SAHA ( Seborrhea, Acne, Hirsutism and Androgenetic Alopecia ) syndrome is a dermatologic disorder, with variant response to treatment.
Triad of cutaneous hyperandrogenism included nodulocystic or severe acne, female pattern hair loss and hirsutism.

A study has compared the effectiveness of Isotretinoin and Cyproterone compound in the treatment of nodulocystic acne, in patients with SAHA syndrome or triad of cutaneous hyperandrogenism.

30 female patients with SAHA syndrome were divided randomly into two groups. Group A was treated with Cyproterone compound from day 5 of menstrual cycle onwards for 3 weeks and a week without it and group B received Isotretinoin, with a dose of 0.75 mg/kg per day from the beginning of menses onwards for 4 months.
The results were evaluated by a blind dermatologist using Acne Severity Index ( ASI ) score at baseline and monthly for 4 months.

Despite a continuous reduction in ASI score in both the groups, according to both physician ( P = 0.63 ) and patient ( P = 0.25 ) assessment, Cyproterone compound was not statistically more effective than conventional treatment of nodulocystic acne at the end of the study.

Side-effects were reported in patients in both groups, generally being mild and tolerable except in two subjects.

In conclusion, the study has indicated that Cyproterone compound is not superior to Isotretinoin in the treatment of nodulocystic acne in patient with SAHA syndrome or triad of cutaneous hyperandrogenism.
Indeed, other studies are needed to evaluate the effect of Cyproterone compound ( regardless of androgen level ) and Isotretinoin in subjects with only nodulocystic acne. ( Xagena )

Faghihi G et al, Adv Biomed Res 2014;3:262. doi: 10.4103/2277-9175.148236. eCollection 2014.

XagenaMedicine2014