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Should I see a dermatologist for hormonal acne?

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The term hormonal acne refers to a very stubborn form of acne that is often misunderstood by most acne sufferers. Many women self-diagnose hormonal acne based on a variety of misconceptions.

For example, women who suffer from acne often attribute their stubborn acne breakouts to hormonal acne because they tend to break out during their menstrual period, or simply because they feel like they have abnormal hormone levels, even when they have no signs of it.

That’s not to say acne can’t result from abnormal hormone production. Some women actually have medical conditions where abnormal hormone levels can be linked to acne breakouts. Polycystic ovary syndrome (PCOS), for example, is a fairly common condition in which certain hormones that cause acne become overproduced and can be associated with persistent acne.

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A variety of other, less common conditions can also occur that cause hormonal abnormalities that can lead to the development of acne. These conditions can usually be diagnosed through a thorough physical exam and blood tests to check levels of acne-causing hormones.

Aside from actual medical conditions associated with known hormonal abnormalities as the cause of acne, most acne sufferers typically refer to hormonal acne as a generic term to describe their persistent, frustrating acne breakouts, even without a definitive medical diagnosis of a hormonal one anomaly .

How some dermatologists misunderstand hormonal acne

This tendency to label one’s acne as hormonal without evidence is not unique to acne sufferers. Even for dermatologists, hormonal acne can be an arbitrary diagnosis of a pattern of acne breakouts without corroborating medical or scientific test results.

Rather, hormonal acne is a clinical diagnosis based on a physician’s assessment of certain observed characteristics. However, this does not necessarily mean that there is actually an underlying hormone abnormality.

In general, the term hormonal acne is often used by dermatologists to describe a specific clinical pattern of acne breakouts that occurs primarily in young women. For example, a female acne patient with stubborn acne that tends to erupt primarily along the lower facial and jaw lines is a prime candidate for the diagnosis of hormonal acne.

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Additionally, this type of acne tends to be very resistant to many standard acne treatments like topical prescription medications and oral antibiotic pills that are commonly used to treat other forms of acne. This acne pattern typically occurs in women in their 20s and 30s, but may be less commonly seen in other age groups.

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All acne begins with the activity of hormones

It’s also important to understand that hormonal-pattern acne isn’t the only type of acne that suggests a hormonal source. In fact, all acne begins with the activity of hormones. This applies equally to males and females.

The activity of acne-causing hormones, androgens, is at the root of almost all acne breakouts. Androgens are testosterone-derived hormones that activate the oil glands in acne-prone pores, causing the pores to become overactive and overworked.

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The pores then begin to collapse and fill with excess amounts of oil and other material. Bacteria also begin to grow in the poorly functioning pores, leading to even greater disruption. As a result of these steps, the pores can become inflamed, leading to a breakout.

As a result, the acne pores are raised and form an uneven complexion. When the inflammation becomes intense, red pimples begin to form on the skin’s surface, which can become very large and painful.

While it’s not well understood why some women develop hormonal acne, the basic steps in its development are essentially the same as for all acne breakouts in general. The contribution of other undefined factors is likely at work leading to the development of this particular form of acne breakouts.

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Hormonal acne can be difficult to treat

In general, hormonal pattern acne is more difficult to treat with conventional acne treatments. It is often necessary to rely on more effective methods to manage this type of acne. In fact, acne sufferers are often very frustrated because standard treatments don’t bring relief.

Prescription creams, gels, and lotions are typically ineffective at controlling a hormonal acne breakout. Likewise, antibiotic pills usually do not provide significant improvement.

Certain birth control pills that help regulate acne-causing hormones can sometimes be effective. However, birth control pills are not always helpful and can sometimes make this form of acne worse.

Even though hormonal pattern acne is not directly related to a proven hormonal imbalance, treating this type of acne with hormone-based treatments is often very helpful.

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One such treatment is a drug that works by blocking the acne-causing hormones from the start. Spironolactone is a pill that can prevent these hormones from activating acne-prone pores. This treatment option can be very effective and is often used to control hormonal acne. For many women suffering from this type of acne, spironolactone can be life-changing.

When hormonal acne is highly resistant to treatment and for those looking for a more definitive solution, Isotretinoin (also known by its original brand name, Accutane) can be a very effective option. This oral medication is the most effective acne treatment available and works on the acne-prone pore to prevent the development of acne breakouts even with hormonal acne.

Why you should see a dermatologist for hormonal acne treatment

For women suffering from possible hormonal acne, an examination by a dermatologist is appropriate. However, it is quite common for some patients to first see their gynecologist or even an endocrinologist to seek help for their perceived abnormal hormones as the cause of their hormonal acne. While this can provide reassurance that hormone levels are within the normal range, this detour can often delay effective treatment and lead to further frustration.

A dermatologist specializing in acne treatment can spot hormonal pattern acne right from the start and begin effective treatment right away. For acne sufferers who may be concerned that they actually have an underlying hormonal abnormality, the dermatologist can also recognize this possibility and recommend referral to the appropriate specialist as part of the overall treatment.

The Advanced Acne Institute is a unique dermatology practice in Miami, Florida that specializes solely in the treatment of acne. We are solely focused on providing the most effective treatments to help our patients achieve clear skin. We are pleased to share our insights and perspectives on acne treatment as an educational service, however this information is provided for educational purposes only and should not be considered medical advice and is not a substitute for seeking advice and treatment from an appropriate physician.

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