† Sebaceous glands are stimulated by androgens and can convert them to more active forms. Isotretinoin, however, has a profound inhibitory effect on sebaceous gland size and function. This study evaluated the effect of isotretinoin on serum levels of precursor and tissuederived androgens. Twenty-four subjects (15 men and nine women) were treated for 20 weeks with 1 mg/kg/d of isotretinoin. Serum samples were obtained at baseline, 8, 16, and 24 weeks, and assayed for precursor andro-gens—total testosterone (TT), free testosterone (free T), dehydroepiandrosterone (DHEA), dehydroepiandrosterone-sulfate (DHEA-S); and tissue androgens—dihydrotestosterone (DHT), and its metabolite, 3 α-androstanediol glucuronide (3 α-diol G). Isotretinoin had no meaningful effects on precursor androgens, except for producing an elevation of free T in women. In contrast, isotretinoin produced depressions in the serum levels of DHT and 3 α-diol G in women and in 3 α-diol G in men. These decreases are believed to be the result, rather than the cause, of a reduction in the size of the sebaceous glands: The magnitude of the observed decreases may represent the amount of tissue-derived androgens that sebaceous glands normally contribute to the circulating pool.
(Arch Derm 1988;124:540-543)
Lookingbill DP, Demers LM, Tigelaar RE, Shalita AR. Effect of Isotretinoin on Serum Levels of Precursor and Peripherally Derived Androgens in Patients With Acne. Arch Dermatol. 1988;124(4):540-543. doi:10.1001/archderm.1988.01670040042019