High levels of androgens in the body can sometimes cause acne. Androgens, more commonly known as male hormones, stimulate the production of an oily substance by the sebaceous glands of the skin. This oily substance traps dirt and dead skin cells in the pores, allowing bacteria to flourish. Some physicians prescribe anti-androgens to reduce the appearance of acne blemishes.
Spironolactone blocks androgen hormone receptors in the body. This slows production of oil in the sebaceous glands. The drug also blocks the production of excess androgens, which controls hormonal acne breakouts. Side effects of spironolactone include vomiting, dizziness, headache, stomach cramps, diarrhea, increased body hair growth, fatigue, irregular menstrual periods, deepening of the voice, restlessness and enlarged or painful breasts, according to MedlinePlus. People with kidney or liver disease should use caution when taking spironolactone.
Cyproterone acetate blocks the androgen receptors in the cells of the sebaceous glands. The website DermNet NZ describes this drug as a powerful anti-androgen that women take during days one to 10 of the menstrual cycle. This drug reduces the amount of oil produced by the sebaceous glands and reduces the formation of blackheads and whiteheads. This drug also treats excessive hair growth in women, female pattern hair loss and testosterone-sensitive cancers. Side effects of cyproterone acetate include swelling of the breasts, increased sexual desire, loss of sexual ability and unexpected milk flow from the breasts.
Flutamide inhibits the binding of androgens in target tissues. Typically used to treat androgen-sensitive prostate cancer, flutamide also has some use in treating acne. One of the most severe side effects associated with flutamide use is liver damage. The DailyMed website reports that those who take flutamide should have liver function tests before treatment and monthly during the first four months of treatment. Other side effects include high blood pressure, skin irritation, gastrointestinal disturbances, drowsiness, confusion and anxiety.
Some oral contraceptives have anti-androgen properties that make them useful in the treatment of acne. The Women’s Health Resource website says that contraceptives used to treat acne have higher amounts of estrogen than other birth control pills. Examples of oral contraceptives that reduce the appearance of acne include Ortho Tri-Cyclen, Modicon, Ortho Evra and Necon. Because oral contraceptives increase the risk of blood clots, women who smoke and women over the age of 35 should use caution when taking these drugs. Other oral contraceptive side effects include irregular menstrual bleeding, mood changes, dizziness, headaches, breast tenderness and nausea.