The development of acne is influenced by many factors, many of which are related to hormones. Androgen hormones increase during
the teenage years, when many people first develop acne. Androgen receptors are present in the sebaceous glands (oil-producing) and play a part in regulating the production and excretion of sebum. When this cycle is altered, the follicle can become an ideal environment for the P. acnes bacteria to grow and that leads to acne.
How do you treat hormonal acne?
There are two major options for influencing the androgenic (hormonal) effect on acne. Oral contraceptive pills (or birth control pills) are commonly used to regulate the circulating androgens and decrease the inflammatory response to the P. acnes bacteria. Another medication, called Spironolactone (brand name is Aldactone) is also used for the treatment of hormonal acne. Spironolactone is an androgen receptor blocker, meaning that Spironolactone doesn’t allow the circulating androgen hormones to bind at their receptors. A hormone cannot exert any influence on the body without binding at its receptor, so by blocking the androgen receptor, Spironolactone decreases the androgenic influence on the body that leads to acne in many women.
Are there topical medications used for hormonal acne?
There are no topical medications specifically formulated to address the androgenic influence that leads to acne. However, inflammatory acne is still caused by P. acnes bacteria. The androgenic influence makes the follicle more hospitable for the bacteria, which is why addressing the androgenic influence helps to control acne. Topical medications can be used to treat the P. acne bacteria, to treat the acne from another direction, while taking Spironolactone or oral contraceptive pills. Topical antibacterial medications, such as Benzaclin, Duac and Acanya are commonly used to treat acne. A new topical antimicrobial medication, called Aczone, is also very effective for the treatment of acne; in clinical studies, Aczone has been shown to be more effective in treating female acne than male acne. For this reason, Aczone may be combined with oral hormonal treatments when appropriate. Retinoids, such as Differin, Retin-A Micro, Atralin and Tazorac, also help to diminish the microcomedone that leads to acne lesions. Combination medications, such as Epiduo, Ziana and Veltin, are also effective tools in the topical management of hormonal acne.
Are in-office laser and light treatments effective for hormonal acne?
Yes, the Isolaz laser and Photodynamic Therapy (PDT) are very effective and useful treatments for hormonal acne. The Isolaz laser and PDT are often combined with other medical treatments, but the in-office treatments allow for faster improvement of acne than medical treatments alone.
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