Hormonal treatments for acne

Hormonal acne treatments At A Glance

  • Best Results2-3 months
  • Treatment Recovery0-1 day
  • Procedure Time10-15 minutes
  • Skin SpecialistNurse, Medical Dermatologist
  • Duration of ResultsVariable
  • AnaestheticNA
  • Back to WorkImmediately
  • Cost$

Hormonal treatments for acne

Hormonal acne is a very common condition affecting over 20% of Australian adult women. This form of acne usually varies with the period cycle, and presents as deep lumps, cysts & blind ending pimples. Hormonal acne can be very distressing, & often resistant to over the counter washes & creams. Early & effective management prevents acne scarring.

FactsFacts on acne and hormones

  • Adult onset acne is common, particularly in women in their 20’s to 40’s
  • Hormonal acne is often tender with inflammatory lumps & deep cysts
  • Acne can significantly impact on self-esteem, mood & confidence. Scarring is common, acne picking can compound the situation
  • Hormone acne favors the chin, jawline and neck
  • Hormones can be affected by the menstrual cycle, pregnancy and menopause
  • This form of acne is usually resistant to topical & home remedies
  • Early control by a medical dermatologist mitigates acne scarring

How do I know if I have hormonal acne?

Hormonal acne often begins in the 20s and may continue into the 30s & beyond. The location of pimples can be a clue to whether you have hormonal acne. Unlike teenager acne, the skin at the jaw line & chin area are more often affected. This may extend to the lower face and neck.

Affected skin areas are sensitive and easily irritated by topical agents. Many patients did not have acne as a teenager.

What causes hormonal acne?

Hormonal acne is thought to result from the interplay of a number of factors. One or several of these factors may cause hormonal acne in any particular patient. It is important that your dermatologist takes a thorough history from you to establish likely contributing factors. Factors that may contribute to hormonal acne include:

  • Hormones, such as progesterones, oestrogens & testosterone – in most cases, levels of these hormones are normal but your doctor may test for them if you have other symptoms
  • Other hormones such as insulin
  • Stress or illness
  • Comedogenic & oily skin care products, make-ups & some sunscreens
  • Hormonal & metabolic disorders such as polycystic ovarian syndrome (PCOS) and diabetes and rarely, some types of cancers
  • Obesity
  • Oral contraceptives – many contraceptive pills help acne but progestogen only pills can worsen it, the same goes for Implenon.
  • Dietary factors play a significant role in some.

What treatment options are there to control hormonal acne?

If your dermatologist suspects a hormonal problem, a number of simple blood tests may be performed to test hormone levels. A pelvic ultrasound may also be requested if an ovarian disorder is suspected.

Often a combined approach to managing hormonal acne is most effective. It is essential for any underlying medical problems that may be contributing to hormonal acne to be corrected. Other contributing factors such as inappropriate cosmetics or medical creams and ointments may need to be stopped. Treatment may be prolonged and it is essential that patients follow their treatment plan to offer the best chance of a cure.

Hormonal acne can often respond to the same treatments used to treat teenage acne. This includes various topical cream & gel treatments for very mild cases, however in most patients other treatment modalities are indicated -see below.

A range of topical creams and gels often containing multiple ingredients including antibiotics, “retinoids” (vitamin A compounds) & benzoyl peroxide are usually a good start to treatment. Sometimes, your doctor may also prescribe an oral antibiotic as well. These treatments usually require a tailored approach to each patient.

More persistent or severe cases often benefit from an “anti-androgen” medication such as spironolactone, which is often effective either alone, or in combination with the oral contraceptive pill.

The most severe cases sometimes require treatment with special vitamin A type systemic (tablet) drugs such as Isotretinoin (Roaccutane, Oratane). These medications are available only from your Dermatologist and are particularly useful where the acne is causing scarring or is not responding to other treatments.

How long will it take for my acne to clear up on hormone control?

It may take up to 3-6 months or more to achieve and maintain improvement in your skin.

The “anti-androgen” spironolactone, may offer quicker results with reduction in skin oiliness occurring within 2 months and acne improving after this time frame.

It is essential that any underlying medical disorder be identified and treated or else the acne may persist.

The use of supportive acne treatments such as topical creams & gels or oral antibiotics may speed up the clearance of your acne.

Do not underestimate the importance of diet. Acne support vitamins such a zinc can help, as can skin care formulations of niacinamide, azelaic acid & ascorbic acid.

Davin’s Perspective on hormone control of acne

Many patients find adult onset or hormonal acne very distressing. Like all acne, the appearance on the face can be devastating to patients and patients often cannot understand why they are getting “pimples” at this older age in life.

While hormonal acne can be difficult to treat often requiring longer courses of treatment, improvement are achievable with the right combination of treatments and thoroughly investigating and treating any underlying medical problems that may be causing the acne.

It is important to manage hormonal acne properly because it can have significant psychological impacts on patients, particularly if it results in scarring. Often, a longer-term maintenance plan may be required to provide ongoing results. Once the acne is controlled, improvement to any scars may be needed. Acne scar management is something we specialise in at Cutis Clinic.

Disclaimer: I DO NOT treat acne, my work is procedural. If you have active acne, please see my colleagues @cliniccutis for management.

Join the conversation

Join Dr Davin Lim on Instagram to stay up to date

@drdavinlim

Enquire now!

Get In Touch

Quick Contact

Dr Lim has unparalleled experience in dermatology. Fill in the form below and he will get back to you with your query