cyproterone and Dermatitis--Seborrheic

Topics: Acne Vulgaris; Androgen Antagonists; Androgens; Benzoyl Peroxide; Cyproterone; Cyproterone Acetate; Dermatitis, Seborrheic; Drug Combinations; Erythromycin; Ethinyl Estradiol; Female; Humans; Isotretinoin; Male; Propionibacterium acnes; Sebum; Tetracycline; Tretinoin

The ongoing development and gradual availability of the new anti-androgens hold exciting clinical implications for the future. The biosynthesis and interchangeability of the sex steroids, the roles of the ovaries and adrenals and the value and interpretation of biochemical assays in clinical practice are briefly discussed. Because the anti-androgens are used primarily for seborrhoea/acne/hirsutism/oligomenorrhoea, the pathophysiological basis of this socially debilitating syndrome is discussed. The classification of the anti-androgens, their indications, side-effects, dosage schemes and results of treatment are reviewed. Finally, a summary of a possible clinical management regimen is presented.

Topics: 17-Ketosteroids; Acne Vulgaris; Adrenal Hyperplasia, Congenital; Androgen Antagonists; Androgens; Androsterone; Contraceptives, Oral, Hormonal; Cyclopentanes; Cyproterone; Dermatitis, Seborrheic; Dihydrotestosterone; Estradiol Congeners; Female; Follicle Stimulating Hormone; Glucocorticoids; Hirsutism; Humans; Hydroxysteroids; Luteinizing Hormone; Male; Medroxyprogesterone; Nandrolone; Prostatic Neoplasms; Receptors, Androgen; Sex Hormone-Binding Globulin; Steroids; Testosterone

A new oral contraceptive has been developed that contains a unique progestogen, drospirenone (DRSP), and that has both antiandrogenic and antimineralocorticoid activity. Our objective was to compare the effect of 30 microg ethinyl estradiol (EE)/3 mg DRSP (EE/DRSP; Yasmin, Schering AG, Berlin, Germany) with that of 35 microg EE/2 mg cyproterone acetate (EE/CPA; Diane-35, Schering AG, Berlin, Germany) on mild-to-moderate cases of acne. Diane-35 is used worldwide (it is not on the market in the United States and Japan) as a hormone treatment for acne, with additional contraceptive benefits. This multicenter, double-blind, randomized study was completed over 9 treatment cycles. A total of 128 women with mild-to-moderate facial acne, with or without seborrhea and/or hirsutism, were randomized. Treatment with either EE/DRSP or EE/CPA was assigned in a 2:1 ratio. Acne lesions, sebum production, and hair growth on the upper lip, chin, and chest were assessed, as well as levels of total and free testosterone, androstenedione, dehydroepiandrosterone sulfate (DHEAS), sex hormone-binding globulin (SHBG), and luteinizing hormone (LH). At study completion, dermatologists, gynecologists, and subjects gave their overall assessment of the effect of treatment on acne. After 9 treatment cycles, the median total acne lesion count was reduced markedly by 62.5% in the EE/DRSP group and 58.8% in the EE/CPA group. A comparison of the 2 groups revealed that EE/DRSP was at least as effective as EE/CPA. Both preparations also reduced sebum production and hair growth on the upper lip and chin. A 3-fold increase in the levels of SHBG was observed in both treatment groups, and levels of androgens and LH decreased. Treatment differences were not seen. Subjective evaluation of the effect of treatment on facial acne by dermatologists, gynecologists, and the subjects themselves indicated an excellent or good improvement for most subjects in both groups. EE/DRSP has been shown to be as effective for treating mild-to-moderate acne as a preparation containing EE/CPA. This new preparation may provide useful hormone therapy for women with androgen-dependent disorders who also require contraception.

Topics: Acne Vulgaris; Adolescent; Adult; Androgen Antagonists; Androstenes; Contraceptives, Oral, Combined; Cyproterone; Dermatitis, Seborrheic; Double-Blind Method; Drug Administration Schedule; Drug Evaluation, Preclinical; Ethinyl Estradiol; Facial Dermatoses; Female; Germany; Humans; Netherlands; Progesterone Congeners; Severity of Illness Index; Treatment Outcome

An open, randomized, multicenter study was carried out to compare two oral contraceptives as regards their therapeutic efficacy in androgenization symptoms such as acne, seborrhea and hirsutism in women. The preparations used were the combination of 2 mg cyproterone acetate (CPA) with 0.035 mg ethinyl estradiol (EE) (Diane 35, Schering AG, Berlin-West) and 0.150 mg desogestrel (DG) with 0.03 mg ethinyl estradiol (Marvelon, Organon, Oss, The Netherlands). The duration of therapy was 9 months. The combination of CPA-EE was used by 83 patients for 658 cycles and the combination of DG-EE by 79 women for 618 cycles. No pregnancy occurred under either therapy. Both preparations are well tolerated. However, some side-effects, such as reduced libido, nervousness and breast tenderness, were observed more frequently (p less than 0.05) in the DG-EE group than among the users of the CPA-EE combination. The therapeutic outcome was better in the CPA-EE group, especially in cases of facial acne (p less than 0.05). Seborrheic symptoms also responded better to the CPA-EE therapy. The results show that the CPA-EE combination is superior to the DG-EE combination in the treatment of acne and seborrhoea.

Topics: Acne Vulgaris; Adult; Breast; Contraceptives, Oral, Combined; Cyproterone; Cyproterone Acetate; Dermatitis, Seborrheic; Desogestrel; Female; Hirsutism; Humans; Multicenter Studies as Topic; Norpregnenes; Randomized Controlled Trials as Topic

Antiandrogens, preventing androgen action at target tissue level, are used in the treatment of various androgen-dependent diseases. Pharmacologically these substances have either a steroidal structure, like cyproterone acetate (CPA) and spironolactone (SPL), or a non-steroidal structure, like flutamide (FLU). In women with hyperandrogenism (PCO syndrome, idiopathic hirsutism, acne), clinical benefit may be obtained with CPA, which also displays a progestational activity and an antigonadotropic effect. CPA (25-50 mg/day) is used in combination with ethinyl-estradiol (EE) (20-30 micrograms/day) in reversed sequential regimen. SPL, less effective than CPA may be employed in moderate hirsutism and acne at dosages of 100-200 mg/day. During SPL treatment menstrual irregularities are frequent: in this case an association with oral contraceptives is indicated. SPL + bromocriptine (2.5-5 mg/day) has been experienced with success in PCO syndrome. The pure antiandrogen FLU, inducing progressive increase in LH and testosterone secretion, may be used only in combination with oral contraceptives. In men antiandrogens have been tested in BPH and prostatic carcinoma. In BPH the decrease in nuclear receptors and DHT nuclear content during CPA or FLU may represent the rational base of the medical treatment. An improvement in urinary obstructive manifestation has been observed with CPA alone or associated with tamoxifen (100 mg + 100 mg day). In advanced prostatic carcinoma antiandrogens represent a good alternative to estrogen therapy with less side effects and in combination with surgical or medical castration (LH-RH analogues) achieve a complete androgen blockade. An increase in the percentage of remissions and survival has been reported.

Topics: Acne Vulgaris; Adult; Androgen Antagonists; Cyproterone; Cyproterone Acetate; Dermatitis, Seborrheic; Female; Flutamide; Hirsutism; Humans; Male; Prostatic Neoplasms; Spironolactone

Low-dose hormonal contraceptives with specifically reduced estrogen are now the drug of choice for the prevention of internal risks. The antiandrogenic hormonal contraceptives have also had to be adapted to this situation. In a study involving 144 women, most of whom were suffering from moderately severe androgenization, Diane-35 (reduced to 0.035 mg ethinyl estradiol) was used as an antiandrogenically active hormonal contraceptive. From the sixth treatment cycle onward acne and seborrhea were significantly improved or already healed. In the 12th treatment cycle the treatment success rate was almost 90%. The side effects occurring with higher-dose hormonal contraceptives were reduced, cycle behavior was acceptable, and the incidence of metrorrhagia corresponded to that found with other micropills.

Topics: Acne Vulgaris; Adult; Alopecia; Androgen Antagonists; Clinical Trials as Topic; Contraceptives, Oral, Hormonal; Cyproterone; Cyproterone Acetate; Dermatitis, Seborrheic; Drug Combinations; Ethinyl Estradiol; Female; Hirsutism; Humans; Menstrual Cycle; Middle Aged

Topics: Acne Vulgaris; Adolescent; Adult; Androgens; Clinical Trials as Topic; Cyproterone; Cyproterone Acetate; Dermatitis, Seborrheic; Drug Combinations; Ethinyl Estradiol; Female; Humans; Male; Middle Aged; Skin Diseases

Topics: Acne Vulgaris; Androgen Antagonists; Chlormadinone Acetate; Clinical Trials as Topic; Cyproterone; Dermatitis, Seborrheic; Drug Combinations; Ethinyl Estradiol; Hirsutism; Humans; Mestranol; Skin Diseases

The combination of 2 mg cyproterone acetate, a pronounced antiandrogenic substance, in combination with 0.05 mg ethinyl estradiol has undergone intensive multiphasic clinical evaluation. The preparation with the trade name Diane has proven to be not only a reliable contraceptive, but also a very potent drug for the treatment of both acne and seborrhea, and of milder cases of hirsutism. The effect of Diane on markedly increased hair growth was not so pronounced. In addition to the presentation of the most pertinent steps of the clinical investigation of Diane, the possible mode of actions of antiandrogens alone and in combination with an estrogen is discussed.

Topics: Acne Vulgaris; Adolescent; Adult; Chemical Phenomena; Chemistry; Clinical Trials as Topic; Contraceptives, Oral; Contraceptives, Oral, Combined; Cyproterone; Cytosol; Dermatitis, Seborrheic; Double-Blind Method; Drug Combinations; Drug Evaluation; Ethinyl Estradiol; Female; Hirsutism; Humans; Norgestrel; Ovulation; Pregnancy; Random Allocation; Receptors, Progesterone; Testosterone

The antiandrogen-containing preparation SH B 209 AB was tested in comparison with an ovulation inhibitor with no antiandrogenic effect (Neogynon) in a randomized, double blind study conducted to determine the effects of both on androgenization symptoms. 88 patients took part in the study. In the majority of cases the duration of the treatment period was more than 6 months. It was shown that the therapy with the combination preparation containing cyproterone acetate was distinctly more successful in cases of acne and seborrhoea: not only acne in its various locations but also all forms of seborrhoea were more favourably influenced by the trial preparation. This difference was statistically significant (p less than 0.05). It was not possible to establish a significant difference between the two preparations in the case of hirsutism in its various locations from the limited number of cases observed. There were also no differences detected in hepatic tolerance. During treatment with both preparations all values measured were within the normal range.

Topics: Acne Vulgaris; Clinical Trials as Topic; Cyproterone; Dermatitis, Seborrheic; Double-Blind Method; Drug Evaluation; Drug Tolerance; Ethinyl Estradiol; Female; Humans; Norgestrel

Treatment of virilization symptoms in 230 patients is reported. 68 patients were treated with Planovin (4 mg megestrol acetate and .05 mg ethinyl estradiol), 77 with SH81041 (100 mg Cyproterone acetate for 10 days and .05 mg ethinyl estradiol for 21 days), and 85 were treated first and Planovin and then with SH81041. Acne, seborrhea, hirsutism, and alopecia improved under treatment with each preparation; results were similar with acne and alopecia, while SH81041 was somewhat more effective than Planovin in treating seborrhea and hirsutism. Therapeutic results obtained during treatment with SH81041 in acne and alopecia are retained during Planovin treatment, but seborrhea and hirsutism become worse again. Successful treatment was independent of the severity of hirsutism and the duration of of treatment. Side effects included breakthrough bleeding and sweating.

Topics: 17-Ketosteroids; Acne Vulgaris; Adolescent; Adult; Alopecia; Androgen Antagonists; Clinical Trials as Topic; Cyproterone; Dermatitis, Seborrheic; Ethinyl Estradiol; Female; Hirsutism; Humans; Megestrol; Virilism

The usefulness of antiandrogenic therapy with cyproterone acetate for androgenisation signs and symptoms in women, when tumours are definitely not the cause, has now been confirmed world-wide in about 100,000,000 therapy cycles using the hormonal contraceptive Diane and its follow-up preparation Diane-35, which contains a lower level of oestrogen. Nowadays, low-dose hormonal contraceptives are preferred in order to minimise the so-called "internal" risk by reducing the level of the oestrogen component and, by careful selection of the progestin, minimising the residual androgenic effect. In an open study on 150 women with moderately severe symptoms of androgenisation, we assessed, for treatment periods of up to 36 cycles, the effect of the only oestrogen-reduced hormonal contraceptive with anti-androgenic activity (Diane-35), and also monitored biochemical parameters, which are indicative of high risk metabolic activity and permit an accurate characterisation of the hormonal contraceptive, especially with long-term use. Although the parameters of liver and fat metabolism occasionally yielded values close to the limit of the normal range, it was particularly favourable to note, that the lipoprotein fraction HDL exhibited a slightly rising tendency, whereas, at the same time, the LDL fraction dropped. Special attention has been paid to ultrasonographic monitoring of the liver, since the influence on the function of this organ has been frequently discussed in conjunction with prolonged use of 17-alpha-alkylated steroidal compounds, and because a possible connection between sex steroids and the development of liver tumours has been a point of discussions.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Acne Vulgaris; Adolescent; Adult; Androgen Antagonists; Cholesterol, HDL; Cyproterone; Cyproterone Acetate; Dermatitis, Seborrheic; Drug Combinations; Ethinyl Estradiol; Female; Follow-Up Studies; Hirsutism; Humans; Lipids; Liver Function Tests; Long-Term Care; Menstrual Cycle; Middle Aged

This study evaluates the effect of therapy over a long period of time (36 cycles without interruption) with the monophasic combination containing 0.035 mg of ethinylestradiol and 2 mg of cyproterone acetate (EE35-CPA) on hormonal and clinical parameters of 66 patients with polycystic ovary syndrome (PCOS). During the administration of the pill a significant decrease in the LH/FSH ratio and in adrenal and ovarian androgens has been observed, as well as a significant increase of the Sex Hormone Binding Globulin (SHBG). The progressive decrease of the total androgenic activity explains the clinical results that have been obtained: at the 36th cycle of therapy acne disappeared in 100% of the cases, seborrea in 76.4% and hirsutism in 75%. Our results underline the need for a continuous administration without interruption of the pill with CPA in patients with clinical hyperandrogenic symptoms.. This study evaluated the effect of therapy over a long period of time (36 cycles without interruption) with the monophasic combination containing 0.035 mg ethinyl estradiol and 2 mg cyproterone acetate (EE35-CPA) on hormonal and clinical parameters of 66 patients with polycystic ovary syndrome. During the administration of the pill, a significant decrease in the LH/FSH ratio and in adrenal and ovarian androgens has been observed, as well as a significant increase in sex hormone binding globulin. The progressive decrease in total androgenic activity explains the clinical results that have been obtained--at the 36th cycle of therapy, acne disappeared in 100% of the cases, seborrhea in 76.4%, and hirsutism in 75%. These results underline the need for continuous administration of the pill with CPA without interruption in patients with clinical hyperandrogenic symptoms.

Topics: Acne Vulgaris; Adult; Alanine Transaminase; Alkaline Phosphatase; Analysis of Variance; Androgen Antagonists; Androstenedione; Aspartate Aminotransferases; Bilirubin; Blood Glucose; Cholesterol; Contraceptives, Oral, Combined; Cyproterone; Cyproterone Acetate; Dehydroepiandrosterone; Dermatitis, Seborrheic; Drug Combinations; Ethinyl Estradiol; Female; Follicle Stimulating Hormone; Hirsutism; Humans; Liver; Luteinizing Hormone; Ovary; Polycystic Ovary Syndrome; Prolactin; Sex Hormone-Binding Globulin; Testosterone; Triglycerides

Modes of action of antiandrogens, their side effects as well as indications for their application to androgen-dependent skin conditions. Particular attention is paid to the possibilities for topical medication with antiandrogenic active substances.

Topics: Acne Vulgaris; Alopecia; Androgen Antagonists; Chlormadinone Acetate; Cyproterone; Cyproterone Acetate; Dermatitis, Seborrheic; Drug Therapy, Combination; Female; Hirsutism; Humans; Male; Skin Diseases; Spironolactone

The low-dose oral standard antiandrogen treatment with cyproterone acetate (CPA), Diane, is frequently associated with unsatisfactory results regarding moderate to severe seborrhoea/acne/acne and/or mild to moderate hirsutism. This multicenter double-blind study (n = 164) was, therefore, initiated to analyze the effectiveness of a medium dose oral regimen, i.e. the addition of 10 mg of CPA during the first 15 days of the Diane-treatment cycle. Good or satisfactory results after 3, 6, 9 and 12 months were observed in 61, 81, 95 and 97% of patients with moderate to severe seborrhoea (n = 79); in 53, 95, 98 and 100% of patients with moderate to severe acne (n = 62); and in 10, 28, 45 and 55% of patients with mild to moderate hirsutism (n = 89), respectively. The regression of moderate facial hirsutism and severe facial acne occurred faster and was more complete under the medium-dose than with the low-dose regimen. Side effects corresponded to those of conventional oral contraceptives except for a higher frequency of mastodynia. Both regimens caused a significant suppression of plasma dehydroepiandrosterone sulfate, while testosterone, triiodothyronine and thyroxine were lowered insignificantly. In contrast, cortisol, prolactin and insulin increased significantly. The extent of these changes did not differ in both modes of treatment. The medium-dose regimen (total dosage per cycle: 192 mg of CPA) is more effective than the low-dose regimen (42 mg of CPA per cycle) in the treatment of patients with moderate hyperandrogenism who do not require the high-dose oral standard antiandrogen therapy (1000 mg of CP A per cycle).

Topics: Acne Vulgaris; Cyproterone; Dehydroepiandrosterone; Dermatitis, Seborrheic; Double-Blind Method; Ethinyl Estradiol; Female; Hirsutism; Humans; Hydrocortisone; Insulin; Placebos; Prolactin; Testosterone; Thyroxine; Triiodothyronine

Management of hirsutism with high-dose oral cyproterone acetate (CPA) is associated with a failure rate of about 30%. The present investigation analyses the efficacy of parenteral CPA administration in non-tumorous hyperandrogenism. Medium-dose CPA (300 mg) was injected intramuscularly once per month, followed by oral ethinylestradiol (40 micrograms daily) for 21 days in 42 patients (total of 293 treatment cycles). The onset of withdrawal bleeding was 3 to 8 days later. This regimen was used as primary therapy (group A; n = 18) as well as follow-up therapy in low-dose (group B; n = 10) and high-dose oral standard CPA failures (group C; n = 14). The following satisfactory or good response rates were observed in regard to hirsutism: group A 83,5%, group B 100%, group C 57%; seborrhea A and B 100%, C 89%; acne and androgenetic alopecia A and B and C 100%. Clinical side effects occurred in 20 patients; they corresponded in type and frequency to those elicited by the high-dose oral standard medication and resulted in termination of treatment in only 3 patients. Pilot studies regarding the pharmacokinetics of CPA as well as the effects on plasma total and free testosterone and prolactin failed to explain the therapeutic superiority of parenteral CPA (n = 7 women). Still, it may be concluded that intramuscular CPA administration represents a new and highly effective means of managing hirsute females.

Topics: Acne Vulgaris; Adult; Alopecia; Cyproterone; Delayed-Action Preparations; Dermatitis, Seborrheic; Female; Hirsutism; Humans; Injections, Intramuscular; Prolactin; Testosterone

We report on 20 female patients suffering from acne, seborrhea, hirsutism, and androgenic alopecia during the years 1980-1982 who have been treated with 1 tablet of Androcur 10 (10 mg cyproteronacetate) daily, in the first 15 days applied together with Diane (0,05 mg ethinylestradiol and 2 mg cyproteronacetate). The results achieved after 2 years show an improvement of acne in 80 per cent of the cases, of seborrhea in 95 per cent, and of both hirsutism and androgenic alopecia in 45 per cent each. So this therapy takes its important place between the therapy with Diane alone and the usual supplementary dosis of 50 mg cyproteronacetate (Androcur) daily.

Topics: Acne Vulgaris; Adolescent; Adult; Alopecia; Androgen Antagonists; Cyproterone; Cyproterone Acetate; Dermatitis, Seborrheic; Drug Combinations; Drug Therapy, Combination; Ethinyl Estradiol; Female; Hirsutism; Humans; Middle Aged; Virilism

Forty two female patients with strong acne and oiliness were studied all of them were treated with a tablet daily of 2 mg. of cyprosterone Acetate and 0.05 mg of ethinyl oestradiol for 3 weeks and a week without it. We found intolerance to the treatment in 9 out of 42 patients and a high percentage of cure or marked improvement in 96.9% of patients. In conclusion this drug is a good help to the treatment of female acne with seborrheic skin.

Topics: Acne Vulgaris; Adolescent; Adult; Cyproterone; Cyproterone Acetate; Dermatitis, Seborrheic; Drug Combinations; Drug Evaluation; Ethinyl Estradiol; Female; Humans

It has been established that, through skin responds to circulating androgens, it can also produce androgens from precursors. Therapy can address either of the two following physiopathological steps: the secretory step can be countered by replacement or suppressive therapy which is now fairly well mastered; the target-organ step opens new possibilities concerning receptor abnormalities and receptor control. The medical literature was reviewed for data on hormonal therapy for women with acne, idiopathic hirsutism and seborrheic alopecia, three conditions which are usually only partially improved by cosmetic treatment.

Topics: Acne Vulgaris; Alopecia; Androgen Antagonists; Androgens; Cyproterone; Dermatitis, Seborrheic; Estrogens; Female; Glucocorticoids; Hirsutism; Hormones; Humans; Progesterone; Skin; Spironolactone

Cyproterone acetate acts as an antiandrogen through competitive inhibition of the androgens at cellular level on the peripheral effectors. Associated with ethynyl estradiol potentiates its action upon the cutaneous effectors, and at the same time has a potent ovulostatic action. Forty one women with seborrhea, acne, hirsutism and androgenic alopecia were treated. In 18 cases serum testosterone level were measured by radioimmunoassay before treatment. Most had levels above the normal range. In 7 cases testosterone level were repeated during treatment. Some did not show changes, but in most testosterone plasma increased. Most of the cases with acne and seborrhea showed a definite improvement between 3 and 6 months. Alopecia and hirsutism needed a longer treatment and the results were not so satisfactory. The tolerance was excellent and the side effects were those usually found with other oestrogens and gestagens associations. No rebound was observed when the medication was discontinued, although most of the cases showed a tendency to mild recurrence.

Topics: Acne Vulgaris; Adolescent; Adult; Alopecia; Androgen Antagonists; Cyproterone; Cyproterone Acetate; Dermatitis, Seborrheic; Drug Combinations; Ethinyl Estradiol; Hirsutism; Humans; Hydrocortisone; Middle Aged; Testosterone

The authors employed a preparation containing ethinyl estradiol and cyproterone acetate (patented as Diane) to treat 32 women showing signs of masculinization; treatment was continued for 252 cycles. The contraceptive effect of the treatment was 100%. During treatment there was a considerable reduction of seborrhoea, acne, and hirsutism, and this improvement could be measured statistically. There were very few side effects serious enough to require interruption of treatment. Because of these favorable characteristics, this drug is considered suitable for the treatment of seborrhea, acne, and hirsutism in women for whom combination contraceptives are not contraindicated.

Topics: Acne Vulgaris; Adult; Androgen Antagonists; Cyproterone; Cyproterone Acetate; Dermatitis, Seborrheic; Drug Combinations; Ethinyl Estradiol; Female; Hirsutism; Humans; Testosterone; Virilism

The use of antiandrogens (principally cyproterone acetate CPA) to treat women with symptoms of hypersecretion of androgens is discussed. Several therapy schemata are presented. A high dosage "reverse sequential" therapy of 100 mg CPA on the 5th-14th days of the menstrual cycle and 40 mcg ethinyl estradiol (EE) on the 5th-25th days is used in severe cases. Low dosage (2mg CPA, 50 mcg EE) preparations are used for light cases of androgen hypersecretion. Parenteral application of 300 mg CPA per cycle with supplementary EE administration has also been tested. Hirsuitism is treated with good results in 65%-80% of those who use high dosage preparations and 50% of those who use the low dosage preparations. The effects of the therapy are apparent 9-12 months after it begins; the therapy is not as successful among patients whose problems are not related to their hormonal balance. Seborrhea and endogenous acne can be effectively treated with all types of antiandrogen preparations. Androgenetic alopecia can also be treated in a majority of cases with CPA preparations. CPA treatment should not last longer than 12 months. High dosage CPA use by ovulating women causes suppression of the preovulatory LH and FSH peaks but has little effect on basal levels; in postmenopausal women, the basal LH and FSH levels are significantly reduced. Use of CPA by itself causes a significant decrease in the levels of testosterone and delta-4-andostendion 3,17-dion. Use of CPA/EE combinations causes an increase in SHBG and the blood cortisol levels. Protein metabolism, hematopoesis, blood coagulation, and liver function are not affected by CPA use. Reduced glucose utilization and an increase in triglyceride levels are observed during CPA use. Pregnant women and women over 40 or with androgen-producing tumors should not use CPA.

Topics: Acne Vulgaris; Adrenocorticotropic Hormone; Alopecia; Androgen Antagonists; Cyproterone; Cyproterone Acetate; Dermatitis, Seborrheic; Dose-Response Relationship, Drug; Drug Therapy, Combination; Ethinyl Estradiol; Female; Follicle Stimulating Hormone; Hirsutism; Humans; Hypertrichosis; Luteinizing Hormone; Pregnancy; Prolactin; Virilism

Topics: Acne Vulgaris; Cyproterone; Dermatitis, Seborrheic; Ethinyl Estradiol; Female; Hirsutism; Humans; Virilism

101 hirsute women received Diane, a combination of 2 mg cyproterone acetate and 50 micrograms ethinyl oestradiol per capsule, from the fifth to twenty-fifth day during a total of 1105 cycles. The treatment was satisfactory in 96% of women with acne, 84% with androgenic alopecia, 79% with seborrhoea, and 50% of those with mild or moderate hirsutism. The effectiveness of treating hirsutism or alopecia depended on its severity and duration. There was no correlation between various measures of androgen levels before and during treatment and the clinical results. Side effects were similar to those after contraceptive one-phase preparations, both in kind and incidence. None of the women became pregnant. Diane is thus the drug of choice in hormonal contraception of patients with acne, seborrhoea, androgenic alopecia or mild hirsutism. It is also suitable in the follow-up or interval management of high-dose cyproterone acetate treatment of severe hirsutism, in order to maintain the effect obtained with lower hormone doses.

Topics: Acne Vulgaris; Alopecia; Contraception; Cyproterone; Dermatitis, Seborrheic; Ethinyl Estradiol; Female; Hirsutism; Humans

Topics: Acne Vulgaris; Alopecia; Cyproterone; Dermatitis, Seborrheic; Female; Hirsutism; Humans; Virilism

In spite of remarkable therapeutic results obtained by gestagens with antiandrogenic activity, usually combined with estrogen, in oily seborrhea, acne, Fox-Fordyce disease, androgenetic alopecia and hirsutism many dermatologist still hesitate to treat the named disorders by hormones. The reason for their hesitation appears to be the erroneous belief, that the named disturbances represent hormonal disorders the treatment of which does not belong to dermatology. After a survey on the mechanism of action of antiandrogens the basic difference between androgen dependent skin disorders and endocrinopathies with manifestation on the skin and its appendages is explained. Androgen dependent skin disorders, like oily seborrhea and most cases of acne are not the result of endocrine disturbances in the sense of an pathologically increased or decreased production of sexual hormons. Administering sexual hormons the physician takes advantage of the sebosuppressive effect of female sexual hormons as he does of the antiallergic activity of the hormon cortisol (and related compounds) in the treatment of eczemas. The antiandrogenic treatment of androgenetic alopecia, hirsutism and androgenetic acne--with their underlying hormonal disturbance, consisting in an increased production of androgens, represents an quasi etiological therapy. As in these cases the hormonal disturbances finds its expression mainly or exclusively in disorders of the skin or hair growth, the dermatologist, preferentially in cooperation with endocrinogists and/or gynacologists remains entitled to take over the treatment. The available drugs are discussed and suggestions are made for their appropriate use.

Topics: Acne Vulgaris; Alopecia; Androgen Antagonists; Chlormadinone Acetate; Cyproterone; Dermatitis, Seborrheic; Female; Hirsutism; Humans; Miliaria; Progesterone

The effectiveness of therapy with cyproterone acetate and ethinyl estradiol was studied in 103 women. Acne and seborrhea responded best with 91.7 and 93.3% respectively, including complete and partial therapeutic success. For hirsutism complete remission and partial improvement were found in 75.3% of the treated women. Under therapy, body weight did not change in 51.9%, while 24.7% of the patients gained weight and 23.4% lost weight. The cycle length remained normal after therapy in 35.8%. Normalization or improvement was found in 54.7%. In 6.3% no improvement was noted after therapy and in 3.2% cycle irregularity developed in women with previous undisturbed pattern. According to BBT, improvement of the functional capacity of the reproductive system was found in 32.9% of the patients. Only 3% of the women studied demonstrated a deterioration. The 17-ketosteroid excretion was diminished in 35.3% after therapy and remained unchanged in 64.7%. The therapeutic regimen used for the study was well tolerated and good cycle control was obtained.

Topics: 17-Ketosteroids; Acne Vulgaris; Adolescent; Adult; Body Temperature; Body Weight; Cyproterone; Dermatitis, Seborrheic; Ethinyl Estradiol; Female; Hirsutism; Humans; Menstruation; Menstruation Disturbances; Remission, Spontaneous

57 women suffering from seborrhea and acne were treated with low doses of estrogens and antiandrogens. A cyclic regimen comprising 21 tablets of 0.05 mg ethinylestradiol and 2 mg cyproterone acetate was used. Results were very favourable: within 6 months, 51 patients were healed or significantly improved. There were only minor side effects, and none of the women conceived. It is concluded that this combination not only provides very effective therapy but might also be the contraceptive of choice for women with skin problems.

Topics: Acne Vulgaris; Adolescent; Adult; Androgen Antagonists; Contraceptives, Oral, Synthetic; Cyproterone; Dermatitis, Seborrheic; Ethinyl Estradiol; Female; Humans; Pregnancy

Topics: Acne Vulgaris; Adolescent; Adult; Alopecia; Child; Chlormadinone Acetate; Cyproterone; Dermatitis, Seborrheic; Female; Fertility; Hirsutism; Humans; Menstruation; Puberty, Precocious; Skin Diseases

The paper refers to 167 patients who were treated with 2 mg Cyproteronacetate and 50 mug Ethinyloestradiol because of acne, seborrhoea, hirsutism and androgenetic alopecia. The application was daily from the 5th to the 25th day of cycle over a period of 12 months. The success of treatment depended on the severity of virilisation: in cases of light acne only 77% of the patients showed improvement, while in cases of severe acne 91,4% showed improvement or healing of acne. The corresponding figures for seborrhoea were 55,7% and 89,4% respectively, and for hirsutism 37,4% and 60,9% respectively. Furthermore the success of treatment of the different virilising symptoms depended on the duration of therapy: while acne was already cured significantly after 6 months of treatment, seborrhoea and hirsutism show continuous improvement up to the 10th month thetherapy. Concerning side effects during therapy spottings and brake through bleedings were registered in 17,1 and 6% of cycles respectively. 16,2% of the patients noted breast tensions. Finally 68,7% of the patients suffered from nervousness, a very subjective symptom, which might be explained by the psychic lability accompanying virilising symptoms. The drop out rate was 7,8%, being not higher than with other oral contraceptives.

Topics: Acne Vulgaris; Alopecia; Cyproterone; Dermatitis, Seborrheic; Ethinyl Estradiol; Female; Hirsutism; Humans; Menstruation Disturbances; Time Factors; Virilism

Topics: Acne Vulgaris; Adolescent; Adult; Alopecia; Androgen Antagonists; Cyproterone; Dermatitis, Seborrheic; Drug Combinations; Drug Therapy, Combination; Ethinyl Estradiol; Female; Hirsutism; Humans; Middle Aged

175 women of reproductive age, with hirsutism of differing degrees and different pathogenetic causes (ovarian, adrenal, iatrogenic) or idiopathic, and acne were treated with two different combinations of Cyprotrone acetate and ethinyl estradiol (SH 8.1041 and SH B209AB). 90 patients were given SH 8.1041 and 10 were given SH B209AB. 75 received both preparations. The total number of treatment cycles was 1534. Clinical, hormonal and biochemical assessments were made before, during and after treatment. The degrees of hirsutism and acne, and of seborrhea and hair loss when present, were scored by means of a modified version of the Ferriman and Gallway criteria. SH 8.1041 brought about a significant improvement in the majority of the patients. SH B209AB was generally used as maintenance therapy for hirsutism and severe acne. It was the initial treatment of choice in patients with milder acne. Reduction of hirsutism was usually apparent after the fourth cycle of therapy and acne regressed after the first month. Both combinations were well-tolerated biochemically. In a few patients on SH 8.1042, slight and transient increases in BSP, SGOT, SGPT and bilirubin were observed, but cessation of treatment was not necessary. Some patients on SH 8.1041 complained of transient frigidity, mild depression, breast discomfort and nausea.

Topics: Acne Vulgaris; Adult; Cyproterone; Dermatitis, Seborrheic; Drug Combinations; Ethinyl Estradiol; Female; Hirsutism; Humans; Sex Factors

Twenty-five female patients, aged 14 to 49, and suffering from syptoms of virilization (hirsutism, acne, seborrhea and alopecia) were treated with an estrogen-progestogen combinantion, i.e. cyproterone acetate and ethinylestradiol, having antiandrogenic and antiovulatory action. Patients were submitted to monitoring by means of a series of laboratory tests in order to detect any toxic or hormonal effects that might occur. In most cases symptoms of virilization were significantly reduced, while untoward side effects were not noted.

Topics: Acne Vulgaris; Adolescent; Adult; Alopecia; Cyproterone; Dermatitis, Seborrheic; Drug Combinations; Ethinyl Estradiol; Female; Hirsutism; Humans; Middle Aged; Virilism

Topics: Acne Vulgaris; Adolescent; Adult; Alopecia; Chlormadinone Acetate; Contraceptives, Oral; Cyproterone; Dermatitis, Seborrheic; Drug Combinations; Drug Evaluation; Ethinyl Estradiol; Female; Follow-Up Studies; Hirsutism; Humans; Megestrol; Mestranol; Nandrolone; Norethindrone; Norgestrel

Topics: Acetates; Acne Vulgaris; Alopecia; Cyproterone; Dermatitis, Seborrheic; Drug Therapy, Combination; Ethinyl Estradiol; Female; Hirsutism; Humans; Time Factors

Topics: Acne Vulgaris; Androgen Antagonists; Animals; Cyproterone; Dermatitis, Seborrheic; Estrenes; Female; Fetus; Growth; Humans; Male; Mice; Pregnancy; Progesterone; Prostatic Neoplasms; Rats; Spermatogenesis; Testis; Testosterone

Topics: Acne Vulgaris; Alopecia; Androgen Antagonists; Animals; Chlormadinone Acetate; Cyproterone; Dermatitis, Seborrheic; Female; Hirsutism; Humans; Male; Progestins; Rats; Time Factors

Topics: Acne Vulgaris; Adolescent; Adult; Cyproterone; Dermatitis, Seborrheic; Ethinyl Estradiol; Female; Humans; Sebaceous Glands; Sebum

Topics: Acne Vulgaris; Adult; Alopecia; Animals; Breast Neoplasms; Chlormadinone Acetate; Contraception; Contraceptives, Oral; Contraceptives, Postcoital; Cyproterone; Delayed-Action Preparations; Dermatitis, Seborrheic; Dogs; Estrogens; Ethinyl Estradiol; Female; Hirsutism; Humans; Injections, Intramuscular; Norgestrel; Progestins