Dermatologist's Take
Clascoterone (Winlevi) is a first-of-its-kind topical anti-androgen cream that lowers oil and calms acne, and it works for both men and women. Results are usually modest and gradual, so many people pair it with other acne treatments.
At a glance
- AKA: Winlevi, clascoterone 1% cream
- Drug Class: Topical androgen receptor inhibitor (anti-androgen)
- Rx or OTC: Prescription only
- Typical Strength/Dose: 1% cream, a thin layer twice a day (morning and night), ages 12 and up
- Time to Work: Often 4 to 12 weeks; skin keeps improving with steady use
- Evidence Level: Good — two large 12-week trials showed it beat a placebo cream
- Important: It is the first topical anti-androgen, and unlike some hormone acne pills, it can be used by males.
What is it?
What is it text.
How it works
Hormones called androgens (like testosterone and its stronger form, DHT) tell oil glands in the skin to make more oil (sebum). Extra oil helps clog pores and feed acne. Clascoterone works right in the skin. It competes with androgens for the same docking spots (androgen receptors) on oil-gland and hair-follicle cells. By blocking these spots, it lowers oil production and calms the inflammation that leads to pimples. Because it acts mostly in the skin where it is applied, it can be used by men without the body-wide hormone effects seen with anti-androgen pills.
What it treats
How it's typically used
Typical use is a thin layer (about 1 gram) spread over the affected area twice a day, in the morning and evening. It is applied to clean, dry skin and is only for use on the skin. Wash your hands after applying. Give it time, since acne often takes 4 to 12 weeks to improve. It can be used along with other acne treatments, but your dermatologist should guide how to combine them. This is general educational information, not a treatment plan.
Common side effects
- Redness at the application site
- Itching
- Dryness, flaking, or scaling
- Mild burning or stinging
- Swelling in the treated area
These are usually mild and happen in about 7% to 12% of people.
Serious side effects
- Signs of hormone gland (HPA-axis) changes: unusual tiredness, weakness, nausea, or dizziness. In trials, a small number of people had a temporary dip in a stress hormone (cortisol) that returned to normal after stopping.
- High potassium levels were noted in a few people; this can rarely cause an irregular heartbeat.
- Severe or lasting skin irritation, or signs of an allergic reaction (rash, swelling, trouble breathing).
Call your doctor if you have these symptoms or if irritation does not settle.
Who shouldn't take it
- People allergic to clascoterone or any ingredient in the cream
- Use with caution, and only under medical advice, in pregnancy or breastfeeding (see above)
The U.S. prescribing information lists no strict contraindications, but your dermatologist may add cautions based on your health. ⚠️ Derm to verify pregnancy wording.