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.
Dermatologist Diane Thiboutot, MD, associate professor of
medicine at the Milton S. Hershey Medical Center, Hershey, Pa.,
proposes to clarify acne 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 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. You can forgo the
androgen blocking hormones by properly consuming essential fatty
acids such as those found in salmon and olive oil. 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. The birth control pill is a centerpiece of hormonal
therapy, albeit a bemoaned option. The medications most
successfully employed in controlling acne contain a hormone
called progestin with low androgenic activity (with generic
pharmaceutical names such as norgestimate or desogestrel)
combined with 35 micrograms of ethinyl estradiol, an estrogen.
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,”
Polycystic Ovary Disease Acne may also be an indicator of
polycystic ovary disease, a hormonal imbalanced characterized by
irregular menstruation, obesity, infertility, acne and hair
growth on the face, chest, and back (hirsutism). Like acne,
polycystic ovary disease is caused by an imbalance in androgen
hormones. Dermatologists should work closely with the young
patient’s gynecologist to reduce the risks of infertility,
cardiovascular disease and insulin-resistant diabetes.
Identifying polycystic ovary disease is an important
contribution to the long-term health of these young patients,
not to mention adults as well. Dr. Thiboutot concludes that,
“Hormonal therapy is a good treatment for many teenage and adult
women,” and. “It is used less often than it could be because
there are so many options to choose from. The patient should
realize it is a good adjunct therapy.” However, I strongly
disagree with Dr. Thiboutot, hormones are immensely complex. Use
of hormone therapy is riddled with enigmas. There are several
well-written books available to help you can control of your
hormones and acne condition without encountering the risks of
hormone therapy. I’m listed some of my favorites below:
Reading Recommendations: Androgen Disorders in Women: The Most
Neglected Hormone Problem by Theresa Cheung Hormone Deception:
How Everyday Foods and Products Are Disrupting Your
Hormones–and How to Protect Yourself and Your Family by D.
Lindsey Berkson PCOS: The Hidden Epidemic by Samuel S. Thatcher
M.D. Ph.D. It’s My Ovaries, Stupid! by Elizabeth Lee Vliet
Hormonal Chaos: The Scientific and Social Origins of the
Environmental Endocrine Hypothesis by Sheldon Krimsky