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OK, to further expound on what I'm saying about accutane, it is a growth inihbitor (hence it's uses as a cancer treatment) and probably why it reduces your sebum production & pore size, but it's also an androgen antagonsit in 3 ways (reduces total testosterone, DHT & 3 alpha diol G). However it's androgen antagonizing abilites are not permanent, they cease once treatment ceases, so if accutane truely works for people (and they just didn't grow out of getting acne), it probably has something to do with it's growth inhibiting (IGF-1) abilities.

[quote]Acta Derm Venereol. 1997 Sep;77(5):394-6. Related Articles, Links

[B]Isotretinoin, tetracycline and circulating hormones in acne.[/B]

Palatsi R, Ruokonen A, Oikarinen A.

Department of Dermatology, University Central Hospital, Oulu, Finland.

Isotretinoin, used to treat severe acne, has been shown to induce hormonal changes, especially to reduce 5 alpha-reductase in the production of the tissue-derived dihydrotestosterone (DHT) metabolite 3 alpha-Adiol G. However, the effects of isotretinoin on other pituitary, adrenal or gonadal hormones have not been thoroughly elucidated. In the present study, isotretinoin administered at a dose of 0.5 mg/kg/day for 4 weeks caused no marked changes in the serum levels of pituitary, adrenal or gonadal hormones or 3 alpha-Adiol G in patients with severe papulopustulotic acne (n = 19). After 12 weeks of therapy, there was a decrease in the levels of the precursor androgens androstenedione, testosterone and 3 alpha-Adiol G in 6/9 patients. Acne improved after 4.5 months in all but 2 male patients, who had very low serum hormone binding globulins (SHBG) and a high free androgen index (FAI). [B]Isotretinoin did not affect the elevated [U]LH/FSH ratio in a patient with the polycystic ovarian syndrome (PCOS)[/U]; nor did it change the [U]high FAI or low SHBG in the male patients[/U].[/B] For comparison, tetracycline had no effects on the serum hormonal levels of patients with mild acne (n = 19) after 7 days of treatment. This study confirms that the effects of isotretinoin on the serum hormone levels are small and unlikely to be of relevance for the resolution of acne or the suppression of sebum excretion.

So above with what I underlined & bolded are examples of hormonal disorders that accutane doesn't have any effect on. Women & Men can both have high & lows in those areas though, and I personally have high FAI (Free Androgen Index/ or Free Testosterone) and as such probalby a low SHBG (Sex Hormone Binding Globulin) which go hand-in-hand (SHBG binds FA). I personally never took accutane (afraid of side effects) but I see that I probably wouldn't have been helped anyway. Yet some people that have hormonal disorders did find that accutane helped reduce/eliminate a type of acne for them, so I suppose even if you do have a hormonal disorder you could try it. At the same time, usually if you just treat your hormnal wouldn't need the accutane ;-)

[QUOTE]Ann Dermatol Venereol. 1999 Jan;126(1):17-9. Related Articles, Links

[B][Acne in the male resistant to isotretinoin and responsibility of androgens: 9 cases, therapeutic implications][/B]

[Article in French]

Chaspoux C, Lehucher-Ceyrac D, Morel P, Lefrancq H, Boudou P, Fiet J, Vexiau P.

Service d'Endocrinologie, Hopital Saint-Louis, Paris.

INTRODUCTION: Treatment failures with isotretinoin in female patients are [U]frequently[/U] related to endocrinological dysfunctions. Such a concept has [B]never[/B] been discussed in male patients. CASE REPORTS: An extensive endocrinological work-up has been performed in nine male patients who presented with an acne refractory to conventional treatment and to isotretinoin. [B]Adrenal dysfunction was found in four patients [/B] and [B]isolated 5-alpha reductase hyperactivity in 2 cases[/B]. Three work-ups were normal. A suppressive treatment in three patients with adrenal dysfunction provided immediate efficacy. COMMENTS: These results would provide insight into the mechanism of refractory acne in men.

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