Metformin effective against PCOS related acne: Study

Taipei, Taiwan: Metformin, as a stand-alone or adjuvant medication for polycystic ovarian syndrome (PCOS) patients, was linked to a reduction in acne, says an article published in the American Journal of Clinical Dermatology on 13th October 2020.

One of the cutaneous indications of PCOS is acne. Metformin usage for acne therapy in PCOS individuals has insufficient evidence. As a result, Hsuan Yen and colleagues set out to perform a systematic review and meta-analysis to assess the efficacy of metformin for the treatment of PCOS-related acne.

Researchers examined PubMed, the Cochrane Library, and Embase databases on November 23, 2019, for human clinical trials in any language. 'Acne' and 'polycystic ovarian syndrome' were among the terms, as were metformin,' 'biguanide,' and 'glucophage.' The search covered randomized controlled trials (RCTs), non-randomized controlled trials (NRCTs), and open-label studies on individuals with PCOS who were treated with metformin. The researchers generated standardized mean differences (SMDs) for acne scores and odds ratios (ORs) for acne presence with 95 percent confidence intervals (CIs). The risk of bias instrument for RCTs developed by the Cochrane Collaboration was used to assess quality. The chosen methodological index for nonrandomized research was used to evaluate NRCTs and open-label trials (MINORS).

The key findings of this study are as follow:

1. A total of 51 trials including 2405 PCOS individuals were included in the study.

2. Metformin as an adjuvant therapy improved acne scores more than did the same therapy without it (SMD 0.256).

3. After combining pre- and post-metformin medication data, researchers discovered that metformin use resulted in a substantial reduction in acne scores (SMD 0.712).

4. The presence of acne was dramatically reduced after using metformin (OR 0.362).

In conclusion, Metformin, as an individual or adjuvant therapy, may be useful in treating acne in women with PCOS, especially those who have diabetes or want to conceive, according to this comprehensive review and meta-analysis.

Reference: Yen, H., Chang, YT., Yee, FJ. et al. Metformin Therapy for Acne in Patients with Polycystic Ovary Syndrome: A Systematic Review and Meta-analysis. Am J Clin Dermatol 22, 11–23 (2021). https://doi.org/10.1007/s40257-020-00565-5