The most common hormonal therapy prescribed to treat acne are oral contraceptives, but clinicians need to consider other factors, such as age, before prescribing oral contraceptive agents to acne patients, according to the director of the Dermatology and Skin Care Center of Birmingham in Birmingham, Ala.
"We have a tendency as dermatologists to talk about acne that flares at certain times of the month as being hormonal, or acne that occurs in women as being hormonal, or acne that occurs on the lower part of the face as being hormonal," explains Julie Harper, M.D., who spoke at an acne guidelines workshop during the annual meeting of the American Academy of Dermatology (AAD).
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"All of that may be true, but, really, all acne is hormonal to a certain extent because androgens play a role, both by promoting plugging of the follicle, which is a crucial part of acne development, and in stimulating the sebaceous gland," she says.
Almost any woman can benefit from taking oral contraceptives, four of which are approved by the FDA for the treatment of acne, in terms of improving this chronic condition, Dr. Harper says.
Studies have not shown that any one particular oral contraceptive is better than another in treating acne, she notes.
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"All combinations of pills that combine estrogen and progestin appear to make acne better," she says.
In particular, a Cochrane meta-analysis found no consistent differences among oral contraceptives in decreasing acne.1