Editing Antiandrogen (section)

===Topical administration===
There has been much interest and effort in the development of topical AR antagonists to treat androgen-dependent conditions like acne and pattern hair loss in males.<ref name="HelmsQuan2006">{{cite book| vauthors = Helms RA, Quan DJ |title=Textbook of Therapeutics: Drug and Disease Management|url=https://books.google.com/books?id=aVmRWrknaWgC&pg=PA211|year=2006|publisher=Lippincott Williams & Wilkins|isbn=978-0-7817-5734-8|pages=211–}}</ref> Unfortunately, whereas systemic administration of antiandrogens is very effective in treating these conditions, topical administration has disappointingly been found generally to possess limited and only modest effectiveness, even when high-[[affinity (pharmacology)|affinity]] steroidal AR antagonists like cyproterone acetate and spironolactone have been employed.<ref name="HelmsQuan2006" /> Moreover, in the specific case of acne treatment, topical AR antagonists have been found much less effective compared to established treatments like [[benzoyl peroxide]] and [[antibiotic]]s.<ref name="HelmsQuan2006" />

A variety of AR antagonists have been developed for topical use but have not completed development and hence have never been marketed. These include the steroidal AR antagonists [[cyproterone]], [[rosterolone]], and [[topterone]] and the nonsteroidal AR antagonists [[cioteronel]], [[inocoterone acetate]], [[RU-22930]], [[RU-58642]], and [[RU-58841]]. However, one topical AR antagonist, [[topilutamide]] (fluridil), has been introduced in a few European countries for the treatment of pattern hair loss in men.<ref name="TrüebLee2014" /> In addition, a topical 5α-reductase inhibitor and weak estrogen, [[alfatradiol]], has also been introduced in some European countries for the same indication, although its effectiveness is controversial.<ref name="TrüebLee2014" /> [[Spironolactone]] has been marketed in [[Italy]] in the form of a topical cream under the brand name Spiroderm for the treatment of acne and hirsutism, but this formulation was discontinued and hence is no longer available.<ref name="FARIDDiamanti-Kandarakis2009">{{cite book|vauthors=Farid NR, Diamanti-Kandarakis E|title=Diagnosis and Management of Polycystic Ovary Syndrome|url=https://books.google.com/books?id=fgMYVxmPDnMC&pg=PA235|date=27 February 2009|publisher=Springer Science & Business Media|isbn=978-0-387-09718-3|pages=235–|access-date=30 December 2016|archive-date=11 January 2023|archive-url=https://web.archive.org/web/20230111121904/https://books.google.com/books?id=fgMYVxmPDnMC&pg=PA235|url-status=live}}</ref>

Topical [[clascoterone]], brand name Winlevi, was approved to treat acne in males and females in the [[United States]] in 2020.<ref name="AdisInsight">{{cite web | title=Clascoterone - Cosmo Pharmaceuticals | website=AdisInsight | date=12 February 2025 | url=https://adisinsight.springer.com/drugs/800026561 | access-date=8 May 2025}}</ref><ref name="Dhillon2020">{{cite journal | vauthors = Dhillon S | title = Clascoterone: First Approval | journal = Drugs | volume = 80 | issue = 16 | pages = 1745–1750 | date = November 2020 | pmid = 33030710 | doi = 10.1007/s40265-020-01417-6 | url = }}</ref> However, although significantly more effective than [[placebo]], topical clascoterone, like previous topical antiandrogens that have been developed, showed modest effectiveness in treating acne in [[clinical trial]]s, and it appeared to be far less effective than [[systemic administration|systemic]] [[spironolactone]].<ref name="BasendwhAlharbiBukhamsin2024">{{cite journal | vauthors = Basendwh MA, Alharbi AA, Bukhamsin SA, Abdulwahab RA, Alaboud SA | title = The efficacy of Topical Clascoterone versus systematic spironolactone for treatment of acne vulgaris: A systematic review and network meta-analysis | journal = PLOS ONE | volume = 19 | issue = 5 | pages = e0298155 | date = 2024 | pmid = 38814916 | pmc = 11139337 | doi = 10.1371/journal.pone.0298155 | doi-access = free | bibcode = 2024PLoSO..1998155B | url = }}</ref>