Local inhibition of sebaceous gland growth by topically applied RU 58841

Hormonal therapies in acne

Hormones, in particular androgen hormones, are the main cause of acne in men, women, children and adults, in both normal states and endocrine disorders. Therefore, the use of hormonal therapies in acne is rational in concept and gratifying in practice. Although non-hormonal therapies enjoy wide usage and continue to be developed, there is a solid place for hormonal approaches in women with acne, especially adult women with persistent acne. This review covers the physiological basis for hormonal influence in acne, the treatments that are in use today and those that show promise for the future. The main treatments to be discussed are oral contraceptives androgen receptor blockers like spironolactone and flutamide, inhibitors of the enzyme 5 alpha-reductase and topical hormonal treatments.

Activity of 17beta-(N-alkyl/arylformamido) and 17beta-[(N-alkyl/aryl) alkyl/arylamido]-4-methyl-4-aza-5alpha-androstan-3-ones as 5alpha-reductase inhibitors in the hamster flank organ and ear

Skin disorders such as acne, seborrhea, hirsutism, and androgenic alopecia are secondary to excess local androgenic activity. Because the most potent androgen, dihydrotestosterone, is formed from testosterone by the action of 5alpha-reductase, the inhibition of 5alpha-reductase is a logical approach to interfere with androgenic action in the skin. In this study, we have investigated the inhibitory effect of a series of 17beta-(N-alkyl/arylformamido)-and 17beta-[(N-alkyl/aryl)alkyl/arylamido]-4-methyl-4-aza-5alpha -androstan-3-one derivatives as 5alpha-reductase inhibitors following their topical application on the flank organs and ears of Golden Syrian hamsters. The parameters measured were mainly the size of the underlying sebaceous glands and 5alpha-reductase activity in the flank organs and ears. We found that 17beta-(N-amylformamido)-4-methyl-4-aza-5alpha-androstan+ ++-3-one (EM-401), 17beta-(N-hexylformamido)-4-methyl-4-aza-5alpha-androstan -3-one (EM-402), and 17beta-(N-heptylformamido)-4-methyl-4-aza-5alpha-andro -stan-3-one (EM-540) are potent inhibitors of 5alpha-reductase activity. EM-402 decreases the size of treated flank organs by 22%, 31%, and 32% (p < 0.01 for all) after topical application at the doses of 30, 100, and 300 microg, respectively, twice daily for 4 wk. EM-402 also reduced the size of underlying sebaceous glands by 38%, 42%, and 59% of intact control values at the same doses. Comparable results were observed on the size of the sebaceous glands of the ears. In addition, we have observed a concentration-dependent 47%-80% (p < 0.01) and 46%-80% (p < 0.01) inhibition of 5alpha-reductase activity in the right flank organs and ears, respectively, using topical EM-402. EM-402 had no significant effect on the same parameters in the left contralateral flank organs or ears. In addition, EM-402 had no effect on prostatic and seminal vesicle weights whereas EM-401 and EM-540 showed some systemic effects. These data illustrate that EM-402 applied topically, at the concentrations used, exerts a potent local anti-androgenic effect without any systemic action in the hamster.