Metformin as a stand-alone or adjuvant therapy was associated with improvement in acne in patients with polycystic ovary syndrome (PCOS), researchers reported in a study published the American Journal of Clinical Dermatology.
The investigators conducted a systematic review and meta-analysis regarding the efficacy of metformin in treating patients with acne related to PCOS. The review included randomized controlled trials, nonrandomized controlled trials, and open-label studies of patients with PCOS who were treated with metformin. Standardized mean differences (SMDs) were calculated for acne scores and odds ratios (ORs) for the presence of acne, with 95% confidence intervals (CIs).
The analysis included 51 studies with a total of 2405 patients with PCOS. The researchers found that metformin as adjuvant therapy led to greater improvement of acne scores compared with the same therapy without metformin (SMD −0.256; 95% CI −0.439 to −0.074). Pooling pre-metformin and post-metformin treatment data showed a significant decrease in acne scores after metformin use (SMD −0.712; 95% CI −0.949 to −0.476). The presence of acne decreased significantly after metformin treatment (odds ratio [OR] 0.362; 95% CI 0.271-0.485).
Among several limitations, the included studies varied regarding grading acne severity or assessing the presence of acne, metformin dosage, and treatment duration. Also, the investigators could not account for confounding factors such as body mass index, glucose, insulin, and hormone status or assess medication adherence.
The researchers noted that further studies with standardized acne grading scales are needed to more precisely assess the effect of metformin on acne in women who have PCOS.
“Based on this systematic review and meta-analysis, metformin, either as individual or adjuvant therapy, may be effective in treating acne in women with PCOS, especially among those who have diabetes or wish to conceive,” stated the study authors.
“After considering other indications and contraindications, metformin can be considered for use in women with polycystic ovary syndrome for treatment of acne,” the study authors stated.
Yen H, Chang Y-T, Yee FJ, Huang Y-C. Metformin therapy for acne in patients with polycystic ovary syndrome: A systematic review and meta‑analysis [published online October 13, 2020]. Am J Clin Dermatol. doi: 10.1007/s40257-020-00565-5