Pituitary function (TRH-
LHRH stimulation test) was investigated in male
acne patients and serum levels of
dehydroepiandrosterone sulphate (
DHEA-S),
sex hormone binding globulin (SHBG) and other biochemical parameters were investigated in male
acne patients and in female
acne patients before and
after treatment with an
oral contraceptive. The TRH-
LHRH stimulation test was performed with 15 male patients suffering from severe cystic
acne and 7 healthy volunteers. Basal and stimulated
prolactin, LH and FSH levels were statistically similar in the patients and control groups. However, the stimulated LH levels of the patients were 60% higher than those in controls. SHBG levels were significantly) higher in the patient group compared to those in the control group. Thirty-three female
acne patients were randomly divided into two groups and treated for six months with an
oral contraceptive containing 0.030 mg ethinylestradiol (EE) plus 0.150 mg
levonorgestrel or 0.150 mg
levonorgestrel. After six months' treatment a 30% decrease in
DHEA-S levels were observed in the
desogestrel/EE group and a 15% decrease in the
levonorgestrel/EE group; the difference was not statistically significant. At the same time serum total
cortisol increased by 75-100% and free
testosterone fell by 30-40% in both groups, whereas SHBG elevated 250% in the
desogestrel/EE group and 30% in the
levonorgestrel/EE group.
Acne improved significantly in both groups,
desogestrel/EE showing greater improvement. A decrease in SHBG and increase in
DHEA-S levels appear to be the most common hormonal changes in
acne.
Oral contraceptive treatment induces an increase in SHBG and decrease in
DHEA-S and also improves
acne.