Hormonal therapies can help teenagers with acne
Acne is not just a cosmetic issue; it is a medical condition. It can greatly affect a teenager’s self-esteem and quality of life.
Hormones are important in the development of acne. This is especially true during adolescence. People often link acne to oily skin and clogged pores.
Understanding the hormonal underpinnings of acne can lead to more effective treatments, particularly through hormonal therapies.
Hormonal Causes of Acne
Acne during the teenage years can feel like an inevitable part of growing up.
More than 80% of teenagers and young people aged 11-30 have had acne or acne prone skin.
This is why researchers want to understand how hormone changes during the teen years affect acne.
But what hormones are causing acne?
Androgens, a group of steroid hormones, increase during puberty, leading to oilier skin and clogged pores.
Although people typically consider androgens male hormones, both males and females have it.
These hormones cause oily skin on the body and clog pores, leading to acne.
If you do not treat oily skin correctly, you can make acne worse.
While over-the-counter cleansers and spot treatments help some, hormonal imbalances often require a more targeted approach.
Hormonal therapies target the main cause of acne in many teenagers. They provide a long-term solution for clear and healthy skin without acne scars.
Role of Androgens
- Increased sebum production: Androgens make the sebaceous glands in the skin produce more sebum. Sebum is an oily substance that helps keep the skin lubricated.
- Clogged pores: Excess sebum can mix with dead skin cells and bacteria, leading to clogged pores and acne formation.
- Inflammation: The overgrowth of acne-causing bacteria like Propionibacterium acnes can trigger an inflammatory response, worsening acne lesions.
Why Acne Peaks During Teenage Years
Puberty triggers a surge in hormone production, leading to increased sebum production.
Increased sebum production is a key cause of acne.
Too much sebum creates a good environment for bacteria, like those that cause acne. This triggers immune responses, leading to breakouts.
For many teenagers, this results in a breakout-prone T-zone (forehead, nose, and chin).
The research suggested that a key driver of acne is fluctuating hormone production and not just excess hormone production.
Hormonal fluctuations during menstruation can worsen acne, particularly in girls.
Types of Hormonal Acne
Hormonal acne often presents as:
- Cystic lesions: Deep, inflamed pimples that are often painful.
- Breakouts around the jawline and chin: Common areas where hormonal acne appears.
- Fluctuating severity: Tends to worsen during hormonal shifts, such as menstrual cycles in females.
The Science Behind Hormonal Therapies
A recent study published in the Journal of Dermatological Treatment highlighted the effectiveness of hormonal therapies in reducing acne severity.
The study shows that topical hormonal therapies, often called ‘puberty blockers,’ can lower sebum production and skin inflammation.
This offers a good treatment option for teenagers to manage acne, especially hormonal acne.
These therapies work by:
- Regulating hormone levels: Oral contraceptives suppress androgen activity, reducing sebum production.
- Blocking androgen receptors: Anti-androgen medications like spironolactone prevent androgens from binding to sebaceous glands.
- Reducing inflammation: Hormonal therapies calm the skin, making it less prone to redness and swelling.
Hormonal therapies are particularly beneficial for:
- Teenagers with persistent, severe acne unresponsive to topical treatments.
- Those with acne linked to menstrual cycles.
- Patients with signs of excess androgen activity, such as oily skin or hirsutism (excessive hair growth).
Available Hormonal Treatments
Understanding the hormonal influence on acne has led to the development of targeted hormonal therapies.
Here are some of the available hormonal treatments:
These pills contain estrogen and progesterone, which can help regulate hormonal fluctuations and reduce androgen levels.
Benefits of this treatment include decreased sebum production and reduced acne lesions.
This treatment is most suitable for females; however, it requires medical supervision to choose the appropriate type.
Spironolactone for acne has anti-androgen effects that reduce sebum production.
Benefits include effective in treating hormonal acne in females.
A side effect of this treatment may include menstrual irregularities and increased potassium levels. Experts do not recommend it for males.
Topical retinoids help unclog pores and reduce inflammation.
Common topical treatments include benzoyl peroxide skincare products and antibiotics. They target acne-causing bacteria.
Balancing Benefits and Risks
While hormonal therapies are effective, they come with potential side effects, such as nausea or changes in mood.
Open communication with a healthcare provider ensures the benefits outweigh the risks.
A multi-disciplinary approach may also be helpful: your patients acne team may involve their General Practitioner, Dermatologist, Endocrinologist, Gynaecologist, and Dietician.
Challenges and Compliance
Teenagers may face several barriers when it comes to hormonal therapies:
- Stigma and misconceptions: Concerns about side effects or misunderstandings about birth control pills.
- Parental concerns: Parents may be hesitant to allow hormonal treatments.
- Adherence: Difficulty in maintaining a consistent medication routine.
Holistic Management
Beyond medication, a comprehensive approach can enhance treatment outcomes.
Considerations such as the below are important:
- Dietary modifications: Reducing intake of high-glycemic foods and dairy products may improve acne.
- Stress management: Stress can exacerbate hormonal fluctuations; techniques like mindfulness and exercise can help.
- Consistent skincare routine: Using non-comedogenic products and gentle cleansers to support skin health.
Dermatologist’s Role
For teenagers who have struggled with acne for years, hormonal therapies can be life-changing.
Picture a young girl who feels confident again after her painful cysts go away. Think of a boy who finally feels at ease joining the school swim team.
Dr Lisa Byrom emphasises the importance of considering hormonal therapies, especially for teenagers who haven’t responded to conventional treatments.
“Hormonal therapies can be a game-changer for many young patients,” she says. “By addressing the root cause, we can provide more effective and lasting results.”
Future Research
Dr Lisa Byrom also encourages key areas for further exploration, including:
- Long-term safety: Monitoring the effects of hormonal therapies over extended periods.
- Gender-specific treatments: Developing therapies tailored to the hormonal profiles of males and females.
- Combination therapies: Studying the efficacy of combining hormonal treatments with other acne therapies.
Conclusion
Hormonal therapies offer a promising avenue for treating acne in teenagers by targeting one of its primary causes.
While challenges exist, education and collaboration between patients, parents, and healthcare providers can overcome these barriers.
By treating acne at its hormonal roots, we can improve skin health. This also helps the overall well-being of young people during this important stage of life.
Reference: Del Rosso JQ, Kircik L. The cutaneous effects of androgens and androgen-mediated sebum production and their pathophysiologic and therapeutic importance in acne vulgaris. J Dermatolog Treat 2024;35(1):2298878. doi: 10.1080/09546634.2023.2298878 [published Online First: 2024/01/09]
