Hormonal Therapies for Acne

    October 2016 in “ Clinics in Dermatology ”
    Brittany S. Barros, Diane Thiboutot
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    TLDR Hormonal treatments can improve acne, but they come with potential side effects and risks.
    The document from March 1, 2017, reviews hormonal therapies for acne, highlighting the role of androgens in the condition and the potential presence of endocrinopathies like PCOS in some patients. It details treatment options such as androgen receptor blockers (e.g., spironolactone), adrenal androgen production blockers (e.g., glucocorticoids like prednisone), and ovarian androgen production blockers (e.g., GnRH agonists and oral contraceptives). A small study of 6 women showed improvement in acne with GnRH agonists over 6 months, while a multicenter study demonstrated significant acne improvement with a low-dose oral contraceptive pill in women aged 14-45 after three cycles. The document also discusses side effects and risks of these therapies, including the risk of breast cancer and hepatotoxicity with certain drugs, and the increased risk of thromboembolic events with OCPs, especially in women with higher BMI. It provides guidelines for physicians on endocrine workup and treatment options, and mentions potential future therapies under investigation at the time.
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