March 16, 2000 (San Francisco) -- Some women deal with the occasional pimple or breakout -- others struggle for years to control acne. While many medications are available to prevent new acne, more than half of women either do not respond to standard treatments or build up a tolerance to frequently used medications. Now, women dealing with this upsetting and sometimes disfiguring condition may benefit from a new hormonal therapy.
Speaking recently at a meeting of the American Academy of Dermatology here, dermatologist Diane Thiboutot, MD, associate professor of medicine at the Milton S. Hershey Medical Center in Hershey, Pa., discussed the options that new medical advances have made available to women with persistent acne.
"I want to make an appeal to every woman who has not been able to control her acne through topical treatments or antibiotics to consult with a dermatologist soon," Thiboutot says. "There are so many new therapy options to choose from now, [and] most cases of persistent acne can be improved."
The basic hormonal therapy is the birth control pill. Women whose acne tends to flare before their menstrual cycle and those women with acne on the lower face and neck seem to respond particularly well, according to Thiboutot. Some of the newer birth control pills are especially formulated to control acne, and one in particular, Ortho Tri-Cyclen, has been approved by the FDA for treatment of acne.
But before resorting to hormone therapy, it's best to try conventional therapies first, she says. Accutane (isotretinoin), for example, may provide a lasting effect, she tells WebMD. "In a 14-year-old patient with persistent acne, I would use [Accutane] and see what happens. She may respond. If not, hormone therapy may be [a good optional treatment]," she says.
As with any therapy, there are risks involved in using hormone treatment. Women using hormonal therapy should get regular breast and pelvic exams, and work closely with their doctor to determine the most appropriate treatment and follow-up, particularly if women are smokers.
Most acne treatments require prolonged care ranging from months to years, depending on the women, Thiboutot says. Even after the acne is controlled, ongoing therapy is typically required to maintain the positive results.
"Hormonal therapy is a good treatment for many teenagers and adults," Thiboutot says. "It is used less often than it could be because there are so many options to choose from. Patients should realize it is a good [optional] therapy."