Treatments for Hormonally Influenced Acne

For some female patients, treatment-resistant acne is caused by excessive production of hormones called androgens. Clues that help the doctor diagnose hormonally influenced acne are adult-onset acne, hirsutism (excessive growth of hair or hair in unusual places), premenstrual acne flares, irregular menstrual cycles, and elevated blood levels of certain androgens.

The doctor may prescribe one of several drugs to treat women with this type of acne. Low-dose estrogen birth control pills help suppress the androgen produced by the ovaries. Low-dose corticosteroid drugs, such as prednisone or dexamethasone, may have an anti-inflammatory effect and suppress the androgen produced by the adrenal glands. Finally, the doctor may prescribe an antiandrogen drug, such as spironolactone, which helps prevent androgens from causing excessive oil production. Spironolactone also stops androgen production in the ovaries and adrenal glands. Side effects of antiandrogen drugs may include menstrual irregularities, breast tenderness, headache, and fatigue.

Reprinted from The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)

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