Topical antiandrogens. What use in dermatology?

The interaction between androgenic hormones and the skin has been a fascinating area of research that has tantalized dermatologists for several decades. Hirsutism, balding, and acne are all androgen-related disorders. Elevated levels of circulating androgens have recently been discovered in at least 80% of women suffering from hirsutism1and, to a lesser extent, in women with female-pattern hair loss and acne.2However, some obvious questions persist: Why does androgen cause hair to grow in some areas, such as the face, but cause it to regress to vellus hairs in other areas, such as the scalp? Why, with similar degrees of hyperandrogenemia, does severe acne develop in one woman and hirsutism in another? Answers to these questions seem to lie within the skin itself. An understanding of the response of the skin and its appendages to circulating hormones requires innovative research. We would all like to see a topical