Sebum is produced by sebaceous glands. These glands are found on most parts of the body. Except few, most sebaceous glands open into a hair follicle. When sebum production increases the gland gets blocked and the sebum begins filling the gland like a balloon. Bacteria P. acnes infect this gland and inflamed acne is formed. If sebum production can be reduced the formation of acne will not take place. Androgen hormones are responsible for excess sebum and birth control pills control the androgens and treat acne. Let us find out more.
Androgens are a group of hormones. Androgens are also called male hormones. These hormones are responsible for activity of the sebaceous gland. When androgens are in excess the glands produce more sebum and as a result more acne. That is why puberty is the time when acne flares up. In women acne may also flares up during menstruation and pregnancy. Use of birth control pills and other hormones is done to reduce the activity of androgen s to treat and control acne.
Oral contraceptives may be of two types. One contains only progestin. The other type contains progestin and estrogens. The estrogens may be in the form of ethinyl etradiol. This ethinyl etradiol controls the level of androgens and reduces acne.
Different types of progestins are used in the oral contraceptive pills. The type that reduces the level of androgens is best used to treat and control acne.
Oral contraceptives thus reduce the production of androgens. This reduces the effect of androgens on sebaceous glands and controls sebum production. The possibility of sebaceous glands getting blocked by sebum reduces considerably with this.
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Less oil secretion limits the possibility of having clogged pores and acne flare-ups. Spironolactone works as an androgen receptor blocker. This drug decreases androgen production in the ovaries and adrenal glands.
Side effects from spironolactone can include breast tenderness and menstrual irregularity. For this reason, doctors usually add oral contraceptives like Ortho Tri-Cyclen and Estrostephave to compliment acne treatments and ease potential spironolactone side effects. Ironically though, spironolactone is recommended for women who are not candidates for oral contraceptives.
So should a woman over 35 with acne go with spironolactone? According to the American College of Physicians, the answer is “No".
In the 2004 May/June edition of the American College of Physicians (ACP) published a medical review of studies that tested the effectiveness of spironolactone for controlling hirsutism, acne, or both in fertile or postmenopausal women. The ACP review found insufficient evidence to recommend spironolactone as an acne treatment.
Nevertheless, Dr. Diane Thiboutot of Pennsylvania State University, Hershey uses spironolactone for female patients with acne accompanied by a suspected endocrine disorder.
For example, when a woman experiences a sudden onset of severe acne or acne that is linked with excessive facial hair growth, irregular menstrual periods, increased libido, dark patches of skin, deepening of the voice, insulin resistance and hair loss, spironolactone may be helpful. Dr. Thiboutot noted that spironolactone “seems to control quite well those cystic-type nodules that they [women] get on their lower face and chin."
Yet Dr. Julie C Harper Dr. Harper of the department of dermatology at the University of Alabama, Birmingham doesn’t recommend spironolactone so easily.
Only if neither topical retinoids nor antibiotics have not worked for a woman’s case of acne would Dr. Harper then suggest using spironolactone for women over 35.
Author of “Acne Messages", Naweko San-Joyz, says “A woman’s response to androgens is so varied that limiting herself to an androgen blockers like spironolactone certainly does not guarantee a cure, or even a quick treatment."
San-Joyz adds that overproduction of androgens is just one step in a series of potential events that could lead to acne. Instead of hormonal manipulation with drugs, San-Joyz suggests women with acne regulate this conditional using food, stress control and greater awareness of potential acne triggers like environmental estrogens.
Women with acne have numerous treatments options. If a woman does decide to go with spironolactone, it’s best to get her prescription filled with her gynecologist rather that her general practitioner.
It’s most likely that the gynecologist will be more aware of how a patient may respond to hormonal treatments like spironolactone and oral contraceptives, thus making recovery faster.
Both Cdmohatta & Naweko San-joyz 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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