Indian women's hormonal environments have changed dramatically as a result of increased stress and poor lifestyle choices. When it comes to polycystic ovaries, the condition is a hereditary one that can be passed down from mother to daughter. A hormonal imbalance known as PCOS or PCOD has become more common among women and young girls as obesity has become more common.
Despite the fact that PCOD is a gynaecological condition marked by irregular menstruation, it is most commonly diagnosed when patients visit a dermatologist for persistent acne, hirsutism, or hair loss.
So, as a dermatologist, when do I suspect PCOS or hormonal acne?
Suspicion usually arises during a consultation when one or more of the following factors are present:
* Inflammatory acne exacerbated by premenstrual hormones.
* Acne predominantly on the lower half of their face, the jawline, and upper neck.
* Hair loss and/or hirsutism are also present.
* Intense acne brought on by menstrual irregularities or PCOS.
Acne that does not respond to conventional acne treatments like topicals, antibiotics, or chemical peels is likely hormonal acne if none of the above factors can be ruled out.
Is it possible for a dermatologist to tell whether or not acne is caused by hormones?
It's a little complicated here. It is suggested that you undergo a series of blood tests. A clear hormonal imbalance may be discovered, or the results may be within normal ranges. While normal test results don't exclude PCOD as a possibility, the ratios of different investigations are taken into account when making this determination. The clinical diagnosis may be correct even if laboratory tests are negative!
When do you have your hormonal tests?
The use of anti-androgen medications is usually not recommended during the first consultation if the clinical diagnosis of hormonal acne is clear. Conventional acne treatment is started and response is tracked.
Investigations may not be required if the response is adequate.
After 6-8 weeks of treatment, if the patient does not improve, hormonal testing may be recommended.
Is it necessary to treat hormonal acne and PCOS acne with hormones in all cases?
No, that's not always the case. Patients who need a quick response and are open to hormonal treatment begin taking the medication at the beginning of their acne treatment. Patients who don't want to take hormones are prescribed antibiotics/retinoids, including topical and oral forms, as well as chemical peels.
To effectively control mild to moderate hormonal acne, I typically use advanced chemical peels such as Agera, Obagi Blue peel Radiance, and Azelan. The patient is encouraged to start taking medication if his or her response does not improve after 3-4 sessions. Patients who do not see improvement after 6-8 sessions are re-explained that oral anti-androgen medication is needed to control acne.
Acne is a completely curable dermatology lifestyle disorder. Non-hormonal acne takes 1-2 months to treat, while hormonal acne takes 3-6 months.
Hormonal acne requires a more stringent maintenance plan as well. This may comprise of customised skin care as well as ocassional chemical peels. You should find yourself a dependable dermatologist and start a long-term relationship.