Hormonal Factors in Female Adult Acne

Bethanee Jean Schlosser, MD, Assistant Professor of Dermatology and Director of Womens Skin Health at Northwestern University,presented at the American Academy of Dermatologys 70thAnnual Meeting in March 2012 with exciting new findings on the role of hormonal factors in understanding adult acne in women.

This is a condition becoming increasingly common in women as late as their 50s, and in women hormonal therapies are commonly used to treat acne safely and effectively due to the root causes which can exacerbate the condition. The primary causes of acne are influenced by hormones,including excess oil production, clogged hair follicles, an increase in P.Acnes bacteria, and skin inflammation. The male hormones present in both men and women, and rogens, over-stimulate the oil glands and alter the development of skin cells in the hair follicles.

Further, the additional presence of excess facial hair, deepening voice or irregular/infrequent menstruation point to an androgen imbalance which requires further testing. The therapies used to treat acne must be tailored to the patients specific type and severity of acne, and some therapies are unsuitable for those wishing to conceive or during pregnancy.

While topical retinoids are the preferred therapy for first-line treatment and later prevention of mild to moderate inflammatory acne, hormone therapies which can be used to treat women have been found to effectively clear stubborn acne either alone or in conjunction with other medications. For example, combination oral contraceptives with anti-androgen spironolactone can be very successful as a combination therapy. Oral contraceptives including ethinyl estradiol pluseither progestin norgestimate, norethindrone acetate, or drospirenone have been approved to treat hormonal acne.

Patients must be screened before using hormonal methods to treat acne, due to associated risk factors such as blood clots or stroke. Dr Schlosser also recommended that patients allow time for therapies to work: Clients need to be consistent when using their acne medications and realise that they may not see the full effects of their treatment regimen for 8-10 weeks; and in many cases, some type of maintenance therapy is required for long-term clearance of acne.

Dr Lowe says: This presentation highlights the increasing numbers of mature post teenage women that dermatologists are seeing with facial acne. My own clinic in London is treating more adult women with acne than 10 years ago. Why is this? There are several possible reasons;

  • The modern woman is prone to more stress at work and in daily life. Stress releases hormones which can be acne forming, try stress relaxation programmes.
  • Hormones in some dairy products may be acne forming if you think your acne may be linked to dairy produce, try dark chocolate and soy milk.
  • Oral contraceptive pills that are low in oestrogen levels may provoke acne. Discuss these with your doctor.
  • Hormone replacement in peri and postmenopausal times can trigger acne or Rosacea.
  • Acne may improve or worsen in pregnancy and forthcoming pregnancy again due to changes in hormone balance.
  • The good news is that as a Dermatologist led clinic,we have many different acne treatment options at the Cranley Clinic eg. Non-prescription (including Dr Nick Lowe's acclenz™ Blemish Solutions Range) and prescription creams, gels and cleansers. Different tablets and capsules, some to reduce the hormone triggers.Lasers, acne extraction with pulsed lights and novel skin exfoliation treatments.
  • Acne varies from person to person so our full spectrum of treatments is specifically selected for the individual to achieve maximum improvement.