Acne has a variety of causes, but some women may notice that, like clockwork, they begin to break out right before they begin their period. According to the Archives of Dermatology, around 63% of acne-prone women experience premenstrual acne flare-ups. These types of breakouts also tend to manifest along the chin or jawline in adult women. While some women may just get the occasional pimple, others may get several painful cystic lesions every month. Because this type of acne can’t simply be treated by keeping the pores clean, hormonal acne can be a pain to get rid of. Here we’ll explain how hormones cause acne and go over a few prescription treatments that have worked to keep many women acne-free, no matter the time of month.
How Hormones Cause Acne
Throughout a woman’s menstrual cycle, different hormone levels fluctuate in order to make ovulation and pregnancy possible. At the beginning of a cycle, estrogen levels are high. Around mid-cycle, progesterone levels rise and become dominant causing the skin to swell and pores to shrink. Mid-cycle, the skin may look great. However as the cycle progresses, progesterone may cause sebum production to increase. Sebum is the oily substance produced by the skin. Then, when menstruation begins, estrogen and progesterone levels drop, allowing testosterone to dominate. Testosterone further stimulates sebum production. This combination of tighter pores followed by higher sebum production is a recipe for disaster. Keeping the skin clean can help, but for most women, this isn’t going to solve the problem.
Prescription Acne Treatments
Birth Control Pills
Birth control pills raise estrogen levels, which helps to keep testosterone down. They also help regulate reproductive hormones throughout the cycle so there aren’t as many ups and downs. Some birth control pills that have been known to help women control acne include Ortho Tri-Cyclen and Yaz.
Spironolactone
If birth control pills don’t help control hormonal acne, a second step is to try spironolactone. Spironolactone is an antiandrogen drug that is also used to treat high blood pressure and heart failure due to its diuretic effect. Androgens are male hormones, such as testosterone and dihydrotestosterone. Spironolactone reduces the production of testosterone and also blocks androgen receptors. By reducing testosterone levels, less sebum is produced during the end of the menstrual cycle.
Isotretinoin
The more commonly known name for isotretinoin is Accutane. Though the brand Accutane is no longer on the market, there are other off-brands such as Claravis and Myorisan. Isotretinoin is similar to retinoic acid, a natural derivative of vitamin A. As benign as that sounds, the treatment is somewhat drastic and requires monitoring of the liver as well as the signing of documentation by the patient that says she will use contraception during the treatment period due to the possibility of serious birth defects. Isotretinoin has been a successful treatment for many long-time sufferers of various types of acne. While this medication is expensive (around $800 for a month’s supply), it has been a long-term solution for many. HelpRx can help patients save as much as 75% off the retail price of most forms of isotretinoin.
