Hormonal acne in healthy women responds to a wide variety of treatments. By carefully studying the patient's medical history and conducting a physical examination and blood testing, a dermatologist will select the treatment best suited to the needs of the patient.



Treatment options include oral contraceptives, oral corticosteroids (anti-inflammatories), and anti-androgens.

Oral contraceptive pills contain estrogen-progestin combinations that have been specifically formulated to alter female hormone patterns. Since the combination of estrogens and progestin will alter the production of androgens, oral contraceptives at low dosages have been part of the dermatologist's arsenal for treatment of hormonal acne for many years. The Food and Drug Administration has even approved an oral contraceptive specifically for the treatment of mild to moderate breakouts. If a woman has no plans to become pregnant, oral contraceptives offer a convenient option that can be taken for extended periods of time to control hormonal acne. Side effects of low-dose oral contraceptives can include nausea, weight gain, menstrual spotting and breast tenderness. Only the woman involved can decide whether or not that's a trade-off she's willing to make.

Oral corticosteroids are anti-inflammatory drugs similar in structure to some of the substances produced by the adrenal glands. Prednisone and dexamethasone can be prescribed to suppress androgen production when a woman's adrenal glands are overactive in producing these male hormones. Oral corticosteroids have another useful effect in acne treatment they can also suppress inflammation in severe cases. Side effects of oral corticosteroids can include weight gain and bone thinning. All factors a woman must weigh carefully when making a decision about treatment. The third type of treatment, the anti-androgens, is a class of drugs that have a double action:

These drugs work on both the production and delivery mechanisms of male/female hormone imbalance. By reducing excess androgen available in the hair follicle, and cutting off production at its source, anti-androgens have powerful anti-acne effects. Anti-androgens used in the treatment of hormonal acne include spironolactone and, less commonly, flutamide. Side effects such as irregular periods and breast tenderness may be eased by taking the drug in combination with an oral contraceptive. A dermatologist can effectively treat hormonal acne in a healthy female. However, any underlying disease of ovaries, adrenals or pituitary, or diabetes, should be treated by an appropriate physician trained to deal with these conditions.

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