Some facts about women and acne
- As a general rule, women's hormones tend to fluctuate more than men, which helps explain why acne in women tends to be less constant and more erratic than acne in men.
- More than half of adult women experience at least occasional breakouts.
- 60-70% of women who battle with acne experience premenstrual flare-ups.
- Acne can occur throughout a woman's adult life, in early adulthood, in the late twenties and thirties (which I have personally seen quite a bit), during pregnancy, and during menopause.
- Hormonal acne can be frustrating, but can be effectively treated.
Hormonal acne influences
Premenstrual acne flare-ups may be caused by over-stimulated androgens (male hormones). These hormones stimulate oil glands in the skin. During the pre-menstrual period, a woman's oil-producing glands can go into overdrive. Women may also see acne throughout their entire monthly cycle, the cause of which we still do not fully understand.
When pregnant women experience an acne flare-up, it is typically early in their pregnancy. Later in the pregnancy, the skin will often clear up. Acne can then flare again a few months after giving birth. Why? Again, we are not certain, but we suspect this is due to a change in hormones. As a general rule, any time we see hormones fluctuate in any direction, acne can pop up. During pregnancy in particular, it is extremely important for the expectant mother to speak closely with her doctor regarding appropriate and safe
Women experiencing menopause or post-menopause may also experience hormonal acne. Why? You guessed it. We suspect this is due to hormonal fluctuations that occur at this time in a woman's life.
Treatment options
For many women, the right topical medications can keep acne at bay. However, for women who have found that topical medications have not been helpful, there are still options available. After consulting with a physician, many women may turn to birth control pills. As an acne treatment, certain birth control pills, when used in low dosages, can decrease the amount of androgens, thereby limiting breakouts. However, just like after pregnancy, when a woman stops taking birth control pills, her acne can flare. Before deciding on this type of treatment, women should be aware of the side effects associated with birth control pills and consult a gynecologist. Another more recent prescription option for women is . Spironolactone is a potassium-sparing diuretic which can be used as an androgen-receptor blocker to treat acne in women. By suppressing the androgens, it helps to reduce sebum production.
In my experience, men and women do not differ much in terms of effective acne treatments, and appropriate application of topical treatment is often the best option. I have personally coached many people, male and female, through the with equal success.
References
A. Goodfellow, J. Alaghband-Zadeh, G. Carter, J.J. Cream, S. Holland, J. Scully, P. Wise (1984) Oral spironolactone improves acne vulgaris and reduces sebum excretion. British Journal of Dermatology 111 (2), 209-214 doi:10.111/j.1365-2133.1984.tb04045.x
Fulton, James E. Acne Rx. James E. Fulton Jr., M.D., PhD: 2001. 107-115.
Preston, Lydia. "Breaking Out" A Woman's Guide to Coping with Acne at Any Age. Fireside 2004.
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