In Reply Marks and Mansh highlight a subpopulation that may benefit from topical androgen receptor inhibitor clascoterone cream, 1%, a drug recently approved by US Food and Drug Administration as a topical treatment for acne vulgaris in patients 12 years and older.1,2 Testosterone and dihydrotestosterone are key drivers of acne in males and females. Acne onset typically coincides with adrenarche during the pubertal phase, although flares associated with hormonal fluctuations are also observed in adults. Pubertal hormonal surges, as well as masculinizing hormonal therapy (MHT) to promote secondary sex characteristics and/or suppression of feminine secondary sex characteristics for the treatment of gender dysphoria among transgender men, may result in increased acne incidence and/or severity.3
Thiboutot D, Cartwright M, Mazzetti A. Potential Role for Topical Antiandrogens in the Management of Acne Among Patients Receiving Masculinizing Hormone Therapy—Reply. JAMA Dermatol. 2020;156(12):1381. doi:10.1001/jamadermatol.2020.3341
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