Serum 3 alpha-androstanediol-glucuronide is decreased in nonhirsute women with acne vulgaris.

OBJECTIVE

To determine if acne vulgaris in women has a different pattern of androgen activity than hirsutism at the pilosebaceous unit.

DESIGN

Prospective clinical study.

SETTING

Outpatient clinic for gynecological endocrinology at a university hospital.

PATIENT(S): Twenty women suffering from mild or moderate acne vulgaris compared with 38 controls.

MAIN OUTCOME MEASURE(S): Serum androgens DHEAS, androstendione, T, including 3 alpha-androstanediol-glucuronide (3 alpha-diolG), the metabolite of 5 alpha-reductase activity.

RESULT(S): Serum 3 alpha-diolG was decreased in the acne groups depending on the grade of severity. No statistically significant differences were observed between the other androgens measured in acne patients and controls.

CONCLUSION(S): In contrast to hirsutism, acne is influenced directly by T and not by its 5 alpha-reduced metabolites. In female acne patients, 5 alpha-reductase activity appears to be reduced, which is reflected in decreased serum levels of 3 alpha-diolG. Consequently, 5 alpha-reductase inhibitors are most likely not promising candidates for acne therapy; a postulation that, however, requires further clinical investigation.