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Effect of Isotretinoin on Serum Levels of Precursor and Peripherally Derived Androgens in Patients With Acne
Donald P. Lookingbill, MD;
Laurence M. Demers, PhD;
Robert E. Tigelaar, MD;
Alan R. Shalita, MD
Arch Dermatol. 1988;124(4):540-543.
Abstract
Sebaceous glands are stimulated by androgens and can convert them to more active forms. Isotretinoin, however, has a profound inhibitory effect on sebaceous gland size and function. This study evaluated the effect of isotretinoin on serum levels of precursor and tissuederived androgens. Twenty-four subjects (15 men and nine women) were treated for 20 weeks with 1 mg/kg/d of isotretinoin. Serum samples were obtained at baseline, 8, 16, and 24 weeks, and assayed for precursor andro- gens—total testosterone (TT), free testosterone (free T), dehydroepiandrosterone (DHEA), dehydroepiandrosterone-sulfate (DHEA-S); and tissue androgens—dihydrotestosterone (DHT), and its metabolite, 3 -androstanediol glucuronide (3 -diol G). Isotretinoin had no meaningful effects on precursor androgens, except for producing an elevation of free T in women. In contrast, isotretinoin produced depressions in the serum levels of DHT and 3 -diol G in women and in 3 -diol G in men. These decreases are believed to be the result, rather than the cause, of a reduction in the size of the sebaceous glands: The magnitude of the observed decreases may represent the amount of tissue-derived androgens that sebaceous glands normally contribute to the circulating pool.
(Arch Derm 1988;124:540-543)
Author Affiliations
From the Division of Dermatology, Department of Medicine (Dr Lookingbill) and the Department of Pathology (Dr Demers), College of Medicine, Pennsylvania State University, Hershey; the Department of Dermatology, University of Texas Health Science Center, Dallas (Dr Tigelaar); and the Department of Dermatology, Downstate Medical Center, Brooklyn, NY(Dr Shalita).
Footnotes
Accepted for publication Nov 25, 1987.
Reprints not available.
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