Is hormonal treatment still an option in acne today?
June 2015
in “British Journal of Dermatology”
TLDR Hormonal treatments are effective as a second-line option for moderate-to-severe acne in females, but should be used with caution due to health risks.
The document reviewed the use of combined oral contraceptives (COCs) for acne treatment, finding them more effective than placebos with a 30-75% reduction in lesions and a 50-90% improvement in most cases. However, it noted only mild differences between COC types and inconclusive comparisons with antibiotics due to study biases. Safety concerns, especially the risk of venous thromboembolism (VTE), were discussed, emphasizing the need for cautious use of COCs considering individual health risks. Hormonal treatments were recommended as second-line options for moderate-to-severe acne in females unresponsive to first-line treatments, to be used alongside standard therapies. The document also mentioned alternative hormonal treatments for resistant cases but stressed the importance of individualized treatment choices and risk assessment.
View this study on academic.oup.com →
Cited in this study
research Contraception and the dermatologist
Birth control pills can help manage acne, but dermatologists should know their skin-related side effects, especially when prescribing drugs that can harm unborn babies.
research Hormone therapy in acne
Hormonal treatment is effective for women with acne not helped by usual treatments, especially if they have hormonal imbalances.
research The role of androgen and androgen receptor in skin-related disorders
Targeting androgen receptors could be a promising way to treat skin disorders with fewer side effects.
research Hormonal therapy for acne: why not as first line therapy? facts and controversies
Hormonal treatments can help with acne but are not the first choice due to side effects and the need for careful patient selection.
research Acne and Systemic Disease
Hormones, especially androgens, play a key role in acne, which can be a symptom of systemic diseases like PCOS and may require targeted treatment.
research Efficacy of an oral contraceptive containing EE 0.03 mg and CMA 2 mg (Belara®) in moderate acne resolution: a randomized, double-blind, placebo-controlled Phase III trial
The oral contraceptive with ethinyl estradiol and chlormadinone acetate is effective in treating moderate acne.
research Hormonal Therapy for Acne
Hormonal treatments, including birth control and antiandrogens, can effectively treat acne in women.
research Acne
Acne affects most teenagers and can continue into adulthood, with various treatments available that show improvement but have concerns like antibiotic resistance and side effects.
research Acne: Hormonal concepts and therapy
Hormones, especially androgens, play a big role in acne, but most acne sufferers don't have a hormone disorder. Hormonal treatments, including birth control pills, can be very effective for women whose acne doesn't improve with regular treatments.
research Androgen Excess in Women: Experience with Over 1000 Consecutive Patients
Most women with excess male hormones have Polycystic Ovary Syndrome, and hormonal therapy can improve symptoms but may cause side effects.
research Update and Future of Hormonal Therapy in Acne
Hormonal therapy is becoming a promising treatment for acne.
research Cutaneous Androgen Metabolism: Basic Research and Clinical Perspectives
Creating stronger blockers for skin enzymes might lead to better treatment for conditions like acne and excessive hair growth.
research Endocrinological evaluation and hormonal therapy for women with difficult acne
Hormonal therapy is a good option for women with severe acne, especially when there's a chance of hormone imbalance.
research Sebocytes are the Key Regulators of Androgen Homeostasis in Human Skin
Sebocytes play a key role in controlling androgen levels in human skin.
research Screening for 21-hydroxylase–deficient nonclassic adrenal hyperplasia among hyperandrogenic women: a prospective study
Testing basal 17-HP levels is a good way to screen for nonclassic adrenal hyperplasia in women with high androgen levels.
research Polycystic Ovary Syndrome
PCOS is a common hormonal disorder causing irregular periods and increased hair growth, linked to insulin resistance and long-term health issues.
research Comparison of flutamide and spironolactone in the treatment of hirsutism: a randomized controlled trial
Flutamide is more effective and has fewer side effects than spironolactone for treating hirsutism.
research Flutamide in the treatment of hirsutism
Flutamide effectively reduces hair growth in women with hirsutism and improves acne and seborrhea without side effects.
research Treatment of hirsutism with the pure antiandrogen flutamide
Flutamide effectively reduced excessive hair growth and improved related symptoms in hirsutism patients without significant side effects.