Metformin, either as a stand-alone or adjuvant therapy, seems to improve acne symptoms in patients with polycystic ovary syndrome (PCOS), according to new findings.
Published online ahead of print in the American Journal of Clinical Dermatology (Oct. 13, 2020), the findings come from a systematic review and meta-analysis which entailed a search of PubMed, the Cochrane Library, and Embase databases.
Regarding their rationale for the study, the authors write: “Acne is one of the cutaneous manifestations of [PCOS]. There is limited evidence on metformin use for treatment of acne in PCOS patients.”
The investigators searched for human clinical studies in any language, and used keywords that included ‘acne’ and ‘polycystic ovary syndrome’ combined with ‘metformin,’ ‘biguanide,’ or ‘glucophage’.
Both randomized controlled trials (RCTs) and non-randomized controlled trials (NRCTs) were included, as well as open-label studies. In all, 51 studies were included, representing 2,405 PCOS patients.
The researchers found that metformin used as an adjuvant therapy led to a greater improvement of patients’ acne scores than the same treatment provided without the metformin adjuvant treatment. When they pooled the pre- and post-metformin therapy data, they found a significant decrease of acne scores after metformin use, and the presence of acne decreased significantly after metformin treatment.
One limitation of the findings was that “there was heterogeneity across some studies due to different acne assessment scales, metformin dosages, and treatment durations,” the authors write. They note that more randomized controlled trials will be needed to validate their findings.
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