Endocrine Disorders and Hormonal Therapy for Adolescent Acne

The 2017 document reviews hormonal therapies for adolescent acne, particularly in those with endocrine disorders. It states that acne is increasingly prevalent and can be exacerbated by conditions like PCOS, hyperandrogenism, and others. Four FDA-approved combined oral contraceptives (COCs) and spironolactone are effective treatments, often used in combination with topical agents or antibiotics. The review also notes the potential role of diet, with low glycemic index foods possibly reducing acne severity and skim milk potentially worsening it due to insulin/IGF-1 effects. While topical retinoids and benzoyl peroxide are first-line treatments for mild acne, hormonal therapies are particularly useful when these fail. COCs decrease androgen levels, but their use must be cautious in certain situations. Spironolactone is effective but requires contraception due to teratogenic risks. Other hormonal treatments are not recommended due to hepatotoxicity risks. In refractory cases, isotretinoin may be used. Overall, hormonal therapies are deemed safe and effective for female adolescents with acne, with or without endocrine dysfunction.