Hormonal Therapies for Acne: A Comprehensive Update for Dermatologists

January 2025 in “ Dermatology and Therapy ”

Courtney Smith, Emily Gosnell, Turkan Banu Karatas, Chelsea Deitelzweig, E. Dale Collins, Howa Yeung

hormonal therapies combined oral contraceptives spironolactone clascoterone anti-androgen venous thromboembolism COCs

TLDR Hormonal therapies effectively treat acne and improve quality of life.

Hormonal therapies, such as combined oral contraceptives (COCs), spironolactone, and clascoterone, are effective in treating acne and improving quality of life. COCs are generally similar in efficacy and should be chosen based on patient preferences, though they carry a risk of venous thromboembolism. Spironolactone is recommended as a first-line treatment for women, with minimal need for potassium monitoring unless specific risk factors are present. Clascoterone is a safe topical anti-androgen effective for both men and women, with minimal systemic effects. The review encourages dermatologists to consider these therapies, engage in shared decision-making, and expand their use to men and pediatric patients to enhance treatment adherence and safety.

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