Acne and Hormone Imbalance
Acne normally erupts during the teenage years, which is a time when hormone fluctuations are common, according to the American Academy of Dermatology (AAD). However, some adult women also suffer from acne due to an imbalance in their hormone levels. Fortunately, dermatologists offer treatments for acne caused by imbalanced hormones, the AAD says.
Acne results when the sebaceous glands, which produce the skin's natural oil, create too much oil. This excess oil clogs pores and provides an ideal environment for bacteria to proliferate. Hormones called androgens, which include testosterone, stimulate the sebaceous glands to produce oil. If a person has too much circulating androgen, a hormone imbalance results. The excess androgen hormone overstimulates the sebaceous glands, leading to acne.
Hormonally-driven acne often appears in the pre-menstrual phase of a woman's menstrual cycle. It also occurs frequently in women with polycystic ovary syndrome (PCOS), which is a hormone disorder that results in missed periods and facial hair growth along with acne, according to the National Institutes of Health. In some cases, women have normal levels of androgen, but have sebaceous glands that are ultra-sensitive to androgen's effects.
Women with acne and a hormone imbalance can try other acne treatments, but they have one treatment that is especially suited to their type of hormonally-driven acne: oral contraceptives. According to the AAD, oral contraceptives work by balancing hormones; once androgen levels are properly balanced with estrogen, the sebaceous glands calm down and stop producing so much oil. Oral contraceptives also block the androgens from reaching receptors in the sebaceous glands.
Oral contraceptives don't work to cure acne overnight. According to the AAD, patients will start to see their acne clearing up within about three months of starting birth control pills. Acne also can get worse before it gets better, the AAD warns. The U.S. Food and Drug Administration has approved several oral contraceptives specifically for acne treatment, but dermatologists have the option of prescribing any brand of birth control pill.
Most dermatologists won't prescribe oral contraceptives for acne before trying other treatments, even if it's fairly certain the acne is driven by a hormone imbalance, the AAD says. If other treatments fail to clear up the problem, then the dermatologist might consider prescribing oral contraceptives. In addition, acne treatment may involve two or more simultaneous approaches; for example, oral contraceptives may be paired with a topical benzoyl peroxide treatment.
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