Clinical Evaluation of 16-Epiestriol-3-Allyl Ether in Acne Vulgaris

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Abstract
This is a collaborative report on the efficacy of 16-epiestriol-3-allyl ether in the treatment of acne. A double-blind study of this weak estrogenic compound, as compared with a placebo, was undertaken by five investigators. Essentially identical protocols were followed in the five studies. An attempt was made to control the variables except for the agents being evaluated. The results were based on the effect of the estrogen on the lesions of acne as well as on the oiliness of the skin. The results in 134 patients with recalcitrant acne are reported. Sixty-six received 16-epiestriol-3-allyl ether and 68 placebo. The compound 16-epiestriol-3-allyl ether in oral doses of 15, 30, and 45 mg daily, for three successive four-week periods failed to show any superiority over placebo either in improvement of acne or in reduction of skin oiliness. Fifty-three per cent of those receiving 16-epiestriol-3-allyl ether and 50% of those receiving placebo showed improvement in acne. Fifty-five per cent of those receiving medication and 49% of those receiving placebo showed an estimated reduction in oiliness of the skin. The significance of this high percentage of placebo response even in recalcitrant acne in the evaluation of the efficacy of agents in this field is discussed. A brief review of the etiologic and therapeutic relationships of hormonal factors in acne is also presented. These results are consistent with the report that this compound failed to suppress sebum production determined gravimetrically in adult males.

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