Effect of benzoyl peroxide on skin surface lipids.

Investigations have been performed on the effect of benzoyl peroxide on skin surface lipids by direct lipid extraction with petrol ether and quantitative determination. Though there was no change after 1 week treatment, after 4 weeks a significant reduction of the casual level as well as well as the replacement sum could be observed.     

Effect of cyproterone acetate on rate of hair growth in hirsute females

We determined by trichometry the rate of hair growth in ten hirsute patients receiving a combination of cyproterone acetate (CA) 50 mg/daily and 'Diane' (CA 2 mg + ethinyl oestradiol 0.05 mg). In two patients there was a prompt and persistent reduction in hair growth; in three the response was less marked, and in the remaining five patients the rate of hair growth fluctuated during therapy. However, there was an overall reduction in hair growth in all but one patient during the 12 months of treatment and all patients noticed that their hair became softer, thinner and lighter in colour.     

Effect of low dose cyproterone acetate on the response of acne to isotretinoin

Twenty-seven males with severe acne were treated for 12 weeks with 0.05 mg/kg/day isotretinoin (ten patients) or 5 mg daily cyproterone acetate (eight patients) or both drugs together in these doses (nine patients). With isotretinoin, the sebum excretion rate (SER) fell by 45% +/- 9% s.e.m. (P less than 0.0025), lesion count fell by 65% +/- 10% (P less than 0.0005) and median clinical 17% +/- 12% (NS) fall in SER, a 15% +/- 10% (NS) fall in lesion count and the median severity was unchanged. Patients unchanged. Patients treated with both drugs showed a 42% +/- 13% reduction in SER (P less than 0.005), a 68% +/- 11% decrease in lesion count (P less than 0.0005) and a decrease in median severity from 8 to 4 (P less than 0.01) which was no different from the response to isotretinoin alone. Isotretinoin increased serum cholesterol from 4.4 mmol/l +/- 0.3 s.e.m. to 4.7 mmol/l +/- 0.3 s.e.m. (P less than 0.01), serum triglyceride from 0.73 mmol/l +/- 0.07 s.e.m. to 0.96 mmol/l +/- 0.14 s.e.m. (P less than 0.05) and gamma-glutamyltransferase (GGT) from 15.9 i.u./l +/- 2.1 s.e.m. to 19.0 i.u./l +/- 2.4 s.e.m. (P less than 0.01). Comparison of the area under the concentration-time curve for triglyceride and high density lipoprotein (HDL)-cholesterol showed that the changes were smaller when isotretinoin was combined with cyproterone acetate. We conclude that the effect of isotretinoin in acne was not enhanced by the antiandrogen, but the increase in serum triglyceride and decrease in HDL-cholesterol produced by the retinoid were reduced by combination with the antiandrogen.     

Treatment of acne with cyproterone acetate and ethinyl estradiol.

Tablets containing 2 mg cyproterone acetate and 0.05 mg ethinyl estradiol in a calendar package of 21 days were used as an oral contraceptive to treat acne. The series comprised 20 patients. The women were 18--43 years of age, and all had acne which had previously been resistant to therapy. The treatment was continued for 6 months. Serum testosterone, 17-OHCS, 17-KS, serum ALAT and gamma-GT were recorded prior to the treatment at 3 and 6 months. Ten patients responded well to the treatment, 5 responded moderately well, 3 experienced no change, and 2 became worse. The serum testosterone level fell during the therapy and the ALAT level rose, though only one pathological ALAT value was recorded.     

Studies on skin surface barrier functions:--skin surface lipids and transepidermal water loss in atopic skin during childhood.

The relationship between skin surface lipids and transepidermal water loss (TWL) was investigated in 22 children with atopic skin. TWL values and casual and replacement lipids were measured by electro-hygrometric and gravimetric methods respectively. Free and total cholesterol and squalene were measured by gas chromatography. The inverse correlations between casual lipids, especially total cholesterol, and TWL exhibited in the normal adult and juvenile skin were not found in the atopic skin. In addition, a significant increase in TWL and decrease in sebaceous lipids was characteristic of atopic skin. In conclusion, the inhibitory action of epidermal cholesterol on TWL is considered to exist only when the skin has a normal keratinization process.     

Effect of topically applied lipids on surfactant-irritated skin

Summary Moisturizers are used daily by many people to alleviate symptoms of dry skin. All of them contain lipids. It has been suggested that topically applied lipids may interfere with the structure and function of the permeability barrier. The influence of a single application of nine different lipids on normal skin and skin irritated by sodium lauryl sulphate (SLS) was studied in 21 healthy subjects. Parameters assessed were visible signs of irritation, and objectively measured cutaneous blood flow and transepidermal water loss (TEWL). The substances tested were hydrocortisone, petrolatum, fish oil, borage oil, sunflower seed oil, canola oil, shea butter, and fractions of unsaponifiable lipids from canola oil and shea butter. Water was included as a control.
On normal skin, no significant differences in the effects of the test substances were found, whereas significant differences were observed when they were applied to SLS-irritated skin. The visible signs of SLS-induced irritation were significantly less pronounced after treatment with the sterol-enriched fraction from canola oil than after treatment with water. This fraction, and hydrocortisone, reduced cutaneous blood flow. Furthermore, application of hydrocortisone, canola oil, and its sterol-enriched fraction, resulted in significantly lower TEWL than with water. The other lipids had no effect on the degree of irritation.
In conclusion, lipids commonly used in moisturizers may reduce skin reactions to irritants. Previous studies have shown that, in barrier perturbed skin, the synthesis of sterols is increased. The observed effects of canola oil and its fraction of unsaponifiable lipids on SLS-induced irritation suggest the possibility that they assisted the skin in supplying the damaged barrier with adequate lipids.     

Anti-androgen treatment of hirsutism with cyproterone acetate

22 female patients suffering from idiopathic hirsutism were treated according to Hammerstein's reversed sequential scheme over 12 months. During each treatment cycle of 21 days, the daily medication consisted of 1 coated tablet containing 0.035 mg ethinyl estradiol and 2 mg cyproterone acetate (Diane-35); in addition, the patients received one i.m. injection of 300 mg cyproterone acetate (Androcur-Depot) on the first day of each cycle. This therapy resulted in improvement of the disease in 19 of our patients (86.4%). The transitory, mild side effects observed did not require interruption of the treatment. The reversed sequential scheme making use of the depot form of CPA can successfully be administered in patients with hirsutism.     

Treatment of acne vulgaris with cyproterone acetate and ethinyl estradiol.

The results obtained with low-dosage treatment with 2 mg cyproterone acetate and 0.05 mg ethinyl estradiol in 10 women with moderate to severe acne are reported. Eight of these patients showed a very good response, one a moderate response, and one showed no improvement after 3 months. In four patients the administration of antibiotics could be discontinued, and in most of the other patients the dose could be reduced. Three patients discontinued this treatment, two because of side effects and one because of lack of improvement.     

Effect of cyproterone acetate-ethinyl estradiol treatment on the proportions of linoleic and sebaleic acids in various skin surface lipid classes

Summary The effect of high-dose cyproterone acetateethinyl estradiol treatment on rates of sebum secretion and on the proportions of linoleic acid (1829,12) and sebaleic acid (1825,8) in the skin surface lipids of three female acne patients was examined. Changes in rates of sebum secretion were evaluated indirectly by measuring the ratio of wax esters/(cholesterol +cholesterol esters) in the subjects' skin surface lipid. In two of the subjects, this ratio indicated a reduction of sebum secretion rates to the childhood range. Concomitantly, there was an increase in linoleic acid and a decrease in sebaleic acid in all lipid classes. In the third subject, in whom there was only a small reduction in sebum secretion rate, the proportion of linoleic acid in the cholesterol esters more than doubled, but the changes in the other lipid classes were small or nonexistent. The results indicate that the proportions of linoleic acid and sebaleic acid in sebum are influenced by sebum secretion rates.