Unfortunately, about 60 percent of these women either do not respond to standard acne treatment or build up a tolerance to frequently used medications. Speaking today at the American Academy of Dermatology's Academy '97 Meeting, at the New York Hilton and Towers, James C. Shaw, MD, University of Chicago, Department of Dermatology, discussed the expanding field of hormonal acne treatment. It is not known what triggers adult onset acne. The development of hormonal irregularities in the menstrual cycle may be a factor, or ovarian cysts may cause hormonal abnormalities that increase androgen productivity, resulting in acne breakouts. In addition, many have a history of menstrual irregularities, premenstrual acne flare-up, and facial oiliness.
Most acne treatments require prolonged care, from months to years.
Once improvement is achieved, a maintenance dose is usually necessary. Women who develop adult acne typically have the problem for years, frequently through menopause. Sometimes just regulating the menstrual cycle is enough to stop the acne. Often women are already on birth control pills, so we add antiandrogens. The combination is very effective.