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If adult acne is linked to hormone fluctuations, then acne in women are linked to their menstrual cycle. Women who experience pre-menstrual acne eruptions, like zits on their face and neck, react fairly well to acne medications that decrease or inhibit androgen production. The Fight Against Androgens Acne is believed to be formed through the action of male hormones called androgens on sebaceous glands which grow larger during pubescent years and reacts sensitively to stimulus. This triggers excessive sebum production and clogging of pores which, in turn, forms comedonal acne made up of blackheads and whiteheads. While the P. acnes bacteria spreads, the oilclogged pores becomes inflamed and manifest themselves in the form of pimples, papules and pustules. Hormonal therapy for acne is designed to break up the breeding stage of this snowballing sequence of acne bacteria infestation. Hormonal treatment includes taking birth control pills and a non-contraceptive steroid called spironolactone. Hormonal therapy involving anti-androgens can be used in combination with oral contraceptives when the pill isn't strong enough to manage the acne or, apart from acne, if you have excess androgen and display secondary male sex characteristics like thinning scalp hair, hirsutism or deeper voice. Androgen hormones impart male characteristics in females such as a deeper voice, increased sexual urge or an abnormally excessive growth of body hair. Androgens also stimulate the sebaceous glands to release more oil. The excess oil feeds the P. acnes bacteria and blocks the pores, causing the pores to swell and give birth to acne. The 3 Hormonal Therapy Options If you are a woman suffering from hormonal acne, your treatment choices can include oral birth control pills, corticosteroids and spironolactone. All of these treatments work by reducing oil secretion and inhibiting androgen production. Along with their advantages, they also have side effects to be concerned about. 1. Birth Control Pill The birth control pill, best known as the pill, is the central building block of hormonal therapy. The pills most effectively used in fighting acne contain progestin, a hormone with low masculinizing action, and 35 mcg of ethinyl estradiol, an estrogen. Generic versions of this pill are marketed


under the names desogestrel or norgestimate. 2. Corticosteroids Oral corticosteroids have been found to be effective in improving acne conditions by inhibiting the adrenal gland's androgen production. Prednisone and dexamethasone belong to the corticosteroids group. 3. Spironolactone Spironolactone is a man-made steroid and anti-androgen that blocks excessive sebum production by disabling androgen receptors and, in effect, preventing them from adhering to receptor cells. Furthermore, spironolactone steps down androgen output in the ovaries and adrenal glands, which leads to fewer acne outbreaks. Doctors commonly recommend birth control pills combined with spironolactone to minimize the discomfort of spironolactone's side effects such as breast soreness and menstrual abnormalities. Minimizing the Side Effects Hormonal therapy is often used in tandem with the Pill or the Mini-Pill. This is because there might be a chance that unborn children would be subjected to undue teratogenic effects of anti-androgen drugs. Other effects of extra androgen include: •Overproduction of hair in the chest and other regions of the body (formation of extramasculine features in women) •Balding in men and women Unfortunately, both men and women are exposed to these risks once free androgen manifests itself.

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