How do you know if your acne is hormonal based?

1. Excessive oil production
2. Acne below in the chin and jowl line
3. New or worsen pimple around the time of menstrual cycle, especially before the period.
4. Resistant to basic treatment such as Retin A or Benzoyl Peroxide.

What are the Causes of Hormonal Acne?

1. Over stimulation of oil glands by testosterone
2. Imbalance of hormones.  Ratio of estrogen and testosterone balance is off.
3. Estrogen/ Testosterone in the female body is 10 to 1.  Before period and during menopause and as the female gets older, Estrogen Drops causing the body to have relatively more testosterone, which causes acne through oil gland stimulation.

How do I treat hormonal Acne?

1. Continue your basics such as Retin A and Benzoyl Peroxide
2. Consider Spironolactone. This is a FDA approved pill for management of blood pressure and certain heart conditions.  But dermatologists and endocrinologists ( or physicians who specialize in hormones )  have been using this medication for years to treat hormonal acne.

Spironolactone clears hormonal acne by blocking receptors on the oil gland and by decreasing testosterone level in the body.  It also decreases the inflammation of the pimple, so you see less red and pus.  You need to take it for at least a couple of weeks to see improvement and continue several months until we come up with a topical regimen that controls your acne.  I recommend the Acne Control topical prescriptions available here at the clinic.

For resistant cases specialists will add oral contraceptives that have low androgenic effect ( or testosterone effect).  Some doctors recommend you take a blood test for potassium after 1 month and 2 month and watch for temporary side effects such as breast tenderness and irregular cycle.  The past 5 years I rarely see these side effects and believe Spironolactone is safer than most antibiotics people take to treat acne.  Spironolactone is not recommended for males due to its feminizing effects.

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