Hyperandrogenism: Acne and hirsutism

Abstract

Hyperandrogenism is a common pathology in women, with the main physical manifestations including hirsutism and acne. Etiologies include polycystic ovarian syndrome (PCOS), idiopathic hirsutism, classical and nonclassical congenital adrenal hyperplasia (CAH), ovarian and adrenal tumors, Cushing's disease, and certain medications. The severity of the hirsutism will vary among patients, but treatment should be administered to those who desire it, even if their hirsutism is not severe. Treatment methods include weight reduction, hair removal, oral contraceptive pills, and antiandrogen medications including spironolactone, finasteride, cyproterone acetate, flutamide, and eflorni- thine. Treatments for acne include topical retinoids, topical antimicrobials (benzoyl peroxide), topical antibiotics (erythromycin, clindamycin, sulfacetamide, dapsone), or oral isotretinoin.