Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Endocrine Disorders & Hormonal Therapy for Acne

Curr Opin Pediatr; 2017 Aug; Nguyen, Tollefson

Hormonal therapies are effective and well tolerated options for the treatment of acne vulgaris in adolescents with and without endocrine disorders, according to a recent review. They can be used as monotherapy or in conjunction with benzoyl peroxide, topical retinoic acid, or antibiotics. Investigators found:

  • There are now 4 different combined oral contraceptive pills that are FDA approved for the treatment of acne since they were introduced in 1960.
  • Recent literature has provided more information on the efficacy of different generations of combined oral contraceptive pills, their side-effects, and cancer risks.
  • Spironolactone has been gaining wider use among dermatologists in adolescents with endocrine dysfunction.
  • New diagnostic guidelines and treatment recommendations have also been suggested.

Citation:

Nguyen HL, Tollefson MM. Endocrine disorders and hormonal therapy for adolescent acne. Curr Opin Pediatr. 2017;29(4):455-465. doi:10.1097/MOP.0000000000000515.

Commentary:

Hormonal therapies are an effective adjunct for the treatment of acne, not only for those with endocrine disorders but also for patients with a hormonal influence, such as perimenstrual flares. They can be added to treatment regimens that include topical retinoids, antimicrobials, and oral antibiotics. They can also be used as maintenance to help prevent future flares, often in combination with topical retinoids. The efficacy, side effects, and contraindications of oral contraceptive pills (OCPs) have been studied and published in the dermatologic literature. Dermatologists have become more educated about OCPs, which are FDA approved for the treatment of acne, and are thus becoming more comfortable adding this option to their armamentarium. The antiandrogen, spironolactone, has also gained wider use and is very effective for these patients, either in combination with OCPs or alone, especially in those for whom the latter is contraindicated. Hormonal therapies have been a helpful addition for young adult women with endocrinopathies, as well as those who are often bothered by small hormonal flares. As acne often continues into adulthood, hormonal therapies can be beneficial for our patients. —Diane S. Berson, MD, FAAD

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Must Reads in Acne

Lasers, Light-Based Treatments Help Manage Acne, J Drugs Dermatol; 2017 Nov; Tong, Brauer

Assessing Facial and Torso Acne Separately, J Cutan Med Surg; ePub 2017 Nov 14; McLellan, et al

Differentiating Pityrosporum Folliculitis and Acne, J Am Acad Dermatol; ePub 2017 Nov 11; Prindaville, et al

Stress, Skin Disease, and Quality of Life, Br J Dermatol; ePub 2017 Oct 27; Dixon, et al

Fractional CO2 Laser Efficient Scar Treatment, Lasers Med Sci; 2017 Dec; Elcin, Yalici-Armagan