Hormonal therapy is a blanket term for any medications that decrease male hormones and increase female hormones, both of which have a positive effect on your acne. (Obviously, due to the nature of the treatments, these therapies are not intended for guys). Some hormonal treatments you may have heard of include oral contraceptives, some contraceptive patches, rings, intrauterine devices (IUDs), and injections.
Why would I be prescribed hormonal therapy?
There are a couple of reasons listed below, and your dermatologist should indicate those that apply to you:
1) Polycistic Ovarian Syndrome. This is a condition in which acne is prevalent, but very difficult to treat.
2) Very irregular periods and hormonal imbalance.
3) Cyclical acne patterns. If your acne becomes predictably worse at a specific time in your menstrual cycle, your dermatologist may turn to hormonal therapy.
4) You do not wish to be on antibiotics. If this is the case, hormonal therapy is a good alternative.
5) You have moderate-severe acne and other medications have not worked.
6) You are an older woman suffering from deep, tender pimples on the jaw and neck, – you may be a good candidate for spironolactone.
7) Convenience! If you were already planning on going on oral contraceptives for another reason, your dermatologist may suggest that you let them multi-task.
How do you take them?
For contraceptives, follow the instructions on the package for each product and as directed by your gynecologist. For Spironolactone, take it once or twice a day in doses from 50-200 mg.
How long will it take for them to work?
This is a longer one. Expect hormonal therapy to take several cycles to become effective—even 3-6 months! But don’t fret. Oftentimes, dermatologists will simultaneously try other treatments to see if your acne can’t be resolved faster.
What are the side effects?
This depends. Refer to your package insert and make sure that you have discussed them with, not just your dermatologist, but your gynecologist as well. It’s unlikely, but Spironolactone can sometimes cause irregular periods as well as breast tenderness. It’s best to avoid high potassium foods like bananas and coconut water while on spironolactone, but your dermatologist will do regular blood tests if there’s any risk of your potassium levels reaching the danger zone.
Sidenote: Contraceptives are not intended for people who have had strokes, heart attacks, migraine headaches, breast cancer or blood clots in the legs.