This recent interview was about acne relating to Polycystic Ovarian Syndrome.

(PCOS Interview)

Many of our patients in this practice have PCOS.

“Hormonal Acne”

The idea of “Hormonal Acne” is a newer misconception that has spread quickly among physicians and female patients alike.

When encountering severe acne, there is always the thought of hormonal alterations causing such a breakout. The differential diagnosis includes increased androgen secretion from benign growths, malignant tumors, and hyperactive glands. Fortunately, there are accurate blood tests and imaging studies that can detect such hormone imbalances. If still questioned, the tests can be repeated at a later time.

Real hormone issues combined with the widespread knowledge that oil glands respond to androgens in general, has many patients and doctors believing they are treating a “newly discovered” variant of acne called “Hormonal Acne”, which has normal bloodwork but distict acne characteristics and locations. This line of reasoning has since been solidified by the fact that hormone altering medications have been shown to help some cases of acne in varying degrees.

**Before I make a point about this emotional subject, I’d like to refer to the video gallery and note that the vast majority of the female patients in the gallery had worsening symptoms with menstrual periods.  Afterwards, they completely cleared up and stayed clear without any direct or indirect hormonal treatments.

Question:

If all women have SIGNIFICANT hormone fluctuations before and during their menstral periods, why do only some women have monthly breakouts….???

The answer is because some people are in a State of Acne Proneness while others are not. The hormones are better viewed as “gasoline” poured on a “fire” The acne prone skin itself is the fire and should remain the focus of treatment if all hormone levels prove normal in a simple blood test.

Bottom line: While Hormonal treatments have been used with varying success in this battle, Acne is still simply just “Acne”   (Just like it was in the 60’s……)

This post may be off-putting to some people……  Here’s why:

I’ve observed that women over 25 with chronic acne find it easier to accept their condition under the veil of “Hormonal Acne”.   Maybe it sounds better than “plain old acne”,  Maybe it just doesn’t make sense to have a “teenage” condition throughout adulthood.  Maybe they are sure they have hormonal acne because all other treatments failed except hormonal therapy.  Maybe they locked into this “diagnosis” simply because their physician told them, “You have hormonal Acne”

The stubborn nature of acne has many people desperately searching for a new diagnosis.  If you look hard enough, you’ll find something else besides “plain old acne” to pin this problem on.  The truth is that the diagnosis of acne is far easier than the successful treatment of it.

Here’s the story as I see it…..,     All acne prone skin responds poorly to hormone changes.  Acne prone skin is the problem, not the hormones.  Any successful hormonal treatment that works is simply minimizing a major aggravating factor.  This is a fine treatment option for those who don’t mind taking long term hormonal therapy for their skin.

What about the Acne prone skin?? ……you may ask….

It’s always changeable over time…..  We’ll discuss the misconception of Acne-prone skin as an affliction vs. the temporary state of acne proneness in a separate post.

This topic may be confusing to those who are strongly convinced they have “hormonal acne.”  When all the videos are watched closely, you can see that the women on here are completely transformed without any hormonal treatment whatsoever.

©2008  ”Hormonal Acne” by Dr. Neal Schwartz