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The Difference Between Hormonal and Cystic Acne

Acne is a universal skin concern that doesn’t discriminate between A-list celebrities, teenagers going through puberty, and grown adults. It is a difficult problem to treat, but narrowing down its root cause can help you overcome this cosmetic problem, and your acne blemishes may even be painful. Acne is often caused by a combination of factors, from oily skin to hormonal fluctuations.

The two main types of acne include:

  • Hormonal acne: The body makes 3 hormones that impact your complexion: estrogen, testosterone, and androgen. For premenopausal women, hormonal acne is more prevalent than in men, because of the natural hormone fluctuations during their menstrual cycle. The increase in testosterone and decrease in estrogen causes the skin to produce more oil, which in turn congests the pores. This is especially prevalent around the mouth, chin, and jawline in adults, but teenagers more likely to develop hormonal acne in the T-zone, which includes the forehead, nose, and chin.
  • Cystic acne: This severe acne develops from cysts forming underneath the skin, resulting from a combination of the skin’s oils, bacteria, and dry skin cells becoming trapped in the pores. These form blemishes that aren’t easy to “pop” because they don’t come to a head on the surface. The bumps are often tender or painful to the touch. Cystic acne is usually larger than hormonal acne, and deeper within the skin. Cystic acne is most common in people with oily skin, but it usually improves with age.

Tips for Treating Hormonal Acne

Over-the-counter products usually aren’t successful in treating hormonal acne, unless it is particularly mild. That’s because hormonal acne often overlaps with cystic acne, out of reach of topical medications you can find at the typical drugstore. Your dermatologist can provide oral medications to balance your hormones and clear up your skin, including anti-androgen drugs such as Spironolactone, or oral contraceptive/birth control pills. Typically, it takes about 10 weeks for new acne medication to take effect. Your dermatologist can help formulate a long-term treatment plan and revise your current skincare regimen.

Changing your diet may also help hormonal acne, although the correlation is still not entirely understood by doctors and scientists. However, contrary to popular belief, junk food isn’t the cause of acne.

At home, you can work at keeping your skin clear by always removing your makeup at the end of the day, washing your face twice a day, using a small amount of any acne topical (any more than a pea-sized amount can dry out your skin and cause irritation). Wear sunscreen daily and only use noncomedogenic products (non-blackhead-forming). For instance, using hand cream on your face can block your pores, because it is a much thicker consistency than most face creams.

Tips for Treating Cystic Acne

Your dermatologist can pinpoint the cause of your acne and prescribe the correct combination-therapy to aggressively treat your acne without causing excessive skin dryness. Although over-the-counter acne remedies abound, these are simply not strong enough to combat cystic acne. A dermatologist is your best line of defense, because they can prescribe medications much stronger and effective than what you’ll find in the drugstore.

Your dermatologist will start with conservative treatment and see how your skin responds to it, to start. For instance, you may need oral antibiotics if your cystic acne covers a large area of your skin, which will decrease bacteria and inflammation of the skin. If these antibiotics and prescription topical creams, gels, or foams prove unsuccessful, your doctor may start you on Isotretinoin.

Isotretinoin is one of the most well-known cystic acne treatments. More commonly known as Accutane, this powerful prescription is exceptionally effective at clearing up severe acne. In fact, about 85% of people taking Accutane experience significant skin appearance improvement within 4 to 6 months. However, there are serious risks associated with this drug, including a black box risk for suicidal depression and severe birth defects in growing fetuses. Your doctor will usually only prescribe Accutane as a last resort.

At home, you should wash your face once a day to prevent excessive drying of the skin. Use a gentle cleanser to remove excess dirt and oil, and avoid picking at your skin or popping acne blemishes. This can lead to scarring, which is more likely to occur in cystic acne than hormonal acne. Always make sure to remove makeup by the end of the day, and only use noncomedogenic or oil-free makeup products.

How a Dermatologist Can Help Treat Your Hormonal or Cystic Acne

In most cases of hormonal and cystic acne, you’ll need the help of a skilled dermatologist to help clear up your skin. At Advanced Dermatology Center, we are a nonjudgmental, caring resource for patients of all ages who want to clear up their skin and prevent acne from coming back.

To schedule an acne consultation with our dermatologist, please dial (818) 284-4003 or contact us online for a quick response.