How Well Does Hormonal Therapy Work And Is It Safe
The pill: Many studies have looked at how well oral contraceptive pills fight acne. The pill has been found effective at treating blackheads, whiteheads, pimples, and acne nodules and cysts.
In fact, the pill has proven so effective that the US Food and Drug Administration has approved some oral contraceptives for treating acne.
The pill is generally considered safe for women. Some women, however, should not take it. Your dermatologist can tell you whether the pill may be a safe and effective treatment option for you.
Spironolactone: Doctors prescribe this medication to treat high blood pressure. Its also prescribed for people who are retaining too much fluid.
Dermatologists have been prescribing it for many years to treat acne and excess hair growth in women. When other acne treatments dont work, it can effectively treat deep-seated, tender acne on the lower face, jawline, or neck.
Spironolactone is not prescribed to treat acne in men due to side effects. Men have developed breasts while taking this medication to treat acne.
Spironolactone is generally considered safe for healthy women.
Taking both spironolactone and the pill can increase effectiveness. This combination has another advantage. Its essential to use birth control while taking spironolactone. If you get pregnant while taking spironolactone, your baby can have serious birth defects.
A word of caution
If you can get pregnant, youll need to use birth control while taking spironolactone.
Slay Your Skin Care Routine
At-home remedies can help send your pimples packing. One of the best solutions is a daily skin care regimen. Here are some tips:
- Cleanse your skin at least once per day.
- Try a new chemical exfoliant . This can help clear clogged pores. Only do this a few times per week, though, because it can dry you out.
- Use a retinol cream before bed. This can help promote skin cell turnover.
Pimple PSA: As tempting as it is, DO NOTpick at your skin. This does way more harm than good.
Whats Involved In Taking Hormonal Therapy For Acne
These medications must be prescribed by a doctor. Each is a pill that you would take daily.
If youre wondering whether hormonal therapy could help clear your acne, you may want to make an appointment to see a dermatologist. After examining your acne and gathering the necessary information about your health, this doctor can tell you if hormonal therapy may be an option.
Before you see a dermatologist, it helps to prepare for your appointment. Youll want to be able to tell your dermatologist the following:
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Medical conditions you have , including high blood pressure, heart disease, blood clots, migraines, or cancer
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Medications you take
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Supplements and other natural products you take
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Surgeries youve had
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Medical conditions of close blood relatives, including cancer, kidney disease, or heart disease
If the pill is an option for you, you will have your blood pressure taken to rule out high blood pressure. You dont need a Pap smear or pelvic exam before a dermatologist can prescribe the pill to treat acne.
Before your dermatologist prescribes spironolactone, you will need some blood tests.
If you begin hormonal therapy, you will need to keep follow-up visits with your dermatologist. Spironolactone requires that you gradually increase the dose, so youll need to see your dermatologist every 4 to 6 weeks when you start taking it.
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Can Birth Control Help Improve Your Skin
Yes, birth control can help treat hormonal acne in women. Acne is caused by an excess production of sebum , which is triggered by androgen hormones. Birth control containing estrogen and progesterone lowers the amount of androgens in the body, which helps reduce acne .
Disclaimer: The above information is for informational purposes only and is NOT a substitute for professional medical advice. Always seek the advice of your doctor/primary care provider before starting or changing treatment.
Benefits Ofprobiotics For Acne And Healthy Skin
Probiotics help balance your gut microbiome and contribute to good digestion and a healthy immune system.
Because were also going to look at the effects of topical probiotics, moving forward I will refer to probiotics which are taken internallytargeting your gut microbiomeas oral probiotics. Besides helping your digestion, oral probiotics can also heal key issues linked to skin health and acne reduction.
Your skin also has its own ecosystem of flora, or microbiome, with different strains than your gut. Researchers are also currently testing probiotics that contain healthy bacteria to be applied directly to your skin. These are known as topical probiotics.
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What Does Hormonal Acne Look Like
According to the American Academy of Dermatology, adult-onset acne is becoming more common in women in their 30s, 40s, and 50s. Hormonal acne typically appears on the chin, jawline, neck, and lower cheek area. It often displays red, inflamed breakouts and even deep cysts that can cause discomfort and tenderness. Rather than being surface-level blemishes, pimples caused by internal imbalances often appear as hard bumps under the skin. Hormonal acne can range from mild to severe but is often categorized by larger outbreaks.
Why Is Hormonal Acne Important
Hormonal acne does not always respond fully to treatment with acne creams, such as topical retinoids, and antibiotics. In some cases hormonal acne does not even respond well to treatment with Isotretinoin . Hormonal acne is more likely to come back after a course of Roaccutane has successfully cleared it.
Besides being stubborn to treat, hormonal acne causes redness for prolonged periods, scarring and pigmentation. Some types of hormonal acne cause a large number of comedones to develop especially on the sides of the face temples, cheeks and jaw line.
Enlarged pores on the nose and cheeks are commonly seen with hormonal acne. Hormonal acne can be really frustrating and cause a reduced quality of life for sufferers.
Hormonal acne can be distinguished from fungal acne on the type of spots and their location. Fungal acne causes smaller spots that are more evenly sized and itchy.
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Can Prebiotics Treat Acne
Not as muchresearch has been done on the effect of prebiotics on acne. Prebiotics are worthkeeping an eye on for acne treatment. But given how few trials there are,you shouldnt place too much weight on the results at this early stage:
- The prebiotic galactooligosaccharide improved skin hydration in healthy women.[38
- Trusted SourcePubMedGo to source]
Why Havent You Heard Of Spironolactone For Acne
While dermatologists are increasingly scratching spironolactone onto their Rx pads, many acne sufferers still havent heard of it no matter how many times theyve typed acne and help! into Googles search bar.
Although doctors have known of its skin-clearing effects for the last few decades, the medication is only now gaining recognition as an effective treatment for hormonal acne in women.
The reason spironolactone is still fairly unheard of by acne sufferers is likely due to its main use: treating high blood pressure and heart failure.
While Id taken the birth control pill since I was a teenager in an effort to combat period-induced breakouts, spironolactone works a bit more aggressively. It blocks androgens .
Furthermore, the treatment isnt just targeted for women whose acne flares up around the time of their menstrual cycles. Spironolactone can also help post-menopausal women experiencing a sudden influx of skin issues.
In fact, females with high hormone levels and acne at any age may see improvement with the drug. Men are rarely prescribed spironolactone for acne as it
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What If Antibiotics Dont Work For Me
One thing to keep in mind is that antibiotics may not work for everyone. Sometimes, they dont work at all. Other times, they may just help for a short time. If this happens to you, you might have nodulocystic or adult female acne, and antibiotics may have limited use. Otherwise, there are other treatment options for different types of acne.
Oral antibiotics improve most cases of nodulocystic acne. If they dont help, the acne keeps returning, or theres a risk of scarring, providers may recommend isotretinoin . For AFA, oral antibiotics provide temporary improvement, but its usually incomplete and short lived most people have flare ups once they stop taking antibiotics. For these women, antibiotics are useful as a bridge to hormonal therapies like birth control pills and/or a medication called spironolactone.
What Questions Should I Ask My Healthcare Provider
- How severe is my acne?
- What lifestyle changes should I make to prevent hormonal acne from forming?
- What are the side effects to my acne treatment?
- Can I take this treatment if I become pregnant?
A note from Cleveland Clinic
It can be frustrating to see breakouts on your skin as an adult, considering they are most frequent among adolescents. Talk with your healthcare provider if your acne is persistent and they will be able to offer advanced treatment options to eliminate pesky pimples.
Last reviewed by a Cleveland Clinic medical professional on 09/10/2021.
References
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Take An Antibiotic For As Short As Period Possible
When introducing an antibiotic in your acne medication schedule, your dermatologist will recommend it for the shortest time possible. Since acne takes time to treat, this usually means 3-4 months. Other people with acne, however, need extra time on an antibiotic.
You can shorten the period that you need an antibiotic in your treatment plan by following these steps: Use all of the medicine in your treatment schedule. When you take an antibiotic on its own, it can quickly lose its potential to destroy acne. When this occurs, the bacteria continue to grow, and you can develop a problem known as antibiotic resistance.Antibiotic resistance is a global health issue. Thats the reason a specialist such as a dermatologist recommends other acne medicine alongside an antibiotic. You may need to utilize benzoyl peroxide, or adapalene pronounced as ah-dap-ah-lean gel plus the dose . Minimize acne breakouts through gentle skin care. To clear up acne, you may think of scrubbing your skin. Scouring may irritate your skin and worsen acne. You can minimize flare-ups by following the skin care tips on Acne.
Tips for Managing your Acne
An antibiotic can play an essential role in assisting to clear acne blemishes. If you swallow an antibiotic to cure your acne, ensure you take it seriously. It will allow you to get the most benefit in the shortest time possible.
Best Antibiotics For Acne
There are many different families of antibiotic acne treatments, but looking at which are most effective with fewest side-effects, two stand out: tetracyclines and erythromycin. Here are our TOP 4 products with each of these active ingredients.
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Benefits Of Cephalexin For Acne
Using antibiotics to treat acne is nothing new. Because they can eliminate acne-causing bacteria and they also have an anti-inflammatory property, which helps prevent and treat acne, antibiotics are one of the main categories of internal treatments for acne. However, the oral antibiotics used for this purpose are typically minocycline and doxycycline. According to Dhingra, cephalexin isnt actually able to penetrate into the oil glands like the more traditional antibiotic choices are able to. So then the question becomes: in what instances would someone use cephalexin over all the other acne treatments? A few to note below:
- Those unable to tolerate other antibiotics:“The data is scarce, so its hard to offer a broad recommendation, but for a patient for whom doxycycline isnt cutting it and patients are maybe hesitant about other highly effective tried-and-true acne treatmentlike spironolactone and isotretinoincephalexin may be a reasonable thing to bring up with your dermatologist,” Dhingra explains. It should also be noted that cephalexin should only be used for inflammatory acne .
- Pregnant women: Since traditional acne treatments are not safe during pregnancy, Dhingra says cephalexin might be a good option for women planning a pregnancy or who are currently pregnant but experiencing moderate-to-severe acne flares. It’s important to note that consideration for this approach should be done in conjunction with a board-certified dermatologist and obstetrician.
Are Levels Of Testosterone And Of Other Androgens Raised In Hormonal Acne
There is conflicting evidence on this though the majority of studies show that elevated androgen levels are are frequent.
A large study from 2013 showed that of 835 women with hormonal acne, 55% had elevated levels of androgens DHEA being the one most frequently elevated. A Turkish study from 2017 of 207 women showed 55% of women with acne had elevations in one androgen. Smaller studies from Brazil and Japan have also showed elevated levels of androgens in adult women with acne.
A Czech study from 2000 of 90 women with acne showed that 81% had an elevated level of at least one androgen. The severity of acne did not vary with the degree of elevation however. However a British study from 1989 showed no elevations in androgens in women with acne.
Our clinical impression is that some women do have elevated androgen levels and hormonal acne may be the only sign of this. Other signs include excessive facial and body hair, irregular periods and hair loss. However, a large number of women have normal levels of androgens and it is believed that these women may just be more sensitive to these androgens. This is the reason they get acne.
The bottom line is routine hormone blood tests may be normal in hormonal acne. Hypersensitivity of the skin means that anti-androgen treatment is still important. Also Testosterone and DHT can be produced in the skin and blood tests would not show if too much of these hormones is being produced in the skin in some people.
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Who Should Not Take Doxycycline
You should not take doxycycline if you are allergic to tetracycline-class antibiotics.
Children under age 8, pregnant women, and breastfeeding women should not take doxycycline for acne.
It can cause permanent damage and changes to teeth in children or unborn babies.
Doxycycline can interact with numerous drugs.
If you take any of the following medicines or supplements, be sure to let your pharmacist or doctor know:
- Anticoagulants
Doxycycline is not only used for skin conditions.
It is a broad-spectrum antibiotic that is also used to address multiple types of infections.
It is widely prescribed for chlamydia or pelvic inflammatory disease caused by chlamydia, eyelid infections, bacterial respiratory illness, gastrointestinal infections, and malaria.
It is also prescribed by some physicians for preventing or treating Lyme disease, as well as other bacteria that may be transmitted by insect or animal bites.
How Soon After Treatment Will Hormonal Acne Go Away
Treating acne can be different for each individual, but patience is key. Generally, it could take up to four to six weeks to see improvement in your skin after you begin treatment. Even if you dont notice that the treatment is clearing your skin, it is recommended that you continue treatment to prevent new acne from forming.
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How Does Hormonal Acne Affect Women
For women, hormone levels fluctuate throughout their monthly cycle. Estrogen is what some dermatologists call “the happy skin hormone” – it helps the complexion stay young, clear, and firm. Balanced levels of estrogen typically mean glowing skin! However, this pesky hormone peaks during the second week of a woman’s cycle, during ovulation, and dips just before their period begins. During this dip, a progesterone surge happens, which causes many women to experience breakouts. Women in perimenopause or past menopause may also experience hormonal acne symptoms since estrogen tends to diminish with age.
Can Antibiotics Help Acne
The irony is this. Yes. Truthfully. Antibiotics can definitely help acne to go away.
And you still shouldnt take them. More about this soon.
First up, why do antibiotics help acne?
Whats their superpower?
Most people think antibiotics can help clear up acne because they kill acne bacteria.
Have you heard about acne bacteria?
Your skin has bazillions of bacteria living on it right now. Good and bad and some which even sit on the fence deciding which way to turn next.
Healthy skin has huge parties of good bacteria. These parties of good bacteria keep the bad bacteria locked away. They cant even attempt to bring the mood down because theres just too much happiness to be had.
Skin which is acting out, maybe like yours is right now well it has an unhealthy bacteria balance.
Dont worry we can help change this
Most people believe antibiotics can help kill off acne because they help kill off acne bacteria.
Which yes they absolutely definitely can when used at mega-high doses. However this is not their #1 mode of action.
They have other plans in the mix.
Plans which include taking down the pain and redness of your acne.
Because the #1 way antibiotics for acne really work is by being anti-inflammatory drugs.
Did you know this?
Antibiotics can also have super effective anti-inflammatory benefits.
And acne itself is defined as a chronic inflammatory skin condition. Chronic just means has been going on for a crazy long time.
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