Our experience with Diane-35 in the treatment of acne
J. Georgievska, S. Popovska
Clinic for Gynecology and Obstetrics, Medical faculty Skopje, R Macedonia
Introduction: Because sex steroids, produced both from the ovaries and
from the adrenals, are involved in the development of acne, suggesting increased
androgen activity/sensitivity as an aetiological factor, antiandrogenic drugs
have been used for the treatment of acne. The most potent antiandrogen is
estrogen, with increasing sex hormon binding globulin (SHBG) levels. Other
antiandrogen is cyproterone acetate (CPA). CPA is a derivative of
hydroxyprogesterone and acts as a progestogen and as an antiandrogen. CPA has
been used in combination with different doses of EE for the treatment of acne
and androgenic disorders.
Objective: The aim of this study was to evaluate the effect of
combined oral contraceptive Diane 35 (0.035mg EE/2 mg CPA) in women with mild
and moderate acnae vulgaris and seborrhoea (n=50) against placebo group (n=30)
for period of six months. Materials and methods: We investigated 50 patients
with mild and moderate acne vulgaris treated on our Clinic for Gynecology and
Obstetrics during the 2003. All of them received Diane 35 for the treatment of
acne after complete investigations. They were controled after 3 and 6 months of
treatment. Patients were assessed for the severity of symptoms of acne by
grading, lesion comit and photography. Also hormon and lipid levels were
measured.
Results: The mean age of users (+SD) was 22,5+5,1 years
of the women aged between 15 and 25years. After six months of treatment with
Diane 35, we have found clinical improvement in the treatment group with
reduction in the number and severity of lesions. We have found decrease in
dehydroepiandrosterone sulphate levels (DHEA-S) in 60%, whereas total
testosterone did not decrease. Seborrhea decreased in 25%. We have found
increase in triglyceride levels with decrease in the levels of LDL-c.
Conclusion: Good improvement of acne vulgaris follows treatment with
Diane 35. Therefore, although acne is not the primary indication for combined
OCPs, it seems reasonable to use this preparations to women suffering from acne,
particularly if they also require a contraceptive method.
