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.
Leyden
James
J
University of Pennsylvania Hospital, 36th and Spruce Streets, Philadelphia, PA 19104, USA.
Bergfeld
Wilma
W
Drake
Lynn
L
Dunlap
Frank
F
Goldman
Mitchel P
MP
Gottlieb
Alice B
AB
Heffernan
Michael P
MP
Hickman
Janet G
JG
Hordinsky
Maria
M
Jarrett
Michael
M
Kang
Sewon
S
Lucky
Ann
A
Peck
Gary
G
Phillips
Tania
T
Rapaport
Marvin
M
Roberts
Janet
J
Savin
Ronald
R
Sawaya
Marty E
ME
Shalita
Alan
A
Shavin
Joel
J
Shaw
James C
JC
Stein
Linda
L
Stewart
Daniel
D
Strauss
John
J
Swinehart
James
J
Swinyer
Leonard
L
Thiboutot
Diane
D
Washenik
Ken
K
Weinstein
Gerald
G
Whiting
David
D
Pappas
Frances
F
Sanchez
Matilde
M
Terranella
Lisa
L
Waldstreicher
Joanne
J
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