
Originally Posted by
Mr.BB
Acne is not due to estrogen. Skin oil glands (sebaceous glands) are stimulated by male hormones not estrogens, specially DHT which is the most potent androgen in our body.
The results of hormonal acne, which is the type of acne we get from using steroids , is mainly noticed upon cessation or reduction of the androgens (when you stop the cycle), but the pore blockages start with the androgens influx when cycle begins.
During cycle you get a lot of blocked pores, this blocked pores (whiteheads or blackheads) can remain like that for weeks and not create a pimple or cyst. It will only create an infection (yes pimples and cysts are localized infections) once there is spillage of the oil and pus to the inside of the skin. This spillage and increased virulence of the P Acnes bacteria is not totally understood, it can be due to various reasons. The theory in hormonal acne is that this increased virulence is a reaction of the bacteria to the reduction in oil production by sebaceous glands.
Well, so how to solve hormonal acne? You need to control the P Acnes bacteria from the start of the cycle, if you are only worried about it when pimple and cysts appear you are already late. Exfoliation, chlorhexidine cleanses and blue light therapy are some treatments that will work during cycle to control it. Yes, tanning beds or sun and salt water will also work to an extent.
If you are already with cystic acne, the first step is antibiotics (doxycycline or minocycline) which will help with the infections and inflammation, but antibiotics will not treat the blocked pores, and they will continue to produce cysts, you need to also do the exfoliation, etc, to try and remove this blocked pores. Bare in mind this is for cystic acne, you should not take antibiotics if you have a pimple here and there!
If antibiotics dont work the last resort is accutane, which is a very harsh drug, but for hormonal acne after cycle, it can be very effective in small dosage 10mg EOD (or mon, wed and fri), it will take minimum 6 months of treatment and improvements only after 1-2 months. Please dont cycle while you are still on accutane.