Impact of isotretinoin treatment on testosterone and sex hormone-binding globulin in malepatients with acne vulgaris

Background: Acne vulgaris is primarily a disease of the pilosebaceous unit. Four main pathogenic factors are known to lead to its development: follicular epidermal hyperproliferation, excess sebum production, inflammation, and the activity of propionibacterium acnes. Isotretinoin (ISO) is a 13-cis-retinoic acid derivative of vitamin A. It is a highly effective therapy for severe nodulocystic acne. Objective: The aim was to measure serum total, free testosterone, and sex hormone-binding globulin (SHBG) levels, before and after treatment, in male patients suffering from acne vulgaris and taking ISO as a treatment for their acne. Patients and Methods: The authors included 113 male patients with acne vulgaris. The patients received 0.5░mg/kg/day ISO treatment. Blood samples were collected from the patients for analysis of total, free testosterone, and SHBG levels before and after 6 months of treatment. Results: After 6 months of treatment with ISO, the total lesion count was significantly lower after treatment (88.70±35.04 and 27.80±17.94, respectively, P<0.05).There was significant reduction in mean total testosterone serum levels after treatment (5.553±2.614 and3.329±2.276, respectively, P<0.05).The mean free testosterone serum level was insignificantly lower after treatment (31.237±11.994 and 24.526±14.917, respectively, P>0.05), and the mean SHBG serum level was insignificantly higher after treatment (104.367±14.689 and105.533±16.362, respectively, P>0.05). Conclusion: This study showed that ISO treatment led to significant reduction in serum total testosterone levels, which may be beneficial for tackling the pathogenesis of acne.