A teenager girl with moderate acne is also complaining of irregular menses. Drug of choice will be:
D i.e. Cyproterone acetateCyproterone acetate is a progestin and a weak anti androgen by viue of binding to the androgen receptor (i.e. progestational antiandrogen that blocks androgen receptor). Because of antiandrogen action, it is efective in conditions like acne seborrhoea, hirsutism, female pattern hair loss (androgenetic hair loss in females), hidreadinitis suppurativaQ -i.e. conditions caused or aggravated by androgenic hormones.- Cyproterone acetate (CPA) is effective in treatment of acne as it reduces sebum production (dose dependent) & comedogenesis. In premenopausal women it is usually combined with ethinyloestradiol (Dianette & estelle 35) or other oral contraceptive agents to regulate menstrual cycle irregularitiesQ (caused by high dose cyproterone) and prevent pregnancy (d/t concerns of feminising effects of cyproterone on male fetus). Whereas, in postmenopausal women, it is not necessary to combine ethinyl oestradiol (EOD) with CPA.Reverse sequential regimen (CPA 100 mg / day on days 5 to 15, and EOD 30-50 mg /day on cycle days 5to 26) regulates menstrual bleeding, provides excellent contraception and is effective in treatment of even severe hirsutism and acneQ. Acne usually improves 40-50% by 3rd and 80-90% by 9th cycle.
Oral isotretinon
Oral acitretin
Oral minocycline
Cyproterone acetate