Contraceptive Pills
Does your acne seem resistant to treatment? If you’re female, the source might be excessive production of hormones called androgens. With extra androgens in your system, your oil-producing glands go into high gear and so does your acne.
Extra androgen production is one of several possible root causes of treatment-resistant acne and your doctor can help you figure out if it’s the reason you can’t control your acne. Several clues can help your doctor identify acne that may be influenced by hormones:
- Acne that appears for the first time when you’re an adult
- Acne flare-ups exclusively preceding your menstrual cycle
- Irregular menstrual cycles
- Hirsutism (a medical term for excessive growth of hair or hair in unusual places)
- Elevated levels of androgens in your blood stream
If any or all of the above apply, you might be a good candidate for hormonal therapy. This can include specific treatment regimens, drugs (such as birth control pills) that affect hormones, or a combination of both.
Remember to consult your doctor before using any of the remedies listed here.
Oral contraceptive pills
Birth control pills (a combination of estrogen and progestin taken orally) are often prescribed for hormonal acne. Low doses of estrogen help suppress the androgens produced by your ovaries. The newer progestin agents, including desogestrel and norgestimate, are less androgenic than those found in older formulations. That’s good news for you. Discuss with your doctor the significance of these newer solutions.
While only Ortho Tri-Cyclen® and Estrostep® are currently approved by the FDA as acne pills, experts agree that low-dose contraceptives improve acne regardless of which formula is used. Consult your gynecologist to find the formula that’s right for you.
Side effects are generally uncommon, although some women experience brownish blotches, or melasma (hyperpigmentation) on the skin. These can be treated with topical bleaching agents.
Anti-androgens
In combination with oral contraceptives, your doctor might prescribe an anti-androgen. As the name indicates, these drugs inhibit androgen production in your ovaries and adrenal glands. They help prevent existing androgens from causing excessive oil production. Spironolactone, a high blood pressure medicine with anti-androgenic properties, has proven quite effective at fighting acne.
Side effects may include breast tenderness, menstrual irregularities (if you’re not using oral contraceptive pills), headache and fatigue. Since Spironolactone is also a diuretic, you may experience frequent urination as well.
IMPORTANT TO KNOW: Spironolactone is teratogenic, meaning it can disturb the growth and development of an unborn baby and can cause feminization of a male fetus. If you are sexually active and not taking ‘the pill,’ it’s imperative that you use another form of birth control.
Corticosteroids
Small doses of corticosteroids, like prednisone or dexamethasone, may curb inflammation and suppress the androgens produced by the adrenal glands. These are most effective when used in combination with oral contraceptive pills. As far as side effects, some acne sufferers have found corticosteroids actually aggravate their acne
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