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Case Studies In Hormonal Acne Management

By: Laura Cooksey
Posted: April 1, 2014, from the April 2014 issue of Skin Inc. magazine.
Case Studies In Hormonal Acne Management

page 7 of 9

Her testosterone levels were normal, but her didehydroepiandrosterone (DHEA) sulfate levels were high. Her doctor explained that DHEA is a precursor to testosterone, which explained the continuous acne and facial hair without any other symptoms of increased testosterone. Her doctor recommended going on spironolactone, which helps to block androgen receptors. It prevents cells from absorbing androgen hormones and limits hormonal fluctuations that can contribute to acne breakouts. At last report, she was still contemplating taking the spironolactone.


No. 3—Male marijuana-smoker

Smoking marijuana is known to raise and then lower testosterone levels. Skin often reacts to unnatural hormonal fluctuations. This client had been smoking marijuana for years and happened to find out that his testosterone levels were very low and was going to a naturopath for treatment. A pattern of acne is often seen in the chin/jaw area of older women with hormonal acne, and the lowered testosterone levels explain this pattern on this male client.


Treatment: weeks 1–2.

Mild 5% TCA/lactic peel—two layers.

Home care regimen.

Morning: BPO wash; salicylic toner; salicylic serum every other day (his skin was too sensitive for mandelic acid serum); sunscreen