Bicalutamide (Casodex) is an Androgen Inhibitor medication that blocks the activity of androgens (male hormones). Bicalutamide is rarely used for the treatment of acne.
Bicalutamide is a synthetic non-steroidal anti-androgen (NSAA). It is most frequently used for the treatment of prostate cancer, hirsutism (excessive body hair growth) and as part of the hormone replacement regimen for transgender women. Bicalutamide blocks the ability of a receptor to bind androgen hormones, such as testosterone and dihydrotestosterone (DHT).
Androgen hormones can contribute to acne symptoms by stimulating the sebaceous glands to grow and produce more sebum. The increased sebaceous gland activity can lead to clogged pores and excessive growth of acne-causing P. acnes bacteria inside follicles. Androgen Inhibitors can improve acne symptoms by decreasing the activity of sebaceous glands, which leads to a decrease in sebum production.
Androgen hormones are an essential part of male biology. Because androgen inhibitors have significant side effects when used in men, they are usually only used to treat acne in women. The use of Androgen Inhibitors can improve acne symptoms for some female patients, but not all. Testosterone is the best known androgen.