It's adult women, accounts for the fastest-growing section of the population affected by acne, according to a briefing presented at last week's annual meeting of the American Academy of Dermatology.
"Seventeen million Americans have acne, and at least half of adult women suffer from some degree of acne," presenter Diane Berson, MD, tells WebMD. "But half of women don't respond to traditional therapy," such as benzoyl peroxide, retinoids, and antibiotics.
The first-choice therapy for hormonal acne is low-dose birth control pills. Corticosteroids also can be effective, as can Aldactone, a steroidal antiandrogen agent. All three of these treatments decrease sweat production.
In most cases, Berson says, women with hormonal acne have normal serum levels of androgens. That means that the problem is related to high "local" production of androgens in their sweat glands.
If adult acne isn't hormone-related, stress can be an agent or can make existing acne worse, since stress stimulates the adrenal gland. And some cosmetics, especially foundations and sprays/gels, can be a culprit, as can some prescription drugs, such as seizure medications and lithium and other antidepressants.
According to Berson, it's OK for a dermatologist to prescribe the pill to a healthy patient for acne, as long as the patient tells her gynecologist. Berson says that a patient also should commit to an annual physical (including a pelvic exam) with her primary care doctor.
(Eastday.com 03/15/2001)
