DHT and Acne

[Guest]

This is a little off topic but I am interested to hear why people don't think that finasteride and dutasteride can clear up acne. I had a mild case of acne before I started finasteride that I've had for awhile, and it has almost completely cleared up.

Now scientists say that DHT is one of the contributing factors to acne, so why wouldn't reducing the level of circulating DHT also reduce the amount of acne?

This is why I don't understand when I hear reports about finasteride causing breakouts.

 

[CCS]

it should reduce acne some by reducing sebum production, if sebum production is a contributer to acne. finasteride has little effect on 5ar1, which is in sebum glands. dutasteride might have more effect, but it would only reduce the 5ar1 by 50% if taken 7x per week. you could put spironolactone cream on your face, i suppose. maybe less serum DHT will leak into the sebum glands if you take dutasteride or finasteride, or less in the blood will cause DHT to leak out of these cells faster, however you want to look at the diffusion.

 

[Felk]

Im actually very curious about using spironolactone. cream on one's face with the aim of fighting acne. If i find a nice vehicle like a facial cream, ill give it a go.

 

[CCS]

I want to get the spironolactone out of the filler. Bryan says the filler may be good, but I don't want it. I need something that will dissolve it with a small liquid volume but not dissolve the filler. So ethanol may require too much liquid, and glycerol dissolves it all. That leaves PPG and fatty acids as my next candidates.

 

[ANDREW_J_I]

my forehead has never been so smooth and clean. finasteride has def improved my skin.

 

[CCS]

my forehead is shiny and pink. I'll put spironolactone there when I make some. Until then I just have the fatty acids. and i have a suspicion that big pores are caused by androgens.

 

[Felk]

I'm sure androgens are at least partly the cause of big pores. People with severe acne always have enlarged pores/scars. So you think that an anti-wrinkle cream would be too saturated to use as a vehicle for spironolactone. then college?

Hmm was thinking of improving my skin from a few different angles, but schmeh, something else will be cheaper anyway

 

[Bryan]

A few random facts and comments, in no particular order:

1) Imperato-McGinley (the researcher who did the early work on the "pseudos" in the Dominican Republic) did some early testing of the effect of finasteride on sebum production. She found no effect.

2) A study from about a year ago found no effect of MK386 (that specific type-1 inhibitor that we've been talking about) on acne. Nobody knows why it didn't work.

3) As far as I know, nobody has yet tested dutasteride for its ability to reduce sebum production, in either man or beast.

4) Some of the same researchers who did that hamster flank-organ test of fatty acids also did a small HUMAN test, as part of a patent application. They found that a twice-a-day application of a small amount of GLA (I'm pretty sure it was 40 mg) to the forehead of a volunteer caused a very significant reduction in sebum production.

5) There's at least one study (I have a copy of it) where topical spironolactone was used successfully to treat acne. It wasn't exactly a panacea, but they did claim to get noticeable benefits. I also have one other study, however, which was unable to find any reduction in sebum from the topical application of a spironolactone cream.

Bryan

 

[CCS]

40mg per day to what size area? just trying to decide what dose and concentration to make my fatty acid topical.

 

[Felk]

5) There's at least one study (I have a copy of it) where topical spironolactone was used successfully to treat acne. It wasn't exactly a panacea, but they did claim to get noticeable benefits. I also have one other study, however, which was unable to find any reduction in sebum from the topical application of a spironolactone cream.

Bryan

I've found some more successful studies with topical spironolactone and acne. Have you seen these before Bryan?

Experience in the therapy of acne with topical administration of spironolactone as an antiandrogen

Istituto di Dermatologia, Universita degli Studi di Messina.

The authors report their clinical experience with topical treatment of seborrheic acne with a 5% spironolactone cream in 20 patients, 11 males and 9 females aged 12 to 28 years (average 20.5). Treatment duration, about one month. Treatment proved remarkably effective in that it brought about complete regression of acne in 30%, improvement in 65% of the patients. The drug was always well tolerated, side effects were never observed.

PMID: 2150020 [PubMed - indexed for MEDLINE]

Topical spironolactone inhibits dihydrotestosterone receptors in human sebaceous glands: an autoradiographic study in subjects with acne vulgaris.

Department of Dermatology, University of Pavia, Italy.

The interaction between spironolactone and dihydrotestosterone (DHT) receptors was evaluated with an autoradiographic technique. The inhibition of DHT receptors by spironolactone was found to be related to the decrease of tritiated DHT granules in the sebaceous glands of the treated site. 6 male patients affected by acne vulgaris entered the study. The acute study was performed by applying to 25 cm2 of the back a cream containing 5% spironolactone under occlusive dressing. The dosage of spironolactone applied was 4 mg/cm2 for 48 h. The long-term study was performed by applying the same amount to the entire back, without occlusion, twice daily for 1 month. Skin biopsies were taken at the end of the treatment, incubated with tritiated DHT and processed for autoradiography. Both the acute and the long-term study revealed a decrease of the autoradiographic granules in the treated site. This effect is related to the binding of spironolactone with dihydrotestosterone receptors in the sebaceous glands. Our study demonstrates that 5% topical spironolactone cream acts as an antiandrogen in human sebaceous glands, competing with DHT receptors and producing a decrease of labelled DHT. At the concentrations used the effect has been only local. No side-effects were recorded during both studies.

PMID: 2972662 [PubMed - indexed for MEDLINE]

Topical spironolactone reduces sebum secretion rates in young adults.

Department of Dermatology, Niigata University School of Medicine, Japan.

The effects of topically applied spironolactone on the sebum secretion rates (SSR) of young adults were investigated. SSR was expressed as the ratio of wax esters/[cholesterol+cholesterol esters] (WE/[C+CE]) and the amount of sebaceous lipids (squalene, triacylglycerol and wax esters). Topical spironolactone 5% gel applied to the right cheeks of the subjects produced a significant reduction in the SSR at 12 weeks (4 weeks after termination of application), but not at 8 weeks (the end of treatment). Untreated "control" areas (the left cheeks of the subjects) showed no significant change during the study. None of the subjects experienced skin rash or signs of local irritation. This results suggests that topical spironolactone may be effective in the treatment of acne patients with high SSR.

PMID: 8935338 [PubMed - indexed for MEDLINE]

I think I'll definately give topical spironolactone a try on my face, in an effort to make my skin less oily and perhaps prevent some blackheads, etc.

 

[Felk]

Hmmm i think this should be in the experimental section, not the side effects section....