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Hormonal Treatments for Acne
This article was Medically reviewed by
Hormone therapy may be helpful for some women with acne, especially for those with signs and symptoms of androgen (male hormone) excess, showing irregular periods or thinning hair. The hormone therapy consists of low-dose estrogen and progesterone (birth control pills) or anti-androgen medications (spironolactone). These treatments work by decreasing the amount of androgens, such as testosterone, in the body.
Hormonal treatment may be appropriate for women with cystic acne, and generally takes 3 to 6 months to work.
How do hormonal treatments work and for which people is it suitable?
Hormonal treatments are limited to those cases or patients that have biochemical markers of hyperandrogenism and are also used in treating very severe, resistant cases.
An accurate picture of the hormone-based response in a person’s body can help the doctor in pinpointing the main underlying causes of an acne outbreak and is helpful in designing an optimized, quick and more suitable treatment option for cystic acne. Outbreaks of acne that present with cysts, nodules or come on suddenly with widely
spread out lesions are usually suggestive of excessive levels of androgens in the patient. The possibility of a hormonal imbalance needs to be considered by your dermatologist even if you are a female that has a normal menstrual cycle period, especially if severe flare-ups occur before menstruation, and acne is not responding to conventional treatment.Severre
The European guidelines on acne treatment recommend the use of hormonal treatment options combined with a suitable supporting treatment option of topical or systemic antibiotics, especially in cases of very stubborn or severe acne. They are a suitable optional therapy to replace treatment using isotretinoin.
Hormonal treatment options can be offered together with other acne treatments, including topical or systematic antibiotics, benzoyl peroxide, azelaic acid as well as even combined therapy with retinoids. Discuss with your dermatologist whether a hormonal treatment is appropriate for your condition.
Which hormonal treatments are available?
The medications utilized in the hormonal treatment of severe acne belong to one of 4 main groups as shown below:
- Androgen receptor blockers.
- Oral contraceptives which suppress the manufacture of androgens in the ovaries.
- Glucocorticoids which suppress the manufacture of androgens.
- Enzyme inhibitors (in particular 5a-reductase inhibitors).
Estimated costs for commonly available products containing hormonal treatments for acne:
- Approximate cost of a 30-day supply of oral contraceptive pills: $9 to $35 [GoodRx_Ortho Tri-Cyclen].
- Approximate cost of 30 tablets of spironolactone: $3 to $12 [GoodRx_Spironolactone].
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