Background: Androgens appear to play a role in the development of acne, and presence of acne is a potential marker of hyperandrogenism. Objective: The authors evaluated androgens and insulin sensitivity markers before and after treatment with isotretinoin in women with post-adolescent severe acne who do not have hirsutism and/or ovulatory dysfunction. Methods: Androgens, lipids, glucose and insulin levels were measured in 26 patients and 21 controls during oral glucose tolerance test. Homeostasis model assessment for insulin resistance, area under curve (AUC)(glucose) and AUC(insulin) were calculated. Twenty patients completed a minimum of 6-month isotretinoin treatment. Results: All studied parameters were similar in patients and controls at baseline. Isotretinoin therapy increased body mass index and triglyceride levels without any effect on androgens or insulin sensitivity. Conclusion: Severe acne itself is not associated with hyperandrogenemia and/or insulin resistance. Isotretinoin treatment does not alter serum androgens or insulin sensitivity, although it increases body weight and serum triglycerides.