What is the best treatment for hormonal acne? (photo)

Doctor's Answers 2

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Dr Abel Soh

Endocrinologist

Acne (or pimples) occurs when skin pores get clogged with dead skin and oil, and bacteria build up. Then the skin becomes inflamed and can turn red or swell.

Apart from external factors and stress, hormonal factors may also increase the likelihood of acne formation.

During adolescence, hormonal changes cause the sebaceous glands to become enlarged. Sebaceous glands are small glands in the skin which produces a lubricating oily matter (sebum) into the hair follicles to lubricate the skin and hair. Sebaceous glands are highly sensitive to hormones. As a result of the enlargement of sebaceous glands, sebum production increases and the risk of skin pores getting clogged with sebum is increased as well.

Women who have the medical condition known as polycystic ovary syndrome (PCOS) may have higher than normal levels of androgens. Androgens are a group of hormones that play a role in male traits and reproductive activity. They are present in both men and women, although in much lower levels in women. Women with PCOS usually complain of irregular or absent menstrual periods and may also have acne problem if androgen levels are higher than normal.

Acne can also flare up before a woman's menstrual period due to changes in hormone levels. This happens especially in women older than 30 years.

Hormonal treatment can be effective in controlling acne if your acne is confirmed to be related to high androgen levels or flares up before your menstrual period.

It seems like you have inflamed acne with post inflammatory erythema (PIE) and post inflammatory hyper pigmentation (PIH). There are many treatment options for acne and usually a combination approach will give you the best result.

  • Topical cream (retinoid/ antibiotic)
  • Chemical peel
  • Carbon laser
  • Oral medication (antibiotic/ isotretinoin/ birth control pill etc)

It is important to control the acne eruption first so as to reduce potential scarring. Speak to a doctor to find out what is suitable for you as the treatments have their pros and cons. Once controlled, you can consider vascular or pigment laser toning to lighten the PIE/ PIH. Depressed acne scars can be further treated with fractional lasers or RF microneedling devices. Hope this helps!

Regards,

Dr Jiwei Wu

Similar Questions

Do I need to see a dermatologist for itchy, red patches on my face?

Thanks for question. It does sound like you are having some jawline acne. I do see this very often in women and this is usually related to hormonal factors. The acne breakout commonly occurs around the mouth and on the jawline areas. You have also described itchy, dry and flaky red patches on the cheeks and eyelids and this sound like possible eczema on the face as well. This can be due to underlying sensitive skin or can be aggravated by use of harsh products. I do think that it would be good for you to see the dermatologist to get both conditions attended to.

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Answered By

Dr Colin Theng

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How should I prevent Post-Accutane relapse, and advise on long term maintenance isotretinoin dose?

Hi S – 6 years is a long time to be on a course of isotretinoin, unless you were specifically prescribed a low dose, long term “maintenance” isotretinoin regime by your doctor. If you’ve been compliant to the dosage regime (at 120 mg/kg), 85% of patients only need one course to achieve complete remission of acne – this would take 4 – 6 months of treatment, depending on the dose administered. Relapse rates in patients after treatment with oral isotretinoin vary between 10% and 60%.

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