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Hormone Therapy for Women with
Acne
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by: Naweko San-Joyz
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More frequently women
are combating acne and wrinkles simultaneously. It’s a hideous
fight wrought with mysterious hormone signals and an even more baffling
search for a cure.
Acne does not go away with age
Dr. Alan R. Shalita, who co-authored "The Effect of the Menstrual Cycle
on Acne," found that contrary to the adage that, “You’ll
grow out of acne”, premenstrual acne only seems to get worse with
age. This study examined a group of 400 women ages 12 to 52. The
investigators observed that 53 percent of women over age 33 experienced
a higher rate of premenstrual acne than women under age 20-- who only
reported a 39 percent increase in premenstrual acne.
Dermatologist Diane Thiboutot, MD, associate professor of medicine at
the Milton S. Hershey Medical Center , Hershey , Pa. , proposes to
clarify acne treatment options for women. Dr. Thiboutot explains that
control of acne is an ongoing process and that all acne treatments work
by preventing new acne. While most women suffering from adult acne seek
standard treatments such as topical preparations or antibiotics, 60
percent of these femmes either do not respond to standard acne
treatments or build up a tolerance to frequently prescribed medications
such as antibiotics.
Causes of Adult Acne
It is not yet known exactly what causes adult acne, but several
dermatologist like Dr. Alan R. Shalita, link adult acne to hormone
fluctuations. Acne in a woman is often linked to her menstrual cycle.
Women with premenstrual acne outbreaks, such as pimples on the lower
face and neck, seem to respond particularly well to treatment with
medications that either reduce or block androgen production. Androgen
hormones create male traits in women such as a deepening of the voice,
an increased libido or hirsutism that causes excessive or abnormal
growth of hair. They also stimulate the oil glands. The oil mixes with
skin cells and bacteria, causing inflammation in the skin that can
result in the arrival of zits.
What to Know Before Your Begin Hormone Therapy for Acne
Polycystic Ovary Syndrome
Before you begin a hormone treatment for acne, you should confirm that
you are not suffering from polycystic ovary syndrome, or PCOS.
According to the American Academy of Dermatology, worldwide, about 15%
of the women of reproductive age have PCOS. Polycystic ovary syndrome
is a hormonal imbalanced characterized by irregular menstruation,
obesity, infertility, acne and hair growth on the face, chest, and back
(hirsutism). Like acne, PCOS is caused by an imbalance in androgen
hormones. Dermatologists should work closely with your gynecologist to
reduce the risks of infertility, cardiovascular disease and
insulin-resistant diabetes.
Before your dermatologist prescribes hormone therapy, she may perform a
standard screening that includes two hormones - testosterone and DHEAS
(dehydroepiandrosterone sulfate). It is important that you stop taking
oral contraceptives for at least one month before any tests are
performed because birth control pills can suppress androgens.
Acne Hormone Treatment Options
Dr. Diane Berson, MD, a clinical Assistant Professor at the Department
of Dermatology, New York University , New York states that once a woman
is diagnosed with hormonal acne, treatment options include oral
contraceptive pills, corticosteroids and spironolactone. These
treatments act by decreasing sebum production.
Oral Contraceptive Pill
The oral contraceptive pill, OCP, is the keystone of hormonal therapy.
The OCPs most successfully employed in controlling acne contain a
hormone called progestin, which has low androgenic activity, combined
with 35 micrograms of ethinyl estradiol, an estrogen. You can find
generic forms of this pill under names such as norgestimate or
desogestrel.
Oral Corticosteroids
Oral corticosteroids, such as prednisone and dexamethasone may help
improve acne by decreasing androgen production in the adrenal gland.
Oral Spironolactone
Oral spironolactone is a steroidal antiandrogen that prevents excessive
oil production by blocking androgen receptors. Additionally,
spironolactone decreases androgen production in both the ovaries and
adrenal glands, resulting in fewer acne flare-ups. Doctors usually
prescribe oral contraceptives with spironolactone to reduce
spironolactone’s side effects of breast tenderness and menstrual
irregularities.
Risk Factors with Hormone Therapy
Dr. Thiboutot counsels, "As with any therapy, there are risks and
rewards. The risks of hormonal therapy require regular breast and
pelvic exams to guard against the increased risk of certain types of
cancers. It is vitally important that dermatologists work with the
patient's gynecologist to determine the most appropriate treatment and
follow-up especially in women over the age of 40 or those who might be
smokers".
About the author:
Health author and Stanford University graduate Naweko San-Joyz lovingly
writes from her home in San Diego. Her works include “Acne
Messages: Crack the code of your zits and say goodbye to acne”
(ISBN: 0974912204) and the upcoming work “Skinny Fat Chicks, Why
we’re still not getting this dieting thing” (ISBN:
0974912212) for release in June of 2005. For useful acne self-help
articles visit http://www.Noixia.com
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