Almost 80 percent of teenage children and young people under 30 suffer from acne vulgaris. Most patients experience subsidence of the disease before the age of 30, and some have to fight it throughout their lives. The main symptoms of acne are:
- increased proliferation and clogged pores,
- increased level of sebum secretion,
- presence of rashes,
- inflammation on the skin.
It is almost impossible to choose standard methods of treating the disease, because new research on this topic is emerging. Hormonal treatment methods are widely used and are used even in the most difficult situations. In order to cope with the disease, the patient's hormonal status is studied.
Causes of acne in women - hormones
The cause of acne is the colonization of the skin by anaerobic bacteria Propionibacterium acnes, which initiates the formation of micro-acne and a local inflammatory reaction. Environmental factors, such as a diet rich in carbohydrates, also influence the development of changes. Cigarette smoking also contributes to skin changes.
The formation of acne is associated with hair follicles and sebaceous glands, which cannot cope with the removal of excess sebum. When the glands are blocked, the internal contents swell and become infected, which is how pimples and acne appear. Therefore, people with oily skin are prone to acne.
Hormones, especially androgens, commonly called male hormones, have a significant influence on this process, further stimulating the growth of the sebaceous glands and their effectiveness. Androgens also help accelerate the growth of the stratum corneum, which can manifest itself, for example, in the presence of dandruff.
In women, androgens are secreted by the adrenal cortex and ovaries. In case of dysfunction of at least one of these organs, excessive secretion of androgens may occur and, consequently, exacerbation of acne on the skin. This occurs, for example, in polycystic ovary syndrome.
Adrenocorticotropic hormone (ACTH) has the same effect as androgens on hair follicles in stressful situations. Therefore, people who constantly live at "high speed" in a nervous environment are definitely more likely to have acne on their face.
The greatest influence on the development of acne is 5-α-reductase, which converts testosterone to 5-α-dihydrotestosterone (DHT). Its increased activity is observed in the outermost layer of the skin - the epidermis and in its appendages - the hair follicles.
How do the hormones in birth control pills help treat acne?
An imbalanced hormonal balance increases the appearance of new acne and inflamed pimples, which leads women to a dermatologist, who, not finding pathologies on his part, redirects the patient to an endocrinologist or gynecologist.
In 7% of women of childbearing age, the appearance of acne is associated precisely with increased levels of androgens in the serum and so-called hyperandrogenism. Usually the pathology is accompanied by other symptoms, such as androgenetic alopecia or hirsutism (excessive hair growth), increased skin pigmentation (cutaneous keratosis).
High androgen levels are also observed in polycystic ovary syndrome, where irregular menstrual cycles coexist with hirsutism and acne. Thus, birth control pills, by suppressing the activity of androgens, have a much broader effect and treat many different diseases.
Oral contraceptives contain female sex hormones estrogens, which, unlike androgens, have the effect of reducing the secretion of sebum by the sebaceous glands. They act contrary to male hormones, suppressing their activity.
Are birth control effective for acne?
The basis of acne treatment is local therapy. Women, having noticed acne, use various types of gels and creams, the active substance of which is an antibiotic. In addition, in order to remove excess oil, the skin is dried with various alcohol tinctures, which leads to the formation of wrinkles. However, the hormonal etiology of acne allows treatment without such aggressive agents. To do this, you need to contact a gynecologist who will regulate hormonal imbalances.
This therapy is indicated for patients with polycystic ovary syndrome, SAHC syndrome - dermatological androgenization with concomitant seborrhea, acne, excessive hair growth and at the same time alopecia, and for acne lesions that occur after puberty. The action of drugs based on female hormones is also a contraceptive.
Combined treatment of acne requires comprehensive care, so after 3 months of taking birth control pills, you need to consult a dermatologist. The doctor will identify non-hormonal problems and residual effects, such as acne scars, and help remove them.
To get the maximum effect, before starting therapy, laboratory tests should be performed to determine the concentration of hormones and confirm abnormalities associated with the presence of acne. It is recommended to check free and total levels of testosterone in the blood, the ratio of dehydroepiandrosterone sulfate and LH, FSH.
Hormonal tablets are effective in treating skin lesions. But stopping therapy can lead to relapses. In addition, improvement does not occur immediately - you have to wait several weeks or even months before the results of acne treatment are visible.
The most effective treatments for acne are androgen reversal drugs, such as spironolactone, or those that block the effects of androgens. The second group includes estrogens, cyproterone acetate and glucocorticosteroids.
Treatment with retinoids: drugs, properties, effectiveness
Manufacturers produce quite a few forms of retinoids. The most popular drugs that have successfully shown themselves in anti-acne therapy and skin rejuvenation are described here.
- Tretinoin. The “flagship” among retinoids in terms of potency.
It consists of retinoic acid and is very effective even for severe forms of acne and deep wrinkles, but it produces significant side effects if used incorrectly (irritation, burns). Presented on the market in the form of lotions, creams, gels, and capsules for oral administration.
- Isotretinoin
. Slightly inferior in strength to tretinoin, but at the same time has a lower risk of side effects. It is mainly used to treat acne and skin rejuvenation. Available in the form of ointments, creams, tablets Roaccutane and Acnecutane.
- Tazarotene
. The active ingredient is tazaratenic acid. Provides an excellent effect in the treatment of acne, but the side effects are also pronounced. As an anti-wrinkle treatment, tazarotene can be used for shallow wrinkles. Available in the form of creams, ointments 0.05% or 0.1%. Not recommended for hypersensitivity or severe dry skin. If we compare tretinoin and tazarotene, cosmetologists advise using tretinoin as a more studied drug.
- Adapalene. The main component is an artificial analogue of retinoic acid.
It is effective against acne, but is practically useless for skin rejuvenation purposes, since it does not penetrate deep into the skin sufficiently to reduce the depth of wrinkles. Available in the form of Differin gel or cream (0.1%), Clenzit gel (0.1%), there is also a lotion form that shows the best results. Adapalene has virtually no side effects and has a gentle therapeutic effect. You can combine it with benzoyl peroxide based products.
- Retinol. The main substance is retinoic acid.
It acts more slowly than other retinoids (the effect is visible after 12 weeks). Popular due to its low side effects. Treatment with retinoids usually begins with it. Common medications are Rapid Wrinkle Repair creams (Neutrogena), SkinCeuticals. The concentration of products with retinol ranges from 0.01-0.4%.
Patients ask where to purchase these drugs, often asking about JSC Retinoids. This enterprise is not a company producing only retinoids; it also produces other pharmacological drugs. You can buy vitamin A preparations at any trusted place, and it is highly desirable that the exact concentration of the active substance is indicated on the packaging.
Reviews from patients and opinions of cosmetologists
Very often, retinoids turn out to be the “saving” remedy that desperate patients come to after using all kinds of medications for acne and acne.
Most of those who have used vitamin A products note their high effectiveness. There are reports of side effects, but the use of any drug (not just retinoids) is in one way or another connected with the individual reaction of the body, so you must read the instructions carefully. Cosmetologists recommend treatment with retinoids under the supervision of specialists to reduce the risk of adverse events and achieve the best results. This article is for informational purposes only, please consult your doctor for details!
Do birth control pills have side effects?
Despite the many positive aspects of hormonal therapy in the treatment of acne, you should be aware of the side effects of the drugs used. The most commonly cited problems include:
- nausea, vomiting;
- slight fluctuations in body weight;
- headache, chest pain;
- slight decrease in libido;
- increased blood pressure;
- increased blood cholesterol levels;
- increased risk of thromboembolic diseases and acute episodes of cardiovascular diseases (heart attack, stroke).
Most patients do not experience any side effects at all or they go away on their own in the first months of taking birth control pills. If this does not happen, you need to replace the drug.
MAKE AN APPOINTMENT
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Abortion and contraception clinic in St. Petersburg - department of the medical gynecological association "Diana"
Make an appointment, tests or ultrasound via the contact form or by calling +8 (812) 62-962-77. We work seven days a week from 09:00 to 21:00.
We are located in the Krasnogvardeisky district, next to the Novocherkasskaya, Ploshchad Alexander Nevsky and Ladozhskaya metro stations.
The cost of a medical abortion in our clinic is 3,300 rubles. The price includes all pills, an examination by a gynecologist and an ultrasound to determine the timing of pregnancy.
Analysis of the endocrine status of patients
It is not necessary to evaluate patients’ hormonal disorders only in two cases:
- acne exacerbation goes away in the shortest possible time,
- Standard treatment methods work for the patient.
Assessment of endocrine status is important and is carried out:
- when the acne problem begins after a person reaches 30 years of age,
- acne cannot be treated with conventional methods,
- acne before puberty,
- acne before menstruation,
- increased levels of the androgen hormone,
- increased testosterone levels,
- obesity,
- location of rashes. If they are located in the chin area, then the reason lies in hormonal disorders.
Hyperandrogenism manifests itself under the influence of the following factors:
- ovarian. The causes of its appearance include: PCOS and ovarian tumors. They can be benign or malignant.
- adrenal. The reasons for the appearance of this factor are: adrenal hyperplasia, which is divided into congenital and acquired, and an adrenal tumor, which can be benign or malignant.
In about 90 percent of cases, PCOS is the cause. It causes a variety of endocrine diseases in women. In this case, cysts may even form. One of the signs that is detected by ultrasound is polycystic ovary syndrome. The disorders are also accompanied by anovulation.
For patients who experience an increase in androgen levels without menstrual irregularities, tests and examinations are carried out in the first half of the menstrual cycle. If another hormonal therapy is already being used, then to determine the new hormonal status, it is important to stop taking oral contraceptives and medications that are used as part of it one month before the tests and procedures. This will eliminate the possibility of false or incorrect results.
The following indicators are taken into account:
- indicators of testosterone levels, which can be total and free.
- androstenedione. Samples taken early in the morning are ideal for analysis.
- DHEA,
- SHBG,
- Prolactin. If it is elevated, the causes may be either hypothalamic or pituitary,
- 17-hydroxyprogesterone,
- Luteinizing hormone
- Insulin. Its level is measured both on an empty stomach and after the patient has eaten.
- Cortisol. If it is elevated, then this is a sign of adrenal neoplasia.
