Hormonal correlates of acne and hirsutism

Clinical traits associated with androgens, acne and hirsutism, are important diagnostic features of polycystic ovary syndrome (PCOS). Current data suggests that the majority of patients with hirsutism, between 75-85%, and between 20-40% of patients with persistent acne only, have PCOs. Androgens are one of the determining elements in the development of acne due to the influence of two major factors in acne pathogenesis: enhanced follicular keratosis and increased sebum production. Even though excess androgen levels play a significant role in the manifestation of acne, in PCOS patients, the degree of severity cannot be linearly associated with serum androgen levels. Their levels, should not, therefore be used in determining the dosage of anti-androgen therapy. In the PCOS patient, the significant negative correlation observed between serum SHBG levels and the degree of hirsutism, gives rise to the fact that hormonal contraception, which increases SHBG levels, should be the therapy of choice in treating the PCOS patient