Overview
What drives hormonal acne.
Androgen hormones stimulate oil glands and pore clogging. Women with hormonal acne usually have normal hormone levels, but their skin is more sensitive to androgens. Breakouts often worsen around menstruation, after stopping birth control, postpartum and during perimenopause. Sometimes acne points to an underlying condition such as PCOS, which Dr. Burris screens for when appropriate.
How we treat
How Dr. Burris treats it.
- Spironolactone: an oral medication that blocks androgen effects on the skin, often highly effective
- Topical retinoids, azelaic acid and clascoterone (a topical anti-androgen)
- Hormonal contraceptives, coordinated with your gynecologist when appropriate
- Salicylic acid peels and cortisone injections for painful cysts
- A plan to prevent and fade dark marks
Questions
Frequently asked questions.
How do I know if my acne is hormonal?
Clues include deep, tender bumps along the jaw, chin and neck; monthly flares; and onset or worsening in adulthood. Dr. Burris can help confirm the pattern and look for underlying causes.
How long does spironolactone take to work?
Most women notice improvement at about 2–3 months, with continued benefit over 6 months.
Is spironolactone safe long term?
For most healthy women, spironolactone has a strong long-term safety record for acne. It's not used during pregnancy, and Dr. Burris reviews any monitoring you may need.