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Women and Acne

For women who break out mainly around their menstrual cycle, some birth control pills can help. Research shows that these pills can clear acne by slowing down overactive oil glands in the skin. Sometimes, birth control pills are used along with a drug called Spironolactone - (Aldactone ®) (Pronounced - speer on oh lak' tone) to treat acne in adult females. This medication lowers levels of the hormone androgen in the body. Androgen stimulates the skin's oil glands. There are many side effects of this drug, just to name a few, irregular menstruation, breast tenderness, headache and fatigue. Spironolactone is not appropriate therapy for all people.


Acne may also be a warning sign of an underlying medical condition. For example, Polycystic Ovary Syndrome (PCOS), is a health problem that can affect a woman's heart, blood vessels, menstrual cycle, ability to have children, hormones, appearance, and causes many small cysts in the ovaries. High levels of hormones - androgens - that are higher than normal can lead to acne, excessive hair growth, weight gain, and problems with ovulation. Always see a doctor if you experience any of these signs and symptoms.

How Acne Affects Women
Most young women and men will have at least a few pimples over the course of their lives. But acne seems to affect men and women in different ways. Young men are more likely to have a more serious form of acne. Acne in young women tends to be more random and linked to hormone changes, such as the menstrual cycle.

As women get older, acne often gets better. But some women have acne for many years. Some women even get acne for the first time at age 30 or 40.

For many women, acne can be an upsetting illness. Women may have feelings of depression, poor body image, or low self-esteem. But you don't have to wait to outgrow acne or to let it run its course. Today, almost every case of acne can be resolved. Acne also can, sometimes, be prevented. Talk with your doctor or dermatologist (a doctor who specializes in treating skin problems) about how you can help prevent acne and if treatment would help you.

Many Things Can Trigger Acne in Women:

  • Hormone changes during puberty. During puberty, girls have an increase in male sex hormones called androgens. This increase causes the glands to get larger and make more sebum.
  • Hormone changes as an adult. The menstrual cycle is one of the most common acne triggers. Acne lesions tend to form a few days before the cycle begins and go away after the cycle is completed. Other hormone changes, such as pregnancy and menopause, improve acne in some women. But some women have worse acne during these times. Stopping use of birth control pills can play a role as well.
  • Medicines. Certain medicines, such as those used to treat epilepsy and types of depression.
  • Make-up.
  • Pressure or friction on the skin. Friction caused by bike helmets or backpacks can make acne worse.
  • Family history. If other people in your family have acne, there is a greater chance you will have it.

*) Poor hygiene does not cause acne. "Too" much washing or scrubbing the skin harshly can make acne worse. And washing away surface oils doesn't do much to prevent or cure acne, because it forms under the skin. The best way to clean the face is to gently wash it twice a day with a mild soap or cleanser. Be careful to remove make-up without harsh scrubbing.

*) Stress does not cause acne. But, acne may be a side effect of some medicines used to treat stress or depression. And in some cases, the social and emotional impact of acne lesions causes stress. Talk with your doctor if you have concerns.

*) Eating chocolate or greasy foods does not cause acne. While many women feel that eating chocolate or greasy foods causes acne, experts have not found a link between the diet and acne. Foods seem to have little effect on acne in most people. But, it's important to eat a healthy diet for good health.

Surgery for Acne Scarring
If you have scarring, your dermatologist may suggest surgery to help heal acne lesions and remove scarring.

  • A laser can reshape scar tissue and reduce redness.
  • Dermabrasion is a type of surgery that can remove surface scars and reduce the depth of deep scars.
  • Another option is to transfer fat from one part of the body to the face. In some cases, a single treatment can help scarring. But for lasting results, several are often needed.

There are also topical treatments for acne scarring.

Photodynamic therapy acne treatment - it begins with light microdermabrasion. This is used to remove dead skin cells on the face's surface. Then, an acid is put on the skin for 30 to 60 minutes. After this period, the acid is taken off. Lastly, the skin is treated with a laser. This treatment is still being researched, but seems to give positive long-term results.

Prevention
*) Clean your skin gently with a mild soap or cleanser twice a day - once in the morning and once at night. You should also gently clean the skin after heavy exercise. Avoid strong soaps and rough scrub pads. Harsh scrubbing of the skin may make acne worse. Wash your entire face from under the jaw to the hairline and rinse thoroughly. Remove make-up gently with a mild soap and water. Ask your doctor before using an astringent.

*) Wash your hair on a regular basis. If your hair is oily, you may want to wash it more often.

*) Do not squeeze or pick at acne lesions. This can cause acne scars.

*) Avoid getting sunburned. Many medicines used to treat acne can make you more prone to sunburn. Many people think that the sun helps acne, because the redness from sunburn may make acne lesions less visible. But, too much sun can also increase your risk of skin cancer and early aging of the skin. When you're going to be outside, use sunscreen of at least SPF 15. Also, try to stay in the shade as much as you can.

*) Choose make-up and hair care products that are non-comedogenic or non-acnegenic. These products have been made in a way that they don't cause acne. You may also want to use products that are oil-free.

*) Avoid things that rub the skin as much as you can, such as backpacks and sports equipment.

*) Talk with your doctor about what treatment methods can help your acne. Take your medicines as prescribed. Be sure to tell your doctor if you think medicines you take for other health problems make your acne worse.


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For more information about acne, contact the National Women's Health Information Center at 1-800-994-9662 or the following organizations:

National Institute of Arthritis and Musculoskeletal and Skin Diseases
Information Clearinghouse, NIAMS, NIH, HHS
Phone: (301) 495-4484, (301) 565-2966 TTY, (877) 226-4267
Internet: http://www.niams.nih.gov/

American Academy of Dermatology
Phone: (847) 330-0230
Internet: http://www.aad.org/

American Society for Dermatologic Surgery
Phone: (800) 441-2737
Internet: http://www.asds-net.org/


References:
January 2005
U.S. Department of Health and Human Services
www.4woman.gov/