Hormone therapy in the treatment of acne in women

The article was professionally consulted with Specialist Doctor I Nguyen Thanh Van - Doctor of Internal Medicine - Dermatology - Department of Medical Examination & Internal Medicine - Vinmec Phu Quoc International General Hospital.

Do you get repeated breakouts on your lower face, along your jawline and neck despite trying all sorts of acne treatments? Have you ever taken antibiotics to treat acne and were disappointed with the results? Are you struggling to get rid of acne on your chest or back?

Endocrine acne is a condition in which many acnes appear on the forehead, lower face, neck, jawbone ... due to abnormal changes in hormone levels in the body, notably hormone changes in age. puberty .
In women, hormonal acne often occurs during the menstrual cycle and perimenopause or menopause, in addition, polycystic ovary syndrome, which leads to an excessive increase in male hormone androgen levels, is also a cause. causes hormonal acne in women. An estimated 50% of women between the ages of 20 and 29 experience hormonal acne.

Any medicine that affects hormones is called hormone therapy. The two hormone therapies that can clear up acne most effectively in women are:
Daily Pironolactone: A potassium-sparing diuretic.

Many studies have shown the effectiveness of oral contraceptives to treat acne, blackheads, whiteheads or inflammatory acne
In fact, some birth control pills have been approved by the Food Administration and the US Food and Drug Administration (FDA) approved as one of the remedies to treat acne. This is considered a safe method for most women, but it is also contraindicated for some subjects. Therefore, if you want to apply this method, the best way is to consult and treat under the guidance of a doctor.

Spironolactone is not indicated for the treatment of acne in men due to side effects such as breast enlargement. However, this is one of the most commonly applied and highly effective therapies in the treatment of acne and hirsutism in women.
Using both spironolactone and oral contraceptives together can increase the effectiveness of acne treatment. Another advantage of combining the two therapies is related to the side effects of spironolactone. Spironolactone is contraindicated for use in pregnant women because of the potential for serious birth defects in the newborn. Therefore, combined use with oral contraceptives is a reasonable choice.
Spironolactone can also be used without combined with oral contraceptives. If the age of a woman receiving this therapy is 35 years or older, birth control pills may not be necessary. In addition, using spironolactone without oral contraceptives is also recommended by doctors in case the patient has some other medical conditions such as blood clots (blood clots) or stroke.

When used alone, spironolactone is still highly effective. Looking at the medical records of 85 women treated with spironolactone, the researchers found that one-third of these women had completely cleared their acne, one-third had a marked reduction in acne, and only 7%. Some women do not improve their acne. Other studies have also shown that spironolactone has the potential to reduce acne by 50 to 100%.
It is important to know before using this therapy that spironolactone is a diuretic, so you will urinate more during treatment. However, this is usually not a big deal.
Because spironolactone is a potassium-sparing diuretic, it is important to be cautious of dangerous hyperkalemia and limit the use of foods or supplements containing potassium during treatment with spironolactone.

The first thing to keep in mind is that the drugs used in hormone therapy need the direction of the doctor and the patient's patience during the treatment.
After examining the condition of the acne and collecting some necessary information about the patient's health problems, the doctor will diagnose and give the appropriate treatment and decide whether to use the treatment. hormone therapy or not. The doctor will also explore some of the health problems that the patient is suffering from such as:
High blood pressure, cardiovascular disease, blood clots, migraine, cancer Drugs or supplements are being used. type of surgery the patient has undergone. Family history of a parent or sibling with cancer, kidney disease, or cardiovascular disease. In addition, patients are also checked blood pressure, blood tests and some other necessary tests to evaluate before treatment.
During hormone therapy treatment, you also need to regularly schedule appointments and monitor the situation with a dermatologist. Unlike oral contraceptives, spironolactone therapy requires a gradual increase in the dose, so patients will need to see a dermatologist four to six weeks after starting the medication.

Like other acne treatments, hormone therapy also takes a while to see results. On average, the treatment effect will appear as follows:
Contraceptive therapy : after 2-3 months spironolactone therapy : acne and seborrhea will improve after a few weeks. Hormone therapy can last for a long time and doesn't need to be combined with other acne treatments.

Depending on the hormone therapy used, their side effects also vary.

Birth control pills increase the risk of:
Blood clots Angina Raised blood pressure However these side effects are less common in healthy women. In fact, the risk of blood clots forming during pregnancy and immediately after childbirth is higher than with the use of oral contraceptives.
In addition, using oral contraceptives can also lead to melasma, darkening of the skin. Avoid sun exposure to reduce this risk.
Another side effect is vaginal bleeding, which can be minimized if you take the pill at the same time every day.

With spironolactone therapy without the addition of oral contraceptives, some common side effects can be experienced such as:
Muscle aches, cramps Irregular menstrual cycle Breast tenderness and enlargement These effects can be reduced when using a combination of both therapies.
Some other side effects that can also be experienced with spironolactone include fatigue, headache, and dizziness.
An animal study showed an increased risk of breast cancer in animals given very high doses of spironolactone. However, there is still no evidence to prove this happens in humans or not.
A study with 1485 patients taking spironolactone and followed for a period of 3 to 7 years only 9 cases of breast cancer were detected. This rate is not different from the rate of breast cancer in the community, so spironolactone does not appear to increase the risk of breast cancer in humans. Other studies have also come to similar conclusions.
Hormone therapy to treat acne is becoming more and more popular because of the effects they bring. To get the best results from hormone therapy, the patient needs to be patient, pay attention to take the medication regularly at the same time each day, follow the doctor's instructions on the treatment of acne. Tell your doctor right away if you experience any side effects. Hormone therapy is an option for many women with acne, but it's not the only option. Your dermatologist will choose the best treatment for you.

Vinmec International General Hospital is one of the hospitals that not only ensures professional quality with a team of leading doctors, modern equipment and technology, but also stands out for its examination and consulting services. and comprehensive, professional medical treatment; civilized, polite, safe and sterile medical examination and treatment space.

Articles refer to the source: aad.org, NCBI