Hormonal acne is common for women in their 20s and 30s. It generally shows up more prominently on the lower parts of the face and the jaw. In some women, acne is caused by an excess of androgen (male) hormones or an oversensitivity of the sebaceous gland to normal levels of androgens.
How do you know if your hormones are OK? Clues to excess androgen levels include hirsutism (excessive growth of hair on the face or body), premenstrual acne flares, irregular menstrual cycles, and elevated blood levels of certain androgens.
Hormonal evaluation in cases of severe or persistent adult acne will usually include evaluation of serum DHEAS, free testosterone, and total testosterone levels. Elevation of serum DHEAS levels indicates an adrenal source of androgen production. Modest elevations of DHEAS are most commonly associated with late-onset congenital adrenal hyperplasia that may not have been previously diagnosed.
Elevation of testosterone is associated with excess androgens produced by the ovaries. Modest elevation of testosterone is most commonly associated with Polycystic Ovary Syndrome (PCOS). Very high levels of DHEAS (Dehydroepiandrosterone) or testosterone can be indicative of adrenal or ovarian tumors.
Blood tests can be drawn just prior to or during your period. It is important that a woman is not taking an oral contraceptive at the time of testing, which can mask an underlying endocrine abnormality. Generally, testing can be performed at least 4-to-6 weeks after stopping the oral contraceptive.
Wondering how you can balance your hormones? Your doctor can help you with one of two kinds of medications: First, birth control pills to help suppress the androgen produced by the ovaries. Second, there are anti-androgen drugs (Such as spironolactone) that can suppress the androgen produced by the adrenal glands.
Talk more with your doctor if you want more information about how to diagnose and then treat hormonal acne.