Introduction and objectives: About 9% of world population suffer from acne, which occupies the 8th place among all human diseases, and the 3d place among dermatological disorders. Acne is diagnosed in 54% of 18 year aged women. Acne manifests mostly in 1214 year age and regresses after 20 year age, even though more and more women have recently addressed their doctors for acne problem developing after 20 year age. Location of this dermatosis in open areas of skin leads to depression and social disadaptation, which underlines the actuality of this problem. It is well known that a leading role in the development of adult acne is played by hyperandrogenism, which is often caused by polycystic ovarien syndrome (PCOS). Well known also is that combined oral contraceptives are used for the treatment of female acne caused by hyperandrogenism syndrome. However, not all patients benefit from this kind of treatment. Therefore, the aim of our study was to better investigate endocrine system status and establish disorders stimulating the appearance and development of acne in adult women and then prescribe the proper therapy.
Material and methods: Our study involved 126 women with acne, of 1837 year age. It included the performance of Sonography of thyroid gland and pelvic organs as well as the determination of levels of the following hormones: Prolactin, TSH, FSH, LH, 17-Hydroxyprogesterone, DHEAS, Free testosterone, Oestradiol, Progesterone, Anti-Mullerian hormone.
Results: The investigation confirmed high androgenic hormones level in 86.5% of women with acne, although clinical manifestations of hyperandrogenism syndrome were found only in 45% of these women. i) PCOS was found in 20.2% of women with acne. ii) Hyperprolactinemia in 34.9%. iii) Atypical (late) form of congenital adrenal dysfunction in 44.9%. So, it was established that, other than PCOS, Hyperprolactinemia and Atypical (late) form of congenital adrenal dysfunction are also main causes of hyperandrogenism in women, which can lead to acne. Depending on the endocrine pathology of patients, appropriate treatment was prescribed: i) Oral contraceptives for PCOS. ii) Dopamine agonists for Hyperprolactinemia. iii) Synthetic glucocorticoids for Atypical (late) form of congenital adrenal dysfunction. Also, regardless of the type of hormonal disorders, all women received proper topical therapy in accordance with the severity of acne.
Conclusions: As a result, we got to the following conclusions: i) On the background of the proposed differentiated combined therapy within 6 months, positive effects were achieved in 85% of women with significant reduction of the eruption and without its recurrent appearance. ii) The condition of skin and acne eruptions was clearly dependent on hormone levels in the blood. iii) In order to achieve efficient treatment of female acne, combined therapy should be based on the correction of hormonal disorders.
20 - 23 May 2017
European Society of Endocrinology