Acne is a disease of the hair follicles and sebaceous glands and the most common dermatological problem in women of reproductive age.
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Causes of acne formation
In its advanced form, it can even lead to scarring, which significantly reduces a woman's quality of life. The causes of ac ne formation can be traced to anaerobic bacteria that have settled on the skin, a local inflammatory reaction, genetics, environmental factors such as climatic conditions, urbanisation or diet, and hormonal disorders.[1]
Hormonal factors are crucial in the formation of acne, especially with regard to the first phase of acne formation, when sebaceous gland hyperreactivity is induced. Specifically, we are referring to androgens (male hormones) produced in the adrenal glands and ovaries, as the testosterone derivative, from which a pro-inflammatory substance is secreted, is of greatest importance for the formation of acne lesions.
Estrogens
Estrogens (female hormones), on the other hand, are androgen-inhibiting hormones. The use of hormone treatment is reasonable for women who have symptoms such as:
- seborrhoea,
- androgenetic alopecia,
- irregular menstrual periods,
- hirsutism with concomitant acne.
Basis of hormone therapy
Also important, in the inclusion of hormone therapy, is the resistance to standard treatments and the recurrence of acne after treatment. The basis of hormone therapy in the treatment of ac ne is the dual-component contraceptive pill (DTA), which consists of estrogens (which inhibit the action of androgens by lowering the level of free testosterone) and antiandrogens, i.e. 4th generation progestogens, which are specially synthesised to
act without affinity to the oestrogen and androgen receptors.
Hormone therapy in women with acne, photo: pantherstock
In addition to its androgen inhibitory and contraceptive effects,DTA also has other beneficial effects on the body. It regulates the menstrual cycle, relieves symptoms of premenstrual stress syndrome, relieves pain associated with menstrual bleeding, has its uses in the treatment of endometriosis, prevention of osteopenia and osteoporosis, prevention of ovarian cysts and uterine fibroids, reduction of ectopic pregnancies and reduction of the risk of certain cancers. Side effects of such therapy include weight changes, reduced libido, soreness and sensitivity of the nipples, nausea, headaches. The most dangerous complications of DTA are related to the formation of blood clots and blockages in the circulatory system.[2]
When selecting DTA, it is extremely important to exclude risk factors such as obesity, smoking or hypertension. After taking the patient's history and carrying out tests, the gynaecologist will select the right pill for the patient in order to combat the problem as effectively as possible, taking into account the other positive effects of DTA. As this is a long-term treatment, it is important to remember to have constant medical checks and to report any worrying symptoms to your doctor.[3]