Although hormones influence acne, most acne patients do not have an endocrine disorder. Hyperandrogenism should be considered in female patients whose acne is severe, sudden in its onset, or is associated with hirsutism, or irregular menstrual periods. Additional clinical signs of hyperandrogenism include Cushinoid features, increased libido, clitoromegaly, deepening of the voice, acanthosis nigricans, or androgenetic alopecia. Women with hyperandrogenism may also have insulin resistance. They are at risk for the development of diabetes and cardiovascular disease. It is therefore important for the long-term health of these patients to identify hyperandrogenism so that they can receive appropriate therapy from an endo-crinologist or gynecologist.
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