Hormonal treatments for acne
Hormonal acne is a very common condition affecting over 20% of Australian adult women. This form of acne usually varies with the period cycle, and presents as deep lumps, cysts & blind ending pimples. Hormonal acne can be very distressing, & often resistant to over the counter washes & creams. Early & effective management prevents acne scarring.

How do I know if I have hormonal acne?
Hormonal acne often begins in the 20s and may continue into the 30s & beyond. The location of pimples can be a clue to whether you have hormonal acne. Unlike teenager acne, the skin at the jaw line & chin area are more often affected. This may extend to the lower face and neck.

Affected skin areas are sensitive and easily irritated by topical agents. Many patients did not have acne as a teenager.

What causes hormonal acne?
Hormonal acne is thought to result from the interplay of a number of factors. One or several of these factors may cause hormonal acne in any particular patient. It is important that your dermatologist takes a thorough history from you to establish likely contributing factors. Factors that may contribute to hormonal acne include:

Hormones, such as progesterones, oestrogens & testosterone – in most cases, levels of these hormones are normal but your doctor may test for them if you have other symptoms
Other hormones such as insulin
Stress or illness
Comedogenic & oily skin care products, make-ups & some sunscreens
Hormonal & metabolic disorders such as polycystic ovarian syndrome (PCOS) and diabetes and rarely, some types of cancers
Obesity
Oral contraceptives – many contraceptive pills help acne but progestogen only pills can worsen it, the same goes for Implenon.
Dietary factors play a significant role in some.

What is the science behind spironolactone?
Spironolactone is an anti-male hormone (anti-androgen) medication. It blocks the male hormone receptor and reduces the level of the male hormones, testosterone and DHEAS. This tablet was first used as a diuretic (“fluid tablet”) effect and increases urine production. This medication lowers blood pressure and reduces fluid retention.

Spironolactone is an oral medication & not a cream because androgens (the target for spironolactone) is found circulating in the bloodstream.

Hormonal acne can often respond to the same treatments used to treat teenage acne. This includes various topical cream & gel treatments for very mild cases, however in most patients other treatment modalities are indicated -see below.

A range of topical creams and gels often containing multiple ingredients including antibiotics, “retinoids” (vitamin A compounds) & benzoyl peroxide are usually a good start to treatment. Sometimes, your doctor may also prescribe an oral antibiotic as well. These treatments usually require a tailored approach to each patient.

My clinic: @Cutis_dermatology on Instagram

Website: www.cutis.com.au

Instagram: @drdavinlim @101.skin

Intro: (0:00)
The main treatment option - Spironolactone: (0:09)
Dealing with Hormonal Acne: (1:05)
Skincare pairings: (2:00)
Treating female pattern hair loss: (2:58)
Side effects/warnings: (4:12)

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