More frequently women are combating acne and wrinkles simultaneously. It’s a hideous fight wrought with mysterious hormone signals and an even more baffling search for a cure.



Dermatologist Diane Thiboutot, MD, associate professor of medicine at the Milton S. Hershey Medical Center, Hershey, Pa., proposes to clarify acne 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 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 hirsutism 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. You can forgo the androgen blocking hormones by properly consuming essential fatty acids such as those found in salmon and olive oil.

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.

The birth control pill is a centerpiece of hormonal therapy, albeit a bemoaned option. The medications most successfully employed in controlling acne contain a hormone called progestin with low androgenic activity (with generic pharmaceutical names such as norgestimate or desogestrel) combined with 35 micrograms of ethinyl estradiol, an estrogen.

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,"

Polycystic Ovary Disease

Acne may also be an indicator of polycystic ovary disease, a hormonal imbalanced characterized by irregular menstruation, obesity, infertility, acne and hair growth on the face, chest, and back (hirsutism).

Like acne, polycystic ovary disease is caused by an imbalance in androgen hormones. Dermatologists should work closely with the young patient's gynecologist to reduce the risks of infertility, cardiovascular disease and insulin-resistant diabetes. Identifying polycystic ovary disease is an important contribution to the long-term health of these young patients, not to mention adults as well.

Dr. Thiboutot concludes that, "Hormonal therapy is a good treatment for many teenage and adult women," and. "It is used less often than it could be because there are so many options to choose from. The patient should realize it is a good adjunct therapy." However, I strongly disagree with Dr. Thiboutot, hormones are immensely complex. Use of hormone therapy is riddled with enigmas. There are several well-written books available to help you can control of your hormones and acne condition without encountering the risks of hormone therapy. I’m listed some of my favorites below:

Reading Recommendations:

Androgen Disorders in Women: The Most Neglected Hormone Problem

by Theresa Cheung

Hormone Deception: How Everyday Foods and Products Are Disrupting Your Hormones--and How to Protect Yourself and Your Family

by D. Lindsey Berkson

PCOS: The Hidden Epidemic

by Samuel S. Thatcher M.D. Ph.D.

It's My Ovaries, Stupid!

by Elizabeth Lee Vliet

Hormonal Chaos: The Scientific and Social Origins of the Environmental Endocrine Hypothesis

by Sheldon Krimsky