Low dose prednisolone or oestrogen in the treatment of women with late onset or persistent acne vulgaris

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Abstract
Women with persistent or late onset acne vulgaris were divided into 2 treatment groups. The first received continuous low dose prednisolone to suppress ACTH-dependent androgen secretion and the 2nd was treated with cyclical estrogens with medroxyprogesterone to elevate sex hormone binding globulin (SHBG). In both groups there was a significant improvement in the severity of the acne after 4 mo. treatment. Although pre-existing hormonal abnormalities were corrected, the improvement in the acne did not correlate with the baseline hormone levels. Suitable estrogen-progesterone combinations or low dose prednisolone may be given, alone or in combination, to suppress free circulating androgens in these patients with a high probability of improving their acne.