What is the best treatment for hormonal acne? (photo)Acne & Scars Skin, Hair & Nails Endocrinology
I'm a 22 year old female and recently starting getting acne last year. It started off as just 2 tiny dots at first, but now it's just bad. :( I've been getting acne on my cheeks area mostly, sometimes on the forehead. The acne on the cheek has gotten worse every month when my period comes.Tea tree oil seems to help, but only a little.
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.
I'm sorry to hear that you've been having trouble with your skin.
Before determining the best treatment for your acne, it may be worth considering if there is any underlying cause for the acne that should be addressed first. There are a number of hormonal causes of acne, for example polycystic ovarian syndrome (PCOS). This is one of the more common causes of acne in young women.
Women with PCOS may experience increased facial hair growth and scalp hair loss, as well as irregular periods (usually longer cycles). This is usually caused by increased male hormones (testosterone) and insulin resistance.
Treatment can be in the form of medications to block the effect of testosterone, improving insulin sensitivity or suppressing the hormones responsible. Other rarer conditions include having excess male hormones, high steroids hormones (cushing's syndrome) and high growth hormone levels. Certain medications can also cause acne.
An evaluation by your doctor would include a thorough history and physical examination, to see if there are features of any of the above mentioned conditions. Once the underlying cause of the acne has been ascertained, effective treatment targeting that can be initiated.
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!
Dr Jiwei Wu
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