The Use of Hormonal Antiandrogen Therapy in Female Patients with Acne: A 10-Year Retrospective Study
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Little is known about how dermatologists prescribe hormonal antiandrogen acne treatment (HAAT).
The aim of this study was to investigate dermatologists’ HAAT-prescribing habits and HAAT’s impact on systemic antibiotic use in women with acne.
We performed a retrospective study at an academic medical center of female patients receiving HAAT (combined oral contraceptive [COC], spironolactone) for acne from January 2005 to October 2015. Data from a control group of female acne patients who never received HAAT were also collected.
A total of 672 female patients received HAAT. Out of all systemic medications for acne, antibiotics were used as first-line treatment in 39% of patients, COCs in 12%, and spironolactone in 21%. Mean antibiotic durations in patients who initiated HAAT for the first time at the study site (250.4 days) were significantly longer than in patients who received HAAT prior to presentation and continued HAAT at the study site (192.0 days) (p = 0.021). A statistically significant inverse association was found between HAAT use and mean antibiotic duration (p = 0.016).
HAAT is not typically used as a first-line systemic therapy in women with acne. HAAT usage is associated with shorter cumulative antibiotic durations and early HAAT initiation can decrease systemic antibiotic use in acne treatment.
We would like to acknowledge Dr Xiaochun Li and Dr Matthew Park for providing statistical and technical assistance in this research project.
Compliance with Ethical Standards
No funding was provided for conduct of the study and/or preparation of the paper. No funding organization or sponsor was involved in any aspect of the following: design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.
Conflict of interest
In the past 12 months, Dr Seth Orlow has served as a consultant for Dermira, on the advising board for Unilever, and as a board member for Almirall. Dr Nagler, Dr Park, and Ms Bienenfeld have no conflicts of interest to declare.
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