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Article
July 27, 1957

CYCLIC ESTROGENIC HORMONE THERAPY OF ACNE VULGARIS USE OF THE VAGINAL SMEAR TECHNIQUE IN EVALUATION AND TREATMENT

JAMA. 1957;164(13):1447-1450. doi:10.1001/jama.1957.02980130023005
Abstract

• Acne vulgaris was treated in a series of 21 female patients from 13 to 30 years of age by administering orally a preparation of conjugated estrogenic substances. The average daily dose was 3.9 mg., and the average duration of treatment was 8.9 months. The treatment was cyclical in that it was given only for the 14 days before the expected day of the menses. The results were good in seven patients and satisfactory in nine. A second series of 50 patients was then treated similarly, except that 8 of these received only a placebo and 12 received only the estrogen; 14 received estrogen for a time followed by a period of placebo medication, while 16 received the placebo for a time followed by a period of estrogen medication. None of the patients who received only the placebo showed results described as good; two had satisfactory results. The results were good in 24 and satisfactory in 13 of the 42 patients who received the estrogen. The effectiveness of the estrogen in influencing hormonal pattern was shown by making vaginal smears and determining the percentage of cornified cells in the smear; normal cornification denoted adequate physiological response and served as a guide in arriving at correct individual dosages. Patients who showed an initial estrogen deficiency by this criterion were found to require a significantly higher dosage. The results showed that estrogens administered during the postovulatory phase of the menstrual cycle are of value in the treatment of acne.

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