Hyperandrogenemia in patients presenting with acne

Objective: To determine whether acne is associated with hyperandrogenemia, regardless of age of presentation. Design: Prospective controlled study. Setting: Tertiary-care medical center. Patient(s): Thirty consecutive unselected women presenting with acne and no hirsutism and 24 eumenorrheic healthy controls. Intervention(s): Serum samples was taken in all patients, and an acute 60-m inute ACTH-(1-24) test was performed in 19 patients. Main Outcome Measure(s): Total and free T, sex hormone-binding globulin (SH BG), and DHEAS levels in basal samples, and ACTH-stimulated 17-hydroxyproge sterone (17-HP) response to exclude 21-hydroxylase (21-OH)-deficient noncla ssic adrenal hyperplasia (NCAH) were determined. Result(s): Nonhirsute patients with acne demonstrated significantly lower l evels of SHBG and higher free-T and DHEAS levels than controls. Nineteen (6 3%) acneic patients had at least one androgen value above the 95% of contro ls. In patients aged 12-18 years, 7/8 (88%) had at least one increased andr ogen value, compared with 12/22 (55%) patients aged 19-43 years. One patien t (5.3%) was found to have 21-OH-deficient NCAH. Conclusion(s): Hyperandrogenemia was evident in a majority of nonhirsute ac neic patients studied. regardless of age. These data suggest that androgen suppression may be useful in treating acne in many of these patients. (Fert il Steril(R) 2001;75:889-92. (C)2001 by American Society for Reproductive M edicine.).