In my last post, I started to unpack hormonal acne, which can plague women well into their 40s, and, in some cases, even beyond then. Here, I’ll talk about a spectrum of strategies for combatting it. While there’s no cure for hormonal acne, there are a number of treatments that can significantly diminish it.
As with all other forms of acne, the best place to start your treatment is with a good over-the-counter cleanser. Look for one that contains glycolic, lactic, or salicylic acids. They help exfoliate the skin by unclogging pores with varying degrees of intensity. Finding the right fit may require some experimentation.
If you’re reading this, there’s a good chance you’ve already tried over-the-counter treatments to no avail. In which case, you may need to seek the help of a board-certified dermatologist.
Most dermatologists will consider topical retinoids as the first step in treating mild to moderate acne, particularly when it’s hormonal. That’s because retinoids help your skin slough off dead skin cells at a more normal rate so the dead skin cells don’t bind together and clog your pores.
That they prevent new acne from forming and have minimal severe side effects also makes them a sensible long-term solution.
That said, prescription retinoids can cause a pretty significant reaction when you first start them. Think dry, reddened, flaky, painful skin. So it’s critical that you follow your dermatologist’s instructions to the letter. They’ll most likely suggest using it just a few times a week to start. If you have especially sensitive skin or a skin condition, retinoids may trigger even more breakouts. You should also avoid them if you’re pregnant.
Oral contraceptives can be effective at clearing acne in women because they’re a form of hormonal therapy. In fact, a few, like Ortho Tri-Cyclen10 and YAZ11, are approved by the Food and Drug Administration for the treatment of hormonal acne.
Antiandrogen drugs work by blocking androgen receptors to decrease the actions and effects of testosterone in the body (yes, women have testosterone, too), which can cause hormonal acne. At low doses, they can improve cystic acne and decrease overall oil production in the skin.
Isotretinoin is a form of oral vitamin A (which means it’s similar to a retinoid, but it’s taken orally) that reduces the amount of oil released by oil glands in your skin. While it’s proven to be effective in the treatment of severe acne and moderate acne that’s causing scarring, it’s a strong treatment with potentially serious side effects. If you’re pregnant or planning to become pregnant in the immediate future, isotretinoin isn’t for you.
Frustrated as you may be, remember that there is a solution to your hormonal acne. It’s just a matter of finding the right treatment, or combination of treatments, which a dermatologist can help you with.