Acne affects most teenagers; the American Academy of Dermatology (AAD) says that up to 85 percent of people will suffer from acne during their lifetimes. However, some women continue to get pimples as adults. Their acne often is due to a hormonal imbalance. Fortunately, this type of acne responds both to conventional acne treatments and to treatment designed to balance the hormones, according to the AAD.
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Acne normally is caused by a combination of several interrelated factors, including overactive oil-producing glands (sebaceous glands) below the surface of the skin, bacterial infection and clogged pores. The sebaceous glands produce oil when they are stimulated by hormones known as androgens. If a woman has too high a level of androgens circulating in her bloodstream, these hormones can overstimulate the skin's sebaceous glands, causing them to produce too much oil. This leads to acne.
Hormone fluctuations often result in a mild breakout, especially during pregnancy or around the time of a woman's menstrual period, according to the Mayo Clinic. However, if a woman constantly has too much androgen hormone and not enough estrogen hormone, she might wind up with a severe acne breakout. This often occurs in polycystic ovary syndrome (PCOS), a disease in which the woman's hormones are seriously imbalanced. PCOS sufferers can have severe acne, facial hair growth in a male pattern, and abnormal or absent menstrual cycles, according to the National Institutes of Health.
Dermatologists often prescribe benzoyl peroxide and topical retinols (a form of vitamin A) to treat acne, including acne that's due to a hormonal imbalance. But women have another option to try: oral contraceptives. Birth control pills can help rebalance hormones, curb androgen production, and stop existing androgen from overstimulating the sebaceous glands.
Oral contraceptives work slowly to clear pimples and stop new acne lesions from forming. According to the AAD, patients shouldn't expect results until they've taken birth control pills for three months or more. In addition, acne can appear worse before it starts to clear. That's why many dermatologists who prescribe oral contraceptives for acne consider it a long-term treatment that likely will last a year or more.
Dermatologists generally prefer to try other treatments for acne first before prescribing birth control pills. In addition, the Mayo Clinic warns that oral contraceptives may cause side effects, including weight gain, nausea, breast tenderness, headaches and depression. Oral contraceptives generally are not prescribed for women who are over 35, who smoke, or who have a history of migraine headaches or high blood pressure.