Dm. Gruber et al., TOPICAL CYPROTERONE-ACETATE TREATMENT IN WOMEN WITH ACNE - A PLACEBO-CONTROLLED TRIAL, Archives of dermatology, 134(4), 1998, pp. 459-463
Objective: To evaluate the clinical and hormonal response of topically
applied cyproterone acetate, oral cyproterone acetate, and placebo lo
tion in women with acne. Design: Placebo-controlled, randomized study.
Setting: Patients were recruited from the Institute of Endocrine Cosm
etics, Vienna, Austria. Patients: Forty women with acne. Interventions
: Treatment with oral medication consisting of 0.035 mg of ethinyl est
radiol and 2 mg of cyproterone acetate (n=12), 20 mg of topical cyprot
erone acetate lotion (n=12), and placebo lotion (n=16) was offered. Pa
tients were assessed monthly for 3 months. Main Outcome Measures: Clin
ical grading according to acne severity and lesion counts as well as d
eterminations of serum cyproterone acetate concentrations. Results: Af
ter 3 months of therapy with topical cyproterone acetate, the decrease
of mean facial acne grade from 1.57 to 0.67 was significantly better
(P<.05) compared with placebo (which showed a change from 1.57 to 1.25
), but not compared with oral medication (1.56 to 0.75) (P>.05). Lesio
n counts also decreased from 35.9 to 9.1 in the topical cyproterone ac
etate group compared with oral medication (45.4 to 15.5) (P>.05) and p
lacebo (38.2 to 23.1) (P<.05). After topical cyproterone acetate treat
ment, serum cyproterone acetate concentrations were 10 times lower tha
n those found after oral cyproterone acetate intake. Conclusions: The
therapeutic effect of topically applied cyproterone acetate for acne t
reatment was clearly demonstrated. Topically applied sexual steroids i
n combination with liposomes are as effective as oral antiandrogen med
ication in acne treatment, while reducing the risk of adverse effects
and avoiding high serum cyproterone acetate concentrations.