How Hormonal Therapy can Change your Acne

Last night, our research on how providers use hormonal therapies in the treatment of acne was published! I started this project during my 1st year of derm residency so seeing it published before I graduate gives me such a sense of relief. Click here to read the full text.

In brief: our team looked at all the data from any female patient who was seen at our institution in the past 10 years. We collected data about their demographics and treatment plans, including what type of systemic medication (oral antibiotics vs. hormonal therapies like spironolactone or oral contraceptive pills) was used and when. We also calculated total time that patients were on systemic antibiotics for acne. Our main 3 takeaways:

1. Hormonal antiandrogen acne treatment (HAAT), such as oral contraceptives and spironolactone, is useful for treating female acne patients.
2. HAAT is often used as second-line treatment in women with acne, but HAAT use is associated with decreased cumulative systemic antibiotic use.
3. Given the growing need for antibiotic stewardship, HAAT can be considered a useful alternative to systemic antibiotics.

Why is this important, you may be asking. Well, for a long time, dermatologists viewed systemic antibiotics as being the easiest and safest first medication to try for moderate to severe acne. However, this has resulted in patients being on systemic antibiotics for VERY long time periods. Most experts agree that 3 months should be the maximum amount of time an acne patient is put on antibiotics, but that is far from true. In a day and age in which antibiotic resistance is growing because of overuse, we have to be really vigilant about giving out antibiotics indefinitely. We know that hormonal therapies like oral contraceptive pills and spironolactone fight acne by blocking male androgen production. We also found in our study that patients who got on hormonal therapies earlier for acne ended up having less time overall on systemic antibiotics. So in the appropriate female patient who has hormonal acne (flares around her period, typically in the chin/jaw area), hormonal therapies may be a very useful alternative to systemic antibiotics, and should be considered earlier on in the treatment course.

Hope you found this interesting as well!