Coneac Andrei, Muresan Adriana, Orasan Meda Sandra
Department of Histology, Morphological Sciences Division, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Department of Physiology, Physiological Sciences Division, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Clujul Med. 2014;87(4):226-34. doi: 10.15386/cjmed-386. Epub 2014 Nov 12.
Androgenetic Alopecia in Women (AGA) occurs due to an underlying susceptibility of hair follicles to androgenic miniaturization, caused by androgens. Clinically, AGA is characterized by progressive hair loss, with a marked hair thinning in the fronto-parietal area so that the scalp can be easily seen. Acne vulgaris is androgen-dependent and often affects the skin that has an increased number of oil glands: face, back and chest. Although the sebaceous glands are present on the scalp too, it is very rare to get acne at this site, as the hair acts as a wig and allows the sebum to drain and does not block the pores. Both AGA and Acne Vulgaris are signs of hyperandrogenism. Cyproterone acetate/ethinyl estradiol (2mg/0.035mg) products are authorized for the treatment of androgenetic symptoms in women, such as acne, seborrhea, mild forms of hirsutism and androgenetic alopecia. Our study had a double purpose: - To evaluate the result of the study regimen Melleva 35 (one pill per day, for 3 consecutive months) in patients with moderate to severe acne, suffering also from Androgenetic Alopecia;- To establish the efficacy of the drug on acne and alopecia improvement, both from the doctor's and patient's point of view.
After being informed of the aims and procedures of the study, participants provided a written informed consent. A number of 35 female subjects with moderate to severe acne vulgaris remained in the study. The subjects had also been diagnosed as suffering from AGA, on the basis of clinical criteria, including the pattern of hair loss and trichoscopy assessment.
83% of study subjects reported that their hair did not continue to fall after 3 months of antiandrogen therapy. The females were evaluated using trichoscopy and the doctor noticed hair regrowth in 77% of the cases. Regarding the improvement of acne lesions after the treatment, 40% of study subjects recorded good improvement and 26% recorded excellent results with Melleva 35. The acceptance of the treatment was very high, 86% patients were compliant with the study therapy. The rate of adverse events (5 cases) was within the limits of the treatment tested by the study. Almost a third of the total number of subjects (28.5%) reached a good satisfaction level after the treatment, while 37.1% claimed moderate satisfaction.
There was no correlation between the age of the subjects and the treatment for acne therefore our first hypothesis was rejected. As a conclusion, antiandrogenic therapy with Melleva 35, 1 pill per day, for 3 consecutive months, shows good results for patients who suffer from both Androgenetic Alopecia and Acne Vulgaris.
女性雄激素性脱发(AGA)是由于毛囊对雄激素导致的微型化具有潜在易感性而发生的。临床上,AGA的特征是进行性脱发,额顶部区域明显变薄,以至于头皮很容易被看到。寻常痤疮是雄激素依赖性的,通常会影响皮脂腺数量增加的皮肤部位:面部、背部和胸部。虽然头皮上也有皮脂腺,但在这个部位长痤疮非常罕见,因为头发起到假发的作用,使皮脂能够排出,不会堵塞毛孔。AGA和寻常痤疮都是雄激素过多的迹象。醋酸环丙孕酮/炔雌醇(2mg/0.035mg)产品被批准用于治疗女性的雄激素症状,如痤疮、脂溢性皮炎、轻度多毛症和雄激素性脱发。我们的研究有两个目的:- 评估研究方案Melleva 35(每天一片,连续3个月)对中度至重度痤疮且患有雄激素性脱发患者的治疗效果;- 从医生和患者的角度确定该药物对痤疮和脱发改善的疗效。
在被告知研究目的和程序后,参与者提供了书面知情同意书。35名中度至重度寻常痤疮的女性受试者留在了研究中。根据临床标准,包括脱发模式和毛发镜评估,这些受试者也被诊断患有AGA。
83%的研究受试者报告说,在接受3个月的抗雄激素治疗后,她们的头发不再继续脱落。对这些女性进行了毛发镜评估,医生在77%的病例中注意到有毛发再生。关于治疗后痤疮皮损的改善情况,40%的研究受试者记录显示有良好改善,26%的受试者使用Melleva 35取得了优异结果。治疗的接受度非常高,86%的患者遵守了研究治疗方案。不良事件发生率(5例)在研究测试的治疗范围内。几乎三分之一的受试者(28.5%)在治疗后达到了较高满意度水平,而37.1%的受试者表示中度满意。
受试者年龄与痤疮治疗之间没有相关性,因此我们的第一个假设被否定。总之,每天服用一片Melleva 35进行连续3个月的抗雄激素治疗,对同时患有雄激素性脱发和寻常痤疮的患者显示出良好效果。