Antiandrogens and hirsutism

The clinical appearance of female idiopathic hirsutism and its pathophysiological aspects and the antiandrogen drugs in relation to the therapy of hirsutism are discussed. Two compounds have been widely employed, namely cyproterone acetate, mainly in the 'reverse sequential regimen', and spironolactone, with or without the association of a contraceptive pill containing cyproterone acetate and ethinylestradiol. The ability to compete with dihydrotestosterone in skin androgen receptors, shared by these two compounds, has led to excellent clinical results for many years. A topical antiandrogen therapy would be a further advantage for these patients.