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Acne: Hormone Treatment
July 2, 2009 | Leave a Comment
Hormone Treatment
Because hormones, especially androgens like testosterone, play a role in acne, changing the balance of these natural compounds in the body can be helpful in some cases. Many young women benefit from taking birth control pills for their acne. This treatment stops the hormone surges and also probably reduces the amount of testosterone that is available to stimulate oil-producing hair follicles and make mischief. Keep in mind, though, that young women who take oral contraceptives for an extended period may have a lowered libido for quite a long time after discontinuing the treatment. (Parents of teenagers may not consider this a negative factor, but it can be very troublesome for a woman in her twenties or thirties.)
Q. You had a question about a teenage girl with acne. Nothing the dermatologist prescribed had worked, and her mother refused to consider birth control pills for her.
My heart goes out to her. I too have suffered with acne my whole life, starting when I was 10 years old. I am now 35.
My parents took me to dermatologists who prescribed pills and creams; we changed my diet; we tried sun exposure and no sun exposure. They kept trying because they knew my self-esteem was suffering. Acne makes you feel ugly. At the age of 16 I saw a gynecologist who suggested birth control pills. I was raised a strict Irish-Catholic, but Mom was open to anything that might help me. Within 2 months of starting birth control pills, my skin was considerably better! I am one of those people whose body loves the pills. As soon as I stop taking them, my skin starts to break out. I hope my experience will help convince that mother that birth control pills could be the magic she wants for her daughter.
A. Usually Accutane or Cipro are prescribed and they help in the vast majority of cases, but there are minor exeptions due to the individuality of each patient. When all else fails, birth control pills can be helpful. The hormones counteract testosterone. Yes, young women make this male hormone too. Not every woman tolerates oral contraceptives as well as you do, but doctors frequently prescribe them for hard-to-treat acne.
A dermatologist may also prescribe a very old-fashioned blood pressure drug called spironolactone by itself or in combination with birth control pills. This is an “off label” use of spironolactone, but one with quite a long history. Spironolactone seems to help reduce the action of testosterone or other androgen hormones. That may explain why it is also used to treat women who have excessive facial hair (hirsutism). The dose that dermatologists use for acne is usually one-fourth that used for hirsutism.
Spironolactone is a potassium-preserving diuretic and must not be combined with potassium supplements or other potassium-preserving medications. In addition, spironolactone carries a black-box warning in its. prescribing information that tells doctors in the strongest way possible that this drug causes cancer in animal studies. Generally, therefore, physicians prescribe it only for a limited time. Women are urged not to become pregnant while on this medicine. When it is used in combination with oral contraceptives, that shouldn’t be as much of a concern.