Most teenagers get pimples; in fact, the American Academy of Dermatology (AAD) estimates that nearly nine out of 10 people will have acne at some point. But for some women, high levels of androgen hormones circulating in their bodies cause more severe acne. Fortunately, these women have treatment options that will help them clear up their acne, the AAD says.
Significance
Several interrelated factors cause acne, including bacterial overgrowth, inflammation and too much oil production in the sebaceous glands below the skin's surface. Androgen hormones normally stimulate the sebaceous glands to make the right amount of sebum to keep the skin from becoming dry. But in acne that's caused by too much circulating androgen hormone, the androgens overstimulate the sebaceous glands, which then produce too much sebum. The excess sebum clogs pores and causes pimples.
Function
Women who have polycystic ovary syndrome (PCOS), the most common hormonal disorder among women of childbearing age, have too much circulating androgen in their bodies. One of the main symptoms of PCOS is bad acne, but the condition causes other symptoms as well, including obesity, irregular or prolonged menstrual periods and unusual hair growth on the face and chin.
Types
Not everyone who has hormonally driven acne also has PCOS. According to a 2002 article in the medical journal Skin & Aging, many women with acne also have abnormal androgen levels but do not have PCOS. The article also reports that some women have normal androgen levels and normal menstrual periods but still suffer from acne. In these women, sebaceous glands that are hypersensitive to even normal levels of androgens appear to cause acne.
Effects
According to the AAD, virtually every case of acne can be treated. In the case of acne that's driven by androgen levels, oral contraceptives offer a long-term treatment for the problem. In a study published in 2009, researchers concluded that birth control pills containing estrogen and progestin can effectively treat acne. Two pills, Ortho Tri-Cyclen and Estrostep, have received U.S. Food and Drug Administration approval specifically for acne treatment, but dermatologists often prescribe other brands of birth control pills as well.
Considerations
Still, oral contraceptives likely won't be your dermatologist's first choice of treatment for acne, even if the doctor believes it is driven by androgen levels. Oral contraceptives only slow sebum production and don't affect bacteria levels and inflammation. Because of this, dermatologists generally will try other treatments, including benzoyl peroxide and topical retinoids, before prescribing birth control pills for acne.
