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

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. 

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. 

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