of acne was classified according to the Pillsbury grading system. Rosacea was diagnosed and classified according to the Standard issued by National Rosacea Society Expert Committee. Questionnaire was designed to collect the information of rosacea triggers from each patient. 563 vulgaris acne combined with rosacea patients (mean age 23.2±43), included 70.33% severe acne (n=396), 15.81% moderate acne(n=89), and 13.85% mild acne(n=78), had finished the study. In severe acne group, 72.47% combine with erythematotelangiectatic rosacea (ETR), 22.47% combined with papulopustular rosacea (PPR), and 5.05% combine with phymatous rosacea (PHR). In moderate acne group, 53.93% combine with ETR, 43.82% combined with papulopustular rosacea (PPR), and 2.24% combine with PHR. All patients in moderate acne subject group was combined with ETR (100%). Patients that did not use skin care produces presented 12.79 times higher rate to combine with ETR than that frequently using skin care products (P=.014). Erythema telangiectasia rosacea is the most common rosacea type in female acne patients. There is a need to be vigilant about the combination of sever/moderate acne and papulopustular rosacea. Rational daily use of skin care products can reduce the incidence of rosacea in acne patients. For acne patients without family history of rosacea, dermatologists should also not ignore the healthy education to avoid potential triggers of rosacea.

A prospective study of anti-mullerian hormone and other ovarian and adrenal hormones in adult female acne.

Polycystic ovarian syndrome (PCOS) diagnosis in adult female acne (AFA) is tough owing to unreliable ultrasonography in virgins or obese females and inconsistent hyperandrogenemia. We analyzed hormones in AFA and established a diagnostic cut-off value of anti-mullerian hormone (AMH) for PCOS. Female acne patients aged ≥25 years were assessed with total testosterone (TT), sex hormone binding globulin (SHBG), free androgen index (FAI), AMH, 17-hydroxyprogesterone (17-OHP), dehydroepiandrosterone sulfate (DHEAS), follicle stimulating hormone (FSH), and luteinizing hormone (LH). Rotterdam's criteria defined PCOS. AMH was measured (Access AMH assay) to calculate the diagnostic cut off value using receiver operating characteristic (ROC) curve. Of 120 cases, 25.83% had PCOS. This group had significant clinical hyperandrogenism, truncal and adolescent acne, polycystic ovarian morphology (PCOM), and raised hormones (AMH, TT, FAI, LH, and LH/FSH). AMH levels were significantly higher in the PCOS group (6.91 ± 3.85 ng/mL) and positively correlated with TT, FAI, 17OHP, LH, and LH/FSH ratio. AMH at >5.1 ng/mL (sensitivity-70.97% and specificity-82.02%) predicted PCOS and correlated with PCOM. AMH (>5.1 ng/mL) is useful for diagnosing PCOS and surrogate for hyperandrogenemia and PCOM. Its correlation with hormones in non PCOS AFA highlights its sensitivity to diagnose endocrinological derangements.

ADULT ACNE: A CLINICAL STUDY WITH SPECIAL REFERENCE TO POLYCYSTIC OVARY SYNDROME

Background: According to Global Burden of Skin Disease study data, 2013, Acne affects nearly 85% of adolescents and young adults in the age group 12-25 years.1 traditionally it was considered to be a transitory disease of teenagers and young adults; however recent study reports indicate it to be a disease affecting all age groups in adults.&#x0D; Aims: To study the clinical profile of adult acne, grade the severity using global acne grading system (GAGS) and to determine the proportion of Polycystic Ovary Syndrome (PCOS) in women with adult acne.&#x0D; Material and Methods: Patients with acne in the age group of 25-60 years were included in the study. A detailed examination of clinical profile of acne was done along with grading of severity of acne using GAGS. Also, documentation of hyperandrogenism using Ferriman Gallwey score for hirsutism and diagnosis of PCOS using Rotterdam criteria was done in all female patients of acne.&#x0D; Results: A total of 105 patients were included in the study. Among these, 82.9% were women and 17.1% were men. The mean age of the patients was 28.04±3.60 years. Persistent acne was observed in 85.7%, while late onset in 14.3%. Most common site of involvement was cheek (98%), followed by chin (76%), and forehead (64.7%). Mild grade acne was observed in 93.3% patients. Hyperpigmentation was seen in 78.1% while scarring was observed in 52.4% patients. A total of 8% female patients had PCOS according to Rotterdam criteria.&#x0D; Conclusion: We found a predominance of females and persistent acne. Although the prevalence of PCOS was low in adult female acne patients, they were affected by more severe grades of acne and risk of hyperpigmentation and scarring was higher as compared to non-PCOS patients.

A prospective study examining trigger factors and hormonal abnormalities in adult female acne

Background:Numerous triggers have been implicated in adult female acne including endogenous (hormonal dysfunction and genetic predisposition) and exogenous causes (drugs, cosmetics, sunscreens, stress, and smoking).Aims:To evaluate the role of various trigger factors in adult female acne and to analyze the androgenic hormone pattern including anti-Mullerian hormone (AMH) in these patients.Materials and Methods:Patients having acne of age ≥25 years were analyzed using a pre devised proforma to elicit trigger factors while the severity was graded using the Global Acne Grading System (GAGS). A detailed hormonal assessment was undertaken that assessed total testosterone (TT), sex hormone-binding globulin (SHBG), free androgen index (FAI), AMH, 17-hydroxyprogesterone (17-OHP), dehydroepiandrosterone sulfate (DHEAS), follicle-stimulating hormone (FSH), luteinizing hormone (LH), thyroid-stimulating hormone (TSH), and prolactin.Results:Out of the 165 cases seen and sub-analyzed for triggers, premenstrual flare, diet, cosmetics, and stress were the most commonly implicated causes. Among cosmetics, fairness creams and foundations were implicated. The hormonal analysis revealed deranged values of all hormones with the most common being 17-OHP and AMH. Almost 42.8% patients with DHEAS derangement and 58.75% females with raised 17-OHP suffered from moderate to severe stress.Limitations:A prospective cohort correlation study of the implicated triggers is needed to confirm the association with adult female acne.Conclusions:Adult female acne may be triggered by diet, stress, and cosmetics and there is a distinct hormonal milieu that accounts for hyperandrogenemia. We noted high levels of adrenal androgens which have been known to be associated with stress and sleep deprivation. Our study shows the value of counseling adult female acne patients about various acne triggers.

The use of flutamide in complex therapy of women with acne affected by hyperandrogenism

Objective — to determine the efficacy, safety, tolerability of the complex therapy, which includes flutamid, in women with acne affected by hyperandrogenism.Materials and methods. During 2014—2017, there were 117 women under observation who had acne illness of varying degrees of severity. The age of the patients varied from 18 to 35, the average age was (28.2 ± 3.2) years. The duration of the disease was from 1 to 8 years, on average — (4.5 ± 0.5) years. The prevalence of acne in the age group of 18 to 25 years was 32 %; in the group of 25—30 years — 29 %; in the group of 30 — 35 years — 39 %. The hormonal status was studied on the third — fifth day of the menstrual cycle by the definition of luteinizing hormone, progesterone, total and free testosterone, anti­mullerian hormone before treatment and at 1, 3, 6 months of the therapy; the sonographic assessment of the pelvic organs was performed on the second — fourth day of the menstrual cycle before treatment and at the sixth month of therapy. For all women with acute acne and hyperandrogenism, complex therapy was conducted with the prescription of one of the systemic antibiotics of the azithromycin rank or retinoid and included flutamid in the dose of 125 mg 3 times per day for 6 months and the appointment of external treatment.Results and discussion. 82 (70 %) patients had second — third degree of severity (clinical course of moderate severity), 35 (30 %) patients — fourth degree of severity (severe clinical course). 92 (78.6 %) patients had hyperandrogenism on the background of polycystic ovarian syndrome, the remaining 25 (21.4 %) patients had a mixed type of hyperandrogenism. During the first two weeks of the complex therapy 104 (89 %) patients, showed significant improvement, revealed as regression of comedones and superficial papula­pustular elements of skin rash, and the maximum effect was achieved only after 6 weeks of therapy. In 13 (11 %) patients, skin clearing from the rash was slower and the significant clinical improvement was achieved after three months of therapy. Complete clinical recovery, revealed as complete absence of any signs of inflammation on the skin, was observed in 117 patients who had undergone the full course of six months of treatment. Analysis of the average values of laboratory parameters after the treatment showed the decrease of the total and free testosterone levels by 4 and 3.5 times, respectively, of the luteinizing and anti­mullerian hormone — by 2.7 and 1.8 times, respectively, the increase of progesterone level — by 1.5 times. Long­term results of treatment allowed marking steady clinical remission for one year after treatment in 111 (95 %) women. Positive changes of sonographic evaluation (ultrasonic diagnosis) after the treatment were noted in 70 (60 %) women, which were revealed as decrease of the thickness of capsules and the decrease or disappearance of small hypoechoic inclusions along the ovarian stroma.Conclusions. The necessary condition for the increase of the effectiveness of treating patients with acne is the correction of all links of the pathogenesis of the disease. With a similar clinical symptomatology, a different tactics of management of patients, aimed at a particular pathogenetic cause, will be required. Since laboratory diagnostics makes it possible to understand the individual links of the pathological process, for female acne patients, primarily of reproductive age, an evaluation of the androgenic status is required – detection of biochemical hyperandrogenism and analysis of the degree of androgen level increase, – which makes it possible to implement the appropriate changes in the treatment, including acne disease. To interrupt hyperandrogenism link in women with acne, confirmed by biochemical and instrumental studies, it is advisable to administer flutamide 125 mg 3 times a day for a total of 6 months in a complex therapy with a possible dose adjustment.

The Use of Hormonal Antiandrogen Therapy in Female Patients with Acne: A 10-Year Retrospective Study.

Little is known about how dermatologists prescribe hormonal antiandrogen acne treatment (HAAT). The aim of this study was to investigate dermatologists' HAAT-prescribing habits and HAAT's impact on systemic antibiotic use in women with acne. We performed a retrospective study at an academic medical center of female patients receiving HAAT (combined oral contraceptive [COC], spironolactone) for acne from January 2005 to October 2015. Data from a control group of female acne patients who never received HAAT were also collected. A total of 672 female patients received HAAT. Out of all systemic medications for acne, antibiotics were used as first-line treatment in 39% of patients, COCs in 12%, and spironolactone in 21%. Mean antibiotic durations in patients who initiated HAAT for the first time at the study site (250.4days) were significantly longer than in patients who received HAAT prior to presentation and continued HAAT at the study site (192.0days) (p=0.021). A statistically significant inverse association was found between HAAT use and mean antibiotic duration (p=0.016). HAAT is not typically used as a first-line systemic therapy in women with acne. HAAT usage is associated with shorter cumulative antibiotic durations and early HAAT initiation can decrease systemic antibiotic use in acne treatment.