Hormones are chemicals produced by our bodies that help with normal body function. There are many different types of hormones that produce a variety of important effects. Androgens are a group of hormones that are important for growth and development of our bodies. Males rely on high levels of androgens, such as testosterone, for normal body development, including the growth of facial hair, muscle mass and other masculine features. Females have androgens too, but at lower levels than males. Women have other female hormones, such as estrogen and progesterone that control a variety of female functions such as the menstrual cycle and pregnancy.
Hormonal acne treatment focuses on the production of androgens by our bodies that stimulates the sebaceous (oil) glands in the skin. Some people are very sensitive to androgens resulting in the sebaceous glands producing too much sebum. This is how acne begins and is the target when treating hormonal acne. (See our Understanding Acne page.) Since males have more androgens than females, acne tends to be worse in boys than in girls. Also, since sebaceous glands are concentrated in the skin of the face, back and chest, these are the areas affected most by androgens and acne.
Since our bodies begin to produce higher amounts of androgens at puberty, acne is usually at its worst in teenagers. As we reach our 20s, androgen production begins to decrease, causing a related decrease in acne breakouts. In some conditions, such as polycystic ovarian syndrome, abnormal hormone production causes acne breakouts to continue into adulthood. In fact, acne may be a sign of an internal condition associated with abnormal hormone production, prompting further medical evaluation before therapy for hormonal acne is prescribed.
By altering hormone levels, birth control pills can be a very effective hormonal acne treatment in women. Another therapy for hormonal acne that is used at the Advanced Acne Institute is spironolactone which works by blocking the hormones that cause oil glands to become overactive. Spironolactone can be a very effective treatment for controlling hormonal acne breakouts in women, especially those who experience significant breakouts associated with their menstrual cycles or who have persistent acne around the lower face and jaws.