The use of topical antiandrogens in the treatment of acne has had a theoretical appeal since the pilosebaceous unit was found to be an androgen-dependent structure. Unfortunately, this theoretical appeal has not been translated into clinical efficacy. In an attempt to improve on this, a new topical antiandrogen, inocoterone acetate (RU882) has recently been evaluated for the treatment of acne.1 We shall discuss this new development in the overall context of antiandrogen therapy.
Control of the pilosebaceous unit is under a series of complex hormonal mechanisms. Central hypophyseal regulation takes place through intermediate endocrine organs2; the most important of these involve the stimulation of androgen (testosterone) production by the ovaries and testes.3 Pituitary corticotropin also plays an important role in triggering the release of androgens from the adrenal gland. While almost all the testosterone in men is produced in the testes, the situation is more complex in women, in whom the total amount of
Cunliffe WJ, Bottomley WW. Antiandrogens and AcneA Topical Approach?. Arch Dermatol. 1992;128(9):1261-1264. doi:10.1001/archderm.1992.01680190117017