A systemic type I 5 alpha-reductase inhibitor is ineffective in the treatment of acne vulgaris.
Excessive sebum production is a central aspect of the pathophysiology of acne vulgaris. Sebaceous gland function is under androgen control and it is hypothesized that dihydrotestosterone is formed by the action of 5 alpha-reductase. Type I is the controlling isoenzyme. This study describes a 3-month, multicenter, randomized, placebo-controlled clinical trial with a potent, selective inhibitor of type I 5 alpha-reductase used alone and in combination with systemic minocycline. Inhibition of type I 5 alpha-reductase was not associated with clinical improvement of acne when used alone and did not enhance the clinical benefit of systemic minocycline. These results indicate the need for further work at the molecular level to better understand the action of androgens on sebaceous gland function.
University of Pennsylvania Hospital, 36th and Spruce Streets, Philadelphia, PA 19104, USA.
James
J
Leyden
Wilma
W
Bergfeld
Lynn
L
Drake
Frank
F
Dunlap
Mitchel P
MP
Goldman
Alice B
AB
Gottlieb
Michael P
MP
Heffernan
Janet G
JG
Hickman
Maria
M
Hordinsky
Michael
M
Jarrett
Sewon
S
Kang
Ann
A
Lucky
Gary
G
Peck
Tania
T
Phillips
Marvin
M
Rapaport
Janet
J
Roberts
Ronald
R
Savin
Marty E
ME
Sawaya
Alan
A
Shalita
Joel
J
Shavin
James C
JC
Shaw
Linda
L
Stein
Daniel
D
Stewart
John
J
Strauss
James
J
Swinehart
Leonard
L
Swinyer
Diane
D
Thiboutot
Ken
K
Washenik
Gerald
G
Weinstein
David
D
Whiting
Frances
F
Pappas
Matilde
M
Sanchez
Lisa
L
Terranella
Joanne
J
Waldstreicher
D000152:Acne Vulgaris / Q000188:drug therapy*; D042944:Cholestenone 5 alpha-Reductase / Q000037:antagonists & inhibitors*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D006801:Humans; D008911:Minocycline / Q000008:administration & dosage; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
D042944:Cholestenone 5 alpha-Reductase; D008911:Minocycline