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Question of the Month

Q: I'm in Los Angeles, and I know you're very busy, but I would really
appreciate it if you could answer one question for me. I have heard so much
about your book, which I'm going to purchase, and I highly value your
opinion.

Do you recommend Diane 35 to women who have suffered from acne for years?
It's not FDA approved so I ordered it on-line, but I was hesitant to take it
since I don't know the risks. I'm a healthy 26 year old and I've had acne
since I was 12. A gyno gave me Aldactone to take. He said the hair and
acne on my chin is due to hormones. Aldactone didn't clear up my acne and I
took accutane too, but my acne came back.

Is Diane 35 any more dangerous than other BCP's such as Ortho-tricyclin?
I've talked to women who have taken both and the side effects with Ortho-Tri
seems to be more sever than Diane 35 so I don't understand why Diane 35 is
not FDA approved.

A: Diane 35 contains the progesting cyproterone acetate (CPA) which has a testosterone-blocking effect. It is available in Canada and almost all other countries except the US. For a medication to be approved by the US FDA, its manufacturer must apply. This has not been done for Diane 35. Often this is an economic decision as the approval process costs many millions of dollars for the company.

There are several OCs available in the US which are nonandrogenic or antiandrogenic. These include OrthoTriCyclen, Estrostep (both FDA approved for acne), OrthoCyclen Desogen, Mircette and Yasmin. I was involved in the research for TriCyclen and Estrostep. At this time there is no evidence that Diane works better than these so for Americans it is generally better to use what is available here. Several factors are involved in deciding which pill is best for an individual woman so the choice should be discussed with your physician.

Spironolactone (Aldactone) can help acne, increased hair growth and androgenic alopecia. This use is discussed in those articles on this website.

Hope this is helpful.

Sincerely,

Geoffrey Redmond, MD


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