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Research presented at the American Academy of Dermatology's summer meeting showcases how hormonal therapy can be used to treat acne in women older than 20.
Although acne traditionally has been considered a disease of teenagers, it is also extremely common in adult women. Studies show that acne affects more than 50% of women between the ages of 20–29 and more than 25% of women between the ages of 40–49*. In fact, after age 20, women are far more likely to report having acne than men.
While there is no cure for acne, dermatologists are finding that hormonal therapies can help some women fight bothersome acne that occurs in adulthood. At the American Academy of Dermatology’s Summer Academy Meeting 2009 in Boston, dermatologist Bethanee J. Schlosser, MD, PhD, FAAD, assistant professor of dermatology and director of the Women’s Skin Health Program at Northwestern University Feinberg School of Medicine in Chicago, discussed the most widely used hormonal therapies available for women with acne and the best candidates for this type of treatment.
Factors that contribute to the formation of acne include excess oil gland production, skin inflammation, abnormal maturation of skin cells lining the hair follicle and an increased number of the acne-causing bacteria Propionibacterium acnes. However, hormones also influence both oil gland production and the maturation of skin cells thereby contributing to the formation of acne lesions. For example, when androgens (the male hormones present in both men and women) overstimulate, the oil glands and hair follicles in the skin, hormonal acne flares can occur.
“Women over the age of 20 may experience worsening of their acne or a change in the nature of their acne. This can include increased lesions on the lower one-third of the face (including the jaw line and upper neck), premenstrual flares, and resistance to oral antibiotics and other traditional acne therapies,” said Dr. Schlosser. “For these women, hormonal therapy in the form of combination oral contraceptives and/or antiandrogen medications, such as spironolactone, flutamide and dutasteride that work by reducing the activity of the male hormone testosterone, may provide significant benefit.”