Serum 3α-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 α -androstanediol-glucuronide (3 α -diolG), the metabolite of 5 α -reductase activity. Result(s) Serum 3 α -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 α -reduced metabolites. In female acne patients, 5 α -reductase activity appears to be reduced, which is reflected in decreased serum levels of 3 α -diolG. Consequently, 5 α -reductase inhibitors are most likely not promising candidates for acne therapy; a postulation that, however, requires further clinical investigation.