Hormonal acne is a condition most of us have experienced as teenagers or still experience it as adults, and we watch our children, siblings and peers struggle with it for years. Myths about the best treatments have swirled around our diet, exercise and medication – and to clear it all up, I’m going to discuss two effective approaches: oral contraceptives and spironolactone.
What’s hormonal acne?
Hormonal acne flares up right before menstrual cycles, according to studies presented at the South Beach Symposium in Miami. In a 2014 survey, 65% of 105 respondents reported worsening of acne with their menstrual cycles, and 56% of those women reported acne in the week preceding menstruation.
What does it look like?
As your progesterone levels increase close to your menstrual cycle, your skin swells and your pores become blocked. Sebum, which is a thick and oily skin lubricant, can either clog up your pores or help your skin glow – you can guess what happens to most women in the weeks before their period. Usually, monthly acne flares on the lower half of your face (such as your chin and sides of your face) are linked to your menstrual cycle.
How can I treat it?
Oral Contraceptives (OCPs)
Because OCPs decrease your testosterone levels (the hormone responsible for all that sebum!), acne breakouts can be reduced as well. When women take the the traditional 21-day active/7-day inactive oral contraceptives, they tend to have acne flares during the 7-day inactive part of the treatment cycle, which increases the active treatment cycle to 24 days of active therapy and 4 days of “blanks” can limit both premenstrual syndrome and acne breakouts.
Originally developed as a diaretic, spironolactone has been found to be effective in treating hormonal acne as well. A dose of 25-50mg of spironolactone can serve either as an alternative or supplement to taking an OCP. It is inexpensive, has minimal side effects, and women have noticed that they get fewer hormonal breakouts when they are on it.
*Warning: If you are pregnant while taking spironolactone, be warned that there is a theoretical risk of feminization of a male fetus.
In conclusion, I would recommend OCPs for teenage girls as they tend to work better that spironolactone at that age, and spironolactone is more effective in women in their 30’s to 50’s. As a middle-aged woman, I can say that I know spironolactone has been very helpful for women that I know, and women with migraines have been able to use it as well. Always be sure to talk your options over with your dermatologist first – best of luck!
Note: If you are uncomfortable with taking OCPs or spironolactone, don’t worry – I understand. Consult your dermatologist about what topical treatments can be made available to you to treat your hormonal acne instead.