What is Hormonal Acne?
New York (USA), January 27, 2012
Imbalances in hormone levels are common during puberty, menstruation, pregnancy, and menopause. Male hormone androgen is present in both men and women. Surplus oil secretion by sebaceous glands clogs hair follicles leading to development of bacteria, which causes acne and pimples.
During periods of hormonal imbalances, acne flare-ups increase due to combined effects of excess sebum or oil secretion and higher androgen levels in body. This is hormonal acne.
Men do not often suffer from hormonal acne as they already have high levels of androgens in their body. Women commonly experience hormonal acne during natural cycles of menstruation, pregnancy, and menopause. Fifty percent of women have hormonal acne during the week before their menstruation. Sometimes hormonal acne flare-ups may start during puberty and could well continue until menopause too.
Causes for Hormonal Acne
The root cause of hormonal acne is not clear. James C. Shaw, MD, University of Chicago, Department of Dermatology, states that either hormonal irregularities in menstrual cycle or ovarian cysts cause changes in androgen levels leading to hormonal acne. Therefore, androgen hormones cause hormonal acne.
Why do Androgens cause Hormonal Acne?
Just before the onset of adolescence, at the age of nine or ten, adrenal glands produce dihydroepiandrosterone sulfate (DHEAS), an androgen. Young adolescents also develop other male hormones like dehydrotestosterone (DHT), and testosterone at puberty. All these hormones together kindle increased secretion of sebum by sebaceous glands. Hence, acne is common among teenage boys.
However, some women continue to experience increased secretion of such androgens well past their teens too. This causes hormonal acne, which appear as blemishes on face, moderate to inflammatory papules, nodules, and comedones of face, chin, jaw line, chest, back, etc. Hormonal acne is therefore more prevalent in women.
Sometimes environmental factors also cause hormonal acne. Certain chemicals like trichlorophenol react with air and produce Dioxin, which is an oily powder that sticks to your skin. Wind and rain spread dioxin in the atmosphere. It takes many years for sun to eradicate this poisonous element from the environment. Dioxin presence in your skin and body propagates increased production of keratin leading to acne breakouts, blackheads, and pimples.
Triclosan, antibacterial agent commonly present in hand soaps, cosmetics, lotions, dish soaps, antimicrobial creams, and even acne treatments, produces dioxins in sunlight. Such dioxins accumulate in your body and hence are present in fish, eggs, chicken, beef, and milk too. Therefore, environmental pollution is also a cause for hormonal acne.
Treatments for Hormonal Acne
Anti-androgens like flutamide or spironolactone and oral contraceptives are effective against hormonal acne. You start on oral contraceptives to regulate your menstrual cycle for one or two months. However, such regularization produces partial effects only. Hence, doctors put you on anti-androgens. This combination proves effective against hormonal acne. Dosage is 50mg to 100mg of spironolactone for ten days in a month, initially for two or three months. Spironolactone can stop the effects of male hormone-testosterone on oil glands.
Adult women benefit from topical acne medications, Benzoyl Peroxide, Accutane, and antibiotics. Hormonal replacement therapy in combination with such medications and antibiotics reduces hormonal acne.
Treatments for hormonal acne extend over months and sometimes even into years. Sometimes, you need to continue with milder forms of treatment even after completion of the total course. Most women developing such acne in their twenties continue their treatment almost all their life, sometimes extending into menopause.
Side Effects of Hormonal Acne Treatments
Common side effects of Spironolactone are menstrual irregularities, and tenderness in breasts. These side effects are almost absent if you take it with other birth control pills. Intake of Spironolactone should not be in combination with other blood pressure medications like Captopril or Vasotec or high doses of NSAIDs as it could lead to higher potassium deposits.
Costs of Hormonal Acne Treatment
Hundred tablets of 100 mg Spironolactone cost $208.
Benzoyl Peroxide-$27
Accutane -$3 per pill
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