Triggers of Acne in Women

DEAR ASK THE DOCTOR: My Brother seems to have perfect skin. I was wondering what triggers acne in women and if it is different triggers from men? Can this be used to treat acne differently in women?

DEAR CATHY: Acne can be frustrating.  As a general rule, women's hormones tend to fluctuate more than men, which helps explain why acne in women tends to be less constant and more erratic than acne in men.  However, men actually have severe acne 10x more frequently than females.  The exact cause of acne is unknown, but doctors believe it results from several related factors.

Fluctuating levels of sex hormones during puberty can affect acne.  Men and women both experience fluctuating levels of hormones during puberty but women experience an increase in male sex hormones called androgens. This increase causes the glands to get larger and make more sebum.  If your physician feels your acne may be due to an excess of androgens, he or she may prescribe a medication called spironolactone which reduces androgen effects on sebum production.  However, before prescribing spironolactone, your physician may try other topical or oral medications

Fluctuating levels of sex hormones as an adult can also affect acne.  The menstrual cycle is one of the most common acne triggers.  Other hormone changes that are unique to women such as pregnancy and menopause can affect acne.  If your acne seems to be related to your cycles, talk to your physician.  Certain types of birth control pills are known to improve acne and certain types of birth control pills are known to worsen acne.

Women tend to use more skin products and make up than men. This can make a difference as well.  Greasy or oily products tend to block your pores allowing for an environment of bacteria causing acne to thrive.  If this is the case for you, switching to a “water based” or “oil free” product can help.

The good news is acne can be treated effectively.  While women may have differing cause of acne, they do not differ from men in terms of effective acne treatments.  I have personally counseled women and men with equal success.  You should see your family physician and discuss your treatment options.