What treatments are effective for hormonal acne?
Whilst hormonal factors can play a role in both males and females, the term hormonal acne is usually reserved for acne affecting women due to fluctuations in the female sex hormones. It fluctuates according to the menstrual cycle and acne lesions often affect the chin and jawline. It can also be precipitated by a change in hormonal contraception, for example switching from a combined (containing oestrogen and progesterone) oral contraceptive pill to a progresterone-only pill or coil.
The combined oral contraceptive pill (OCP) can be an effective treatment for women. Forms of the OCP, such as Yasmin, that also block male hormones (androgens) are particularly effective. Risks of the contraceptive pill include irregular periods, nausea, weight gain, breast tenderness, high blood pressure and blood clots. The progesterone only pill 'minipill' can in some cases exacerbate acne and in this situation changing to an alternative form of contraception may be advisable. All forms of contraceptive pill require ongoing monitoring and for this reason are prescribed by your general practitioner rather than a dermatologist.
Spironolactone is another treatment option for women with acne, particularly if the acne is concentrated around the jawline and chin or is thought to be influenced by hormones. It works by blocking the effects of male hormones (androgens) on the skin, reducing sebum production and making pores less likely to become blocked.
Improvement is usually gradual, with most women noticing a benefit after 2–3 months of treatment. It can be used on its own or alongside topical treatments and is often an alternative to long courses of oral antibiotics.
It is essential that you do not become pregnant whilst taking spironolactone, as it may affect the development of a male baby. Effective contraception should be used throughout treatment, and the medication should be stopped if you become pregnant or are planning a pregnancy.
Common side effects include breast tenderness, menstrual irregularities, light-headedness, increased urination, and occasionally a reduction in blood pressure. Spironolactone can also increase blood potassium levels, which is why blood tests are usually recommended before starting treatment and periodically during therapy. The risk of significant potassium elevation is low in healthy young women but is higher in those with kidney disease or who take certain other medications.
Many women tolerate spironolactone very well, and for suitable patients it can be an effective long-term treatment that reduces the need for repeated courses of antibiotics.
Revessa Health
The Online Acne & Rosacea Specialists
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