Dr. Alan R. Sheltie, who co-authored "The Effect of the Menstrual Cycle on Acne," found that contrary to the adage that, ?You'll grow out of acne?, premenstrual acne only seems to get worse with age. This study examined a group of 400 women ages 12 to 52. The investigators observed that 53 percent of women over age 33 experienced a higher rate of premenstrual acne than women under age 20-- who only reported a 39 percent increase in premenstrual acne.
Dermatologist Diane Thiboutot, MD, associate professor of medicine at the Milton S. Hershey Medical Center, Hershey, Pa., proposes to clarify acne treatment options for women. Dr. Thiboutot explains that control of acne is an ongoing process and that all acne treatments work by preventing new acne. While most women suffering from adult acne seek standard treatments such as topical preparations or antibiotics, 60 percent of these femmes either do not respond to standard acne treatments or build up a tolerance to frequently prescribed medications such as antibiotics.
Causes of Adult Acne
It is not yet known exactly what causes adult acne, but several dermatologist like Dr. Alan R. Sheltie, link adult acne to hormone fluctuations. Acne in a woman is often linked to her menstrual cycle. Women with premenstrual acne outbreaks, such as pimples on the lower face and neck, seem to respond particularly well to treatment with medications that either reduce or block androgen production. Androgen hormones create male traits in women such as a deepening of the voice, an increased libido or hirsute that causes excessive or abnormal growth of hair. They also stimulate the oil glands. The oil mixes with skin cells and bacteria, causing inflammation in the skin that can result in the arrival of zits.
What to Know Before Your Begin Hormone Therapy for Acne
Polycystic Ovary Syndrome
Before you begin a hormone treatment for acne, you should confirm that you are not suffering from polycystic ovary syndrome, or PCOS. According to the American Academy of Dermatology, worldwide, about 15% of the women of reproductive age have PCOS. Polycystic ovary syndrome is a hormonal imbalanced characterized by irregular menstruation, obesity, infertility, acne and hair growth on the face, chest, and back (hirsute). Like acne, PCOS is caused by an imbalance in androgen hormones. Dermatologists should work closely with your gynecologist to reduce the risks of infertility, cardiovascular disease and insulin-resistant diabetes.
Before your dermatologist prescribes hormone therapy, she may perform a standard screening that includes two hormones - testosterone and DHEAS (dehydroepiandrosterone sulfate). It is important that you stop taking oral contraceptives for at least one month before any tests are performed because birth control pills can suppress androgens.
Acne Hormone Treatment Options
Dr. Diane Bergson, MD, a clinical Assistant Professor at the Department of Dermatology, New York University , New York states that once a woman is diagnosed with hormonal acne, treatment options include oral contraceptive pills, corticosteroids and spironolactone. These treatments act by decreasing sebum production.
Oral Contraceptive Pill
The oral contraceptive pill, OCP, is the keystone of hormonal therapy. The OCPs most successfully employed in controlling acne contain a hormone called progestin, which has low androgenic activity, combined with 35 micrograms of thinly estradiol, an estrogen. You can find generic forms of this pill under names such as nor estimate or desogestrel.
Oral Corticosteroids
Oral corticosteroids, such as prednisone and dexamethasone may help improve acne by decreasing androgen production in the adrenal gland.
Oral Spironolactone
Oral spironolactone is a steroidal ant androgen that prevents excessive oil production by blocking androgen receptors. Additionally, spironolactone decreases androgen production in both the ovaries and adrenal glands, resulting in fewer acne flare-ups. Doctors usually prescribe oral contraceptives with spironolactone to reduce spironolactone's side effects of breast tenderness and menstrual irregularities.
Risk Factors with Hormone Therapy
Dr. Thiboutot counsels, "As with any therapy, there are risks and rewards. The risks of hormonal therapy require regular breast and pelvic exams to guard against the increased risk of certain types of cancers. It is vitally important that dermatologists work with the patient's gynecologist to determine the most appropriate treatment and follow-up especially in women over the age of 40 or those who might be smokers".
Unfortunately, for most young teens and women in their reproductive years, menopause is still many years away, which means they are left to deal with the painful symptoms of endometriosis, with no relief in sight. Thus, what is often recommended for many non-menopausal women is hormone therapy.
Hormone therapy is one of the most successful treatments for endometriosis, as it helps around 80-90% of the women who take it. Hormone therapy controls estrogen, helping to alleviate pain caused by endometriosis. It can also reduce the size and amount of endometrial implants, stopping endometriosis from spreading.
However, it is important to note that hormone therapy does not improve a woman's fertility. Therefore, if you are concerned about infertility or wish to become pregnant, these therapies are not an option for you. Moreover, young teenage girls, who have not reached the end of puberty, are usually unable to take this form of treatment, as it poses a risk to their development.
In addition, there are various types of hormone therapy and each woman responds to treatment differently. Furthermore, like taking any medication, there are always pros and cons that need to be carefully considered.
The following is information about the most popular forms of hormone therapies used to treat endometriosis:
Birth control pills - This is the most popular therapy and is considered safe to use for long term use. A woman can generally use it until menopause. Birth control pills are designed to control menses and stop ovulation. Without ovulation, endometrial implants can no longer grow and will shrink.
Birth control pills lower the risk of ovarian cancer, and are generally safe for most women. This therapy is available in pill, skin patch or vaginal ring form. It has few negative side effects including headaches, nausea, breast tenderness, depression, mood swings, and irregular, light or absent menses. It also increases the risk of blood clots and slightly increases the risk of breast cancer.
Gonadotropin-releasing hormone agonist (GnRH-a) - This therapy decreases estrogen levels to those experienced after menopause, and can only be taken for the short term (no more than 6 months). GnRH-a increases the risk of bone loss, which can cause osteroporosis, and is why it is usually taken with progestin to help prevent thinning of bones and other menopausal symptoms. GnRH-a is often used to help prolong the relief of endometriosis pain after surgery, as it works to prevent the return of endometriosis.
High dose progestin - This therapy is taken in the form of pills or a shot. It is designed to produce progestin levels in the body that mirror pregnancy. This therapy ceases monthly ovulation, and decreases estrogen which allows endometriosis growths to shrink, alleviating pain in most women. Progestin can be taken for long term (usually no more than 2 years).
The side effects of progestin include depression, bloating, breast tenderness, weight gain, light or absent menses, risk of bone loss if taken for longer than 2 years, and fertility can take up to a year or longer before it returns.
Danazol - This therapy decreases estrogen levels and increases the level of androgen (male) hormones. Danazol also puts the body into a menopause-like state. Although it effectively shrinks endometrial growths and reduces pain, its side effects can include muscle cramps, weight gain, acne, skin rash, oily hair and skin, decrease in breast size, facial and body hair, and even voice deepening. To make matters worse, most of these male-transforming side effects can be permanent.
Danazol is often short term therapy, and is usually the last doctors will recommend.
Talk to your doctor to find out if hormone therapy is right for you.
Both Kamal Kaushal & Shelley Ross are contributors for EditorialToday. The above articles have been edited for relevancy and timeliness. All write-ups, reviews, tips and guides published by EditorialToday.com and its partners or affiliates are for informational purposes only. They should not be used for any legal or any other type of advice. We do not endorse any author, contributor, writer or article posted by our team.
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Shelley Ross has sinced written about articles on various topics from Medical Condition, Woman Menopause and Womens Health. For other or for details about treating endometriosis symptoms naturally, please visit. Shelley Ross's top article generates over 3600 views. to your Favourites.