Question:

Hi folks, I’ve had bad acne for many years, which became worse during my 20s (I’m now 37). After trying out the various antibiotics without success I was prescribed Dianette, and this worked very well for me. However, I stopped taking it about 6 months ago (having taken it more or less constantly for a period of about 10 years) because I had developed very severe abdominal pains. Without going into boring detail, it seems very likely that the Dianette was responsible, so starting it again is not an option. However, my acne has now returned, and it’s getting worse. I’ve been using Differin gel for about 2 months, with very limited success. I’m due to see the dermatologist again next Tuesday, and the indications last time were that he was likely to prescribe Roaccutane if the Differin didn’t seem to be working. I’ve read many frightening things about Roaccutane, and I’m not sure that I really want to embark upon taking it (particularly with my history of abdominal pain). The question is this, for any experts out there. The fact that the Dianette worked seems to me to indicate that whatever it contains is successful in treating my acne. I asked my GP whether it was possible to take it in some other form, but she said not. Does anyone have any idea what alternative preparation/s might be helpful to me? I’d like to be properly informed when I see the dermatologist. Very many thanks for any help you can offer me. Frances

Response:

Dianette worked seems to me to indicate that whatever it contains is successful in treating my acne. I asked my GP whether it was possible to take it in some other form, but she said not.

  Dianette or Diane-35 is effective in treating acne (in women) because it contains the antiandrogen cyproterone acetate. The sebaceous glands (oil producing glands) are under the control of androgens (male hormones testosterone, DHT, etc.). People with acne have sebaceous glands which seem to be overly sensitive to androgens and bind with them easily. The result is an enlarged fat sebaceous gland pumping out a lot of sebum (oil) causing acne lesions.   Drugs known as anti-androgens (like cyproterone acetate) are effective at binding with the sebaceous gland before the androgen can. The result is smaller oil producing glands, less sebum, and an improvement in the acne. An alternative combo might be to try the Ortho birth control pill with the anti-androgen Spironolactone. Women seem to do well on this combo. Do a web search, or talk to your doctor, for more info.   -James

Response:

James, Many thanks for this reply. I’ll speak to the dermatologist about it when I see him today. Thanks once again – I really appreciate your help. – Hide quoted text — Show quoted text –  Dianette or Diane-35 is effective in treating acne (in women) because it contains the antiandrogen cyproterone acetate. The sebaceous glands (oil producing glands) are under the control of androgens (male hormones testosterone, DHT, etc.). People with acne have sebaceous glands which seem to be overly sensitive to androgens and bind with them easily. The result is an enlarged fat sebaceous gland pumping out a lot of sebum (oil) causing acne lesions.  Drugs known as anti-androgens (like cyproterone acetate) are effective at binding with the sebaceous gland before the androgen can. The result is smaller oil producing glands, less sebum, and an improvement in the acne. An alternative combo might be to try the Ortho birth control pill with the anti-androgen Spironolactone. Women seem to do well on this combo. Do a web search, or talk to your doctor, for more info.  -James

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