Hormonal data were evaluated in 34 women with acne resistant to usual forms of therapy. Radioimmunoassay (RIA) was used to measure serum testosterone, dehydroepiandrosterone sulfate, 17 α-hydroxy-progesterone, prolactin, progesterone, free-testosterone, and testosterone index. Eighty-eight percent of these women were found to have androgen excess. Using the Dexamethasone Suppresion Test, the sources of the hormonal abnormalities were identified and found to be adrenal in 24%, ovarian in 38%, and mixed adrenal and ovarian in 26% of the patients. The data supports the contention that women with acne that persists despite the common therapeutic modalities, warrant endocrinologic evaluation.