A Review of Hormone-Based Therapies to Treat Adult Acne Vulgaris in Women

March 2017 in “ International Journal of Women's Dermatology ”

Megha Trivedi, Kanade Shinkai, Jenny E. Murase

hormone-based therapies adult acne vulgaris combined oral contraceptives COCs spironolactone acne lesions endometrial cancer ovarian cancer venous thromboembolism breast cancer flutamide hepatotoxicity metformin PCOS birth control pills Aldactone polycystic ovary syndrome

TLDR Hormone therapies like birth control pills and spironolactone are safe and effective for treating women's adult acne.

The 2017 review analyzed hormone-based therapies for adult acne vulgaris in women, particularly focusing on combined oral contraceptives (COCs) and spironolactone. It found that COCs and spironolactone are effective and safe treatments for acne, provided that patients undergo proper clinical screenings and risk assessments. COCs were shown to significantly reduce acne lesions and offer protection against endometrial and ovarian cancer, but they also increased the risk of venous thromboembolism by threefold and had conflicting data regarding breast cancer risk. Spironolactone was effective and well-tolerated, serving as an alternative treatment, especially for severe or recalcitrant acne. The review included 36 studies but did not specify the total number of participants. It emphasized the importance of individual patient histories in treatment decisions and noted the psychological impact of acne. Other treatments like flutamide and metformin were also mentioned, with flutamide being used cautiously due to hepatotoxicity and metformin recognized for its potential in patients with PCOS. The review concluded that hormone therapy is a safe and effective option for women with adult acne, with no significant differences in effectiveness between various COC formulations.

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