20 yrs old female presents with moderately severe acne with irregular menstrual period. Treatment of choice is? (LQ)
|D|| Cyproterone acetate|
It is important to understand the following points
1). The most effective drug remains isotretinoin
2). Just irregular menses is not a indication of Hormonal Therapy
3). Even if it has to be given it is given as a OCP not alone
This form of therapy is recommended for cases where the standard antibiotic regimens fails, menstrual control and/or contraception is required with acne therapy (isotretinoin use) and where oral isotretinoin is inappropriate or not available.
Antiandrogens Vs Isotretinoin
1). It has been our experience as of other authors (Larsen TH et al ) that the best drug remains isotretinoin (85 ± 10% improvement), followed by tetracycline(54 ± 3%) and the OCP of CPA plus ethinyl oestradiol (65 ± 4% improvement).
2). Hormonal therapy is an option only in case where acne is not responding to conventional therapy.
3). In all other case isotretinoin is a preferred drug.
4). Even case with normal serum androgen respond well to hormonal therapy