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Female Adult Acne and Androgen Excess: A Report From the Multidisciplinary Androgen Excess and PCOS Committee
Enrico Carmina1, Brigitte Dreno2, W Anne Lucky3
1Endocrinology Unit, University of Palermo Medical School, Palermo, 90139, Italy.
Journal of the Endocrine Society
|February 14, 2022
Summary
Adult female acne management requires considering both dermatological and endocrine perspectives. Guidelines recommend androgen level assessment and specific hormonal therapies for hyperandrogenic acne.
Area of Science:
- Endocrinology
- Dermatology
- Reproductive Endocrinology
Background:
- Adult female acne is viewed differently in endocrine vs. dermatological literature.
- Polycystic Ovary Syndrome (PCOS) guidelines often link acne to androgen excess.
- Dermatological societies have developed new guidelines for adult female acne.
Observation:
- An expert task force convened to assess current knowledge on adult female acne.
- Recommendations were developed for specialists treating female adult acne.
- Evidence-based guidelines were established.
Findings:
- Clinical diagnosis is primary for adult female acne, but grading tools are needed.
- Serum androgen measurements are recommended for all adult acne patients.
- Oral estroprogestins are advised for acne with proven hyperandrogenism, alongside other treatments.
Implications:
- Second- and third-generation estroprogestins are suitable, regardless of dose or progestin type.
- Spironolactone can be added to estroprogestins for moderate-to-severe hyperandrogenic acne unresponsive to standard care.
- Estroprogestins serve as a second-line therapy for nonhyperandrogenic adult acne.
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