Acne Treatment Antiandrogens and Birth Control Pills

Friday, December 17th, 2010 at 8:15 am

Dr. Thomas P. Habif, MD discusses Acne Treatment Antiandrogens and Birth Control Pills. See more at www.dermnet.com PLEASE RATE AND COMMENT!!! Antiandrogen treatment of acne Antiandrogen treatment may be considered for adult women. Those who fail systemic antibiotics, relapse after a course of isotretinoin or for women who have symptoms of hyperandrogenism are likely to benefit. Symptoms of hyperandrogenism include irregular menses, infrequent or light menses, mild hirsutism, oily skin and androgenetic alopecia. Women with premenstrual flares, adult onset acne, acne worsening as an adult and acne on the mandibular line and neck may also benefit. Women with ovarian cysts and hirsutism may also benefit. Patient selection Failure of oral antibiotic Recurrences after isotretinoin Irregular menses Light menses Mild hirsutism Increased oiliness Androgenetic alopecia Treatment There are two approaches. Combination oral contraceptives ( COC) reduce circulating androgens. Spironolactone is an peripheral androgen receptor blockers. The two drugs are frequently purchase prescription drugs without a prescription combined to achieve optimal results. Oral contraceptives All COCs can be effective for mild to moderate acne. They are often ineffective for more severe cases. COC suppress pituitary gonadotropins. This results in ovarian hormone suppression. They also raise circulating sex hormone binding globulin which decreases circulating free testosterone. All of today's low-dose COC s are estrogen dominant and are beneficial in women ...