We all know that feeling you get on the way to an important appointment with an awful bump under your skin. What other people may not notice feels like Mount Everest to you! You reach for your makeup, and begin plastering – and then it's tea tree oil, toothpaste and a range of weird and wonderful cures – but nothing works. Next, you attempt to fix the problem with your fingernails, because you just can't stand its presence, but tomorrow – there are two!
Hormones and your skin
In Beautiful Skin: Every Woman's Guide to Looking Her Best at Any Age, David E. Bank and Estelle Sobel claim hormones can make a woman's life difficult. Although they are the chemical messengers that make men men and women women, they also cause mood swings, zits and unruly hair!
It is completely normal to struggle with a pimple every now and then. For women who are used to flawless skin, this can be more traumatic than for others, but is a normal part of life. Acne, though, is another story. This is a skin condition that has caused many teenagers self-image to plummet, and is caused by the overproduction of oil by the skin's oil glands. Oil that would usually moisturise the skin is caught in blocked oil glands, and causes pimples, blackheads and whiteheads on the skin's epidermis. Often, acne appears alongside other, deeper infections called cysts. Perhaps you assumed that your days of oily hair, a face full of pimples and school dresses were over... but acne is no respecter of age, and affects both adults and children.
In most cases, acne lasts for three to four years – but in 15% of all cases, it can last from eight to twelve years! Luckily, it isn't necessary to suffer for an extended period as a simple visit to a dermatologist can easily cure this affliction. In 5% of all people, acne appears after the age of 25 and can even be found in the 40s age group. In 70% of cases, acne breaks out just before a woman's menstrual cycle. The worst cases of acne appear in men because they have more of the male hormone that acts as a catalyst in the formation of acne. Women with excess body hair and erratic periods have an increased tendency to develop acne, but women have the added advantage of access to one cure that men cannot use.
Birth control pills
On the website www.youngwomenshealth.org, it is claimed that birth control pills improve acne. For moderate to severe acne, which over-the-counter and prescription medications can't cure, birth control pills may be prescribed, as the hormones in the birth control pill help prevent the formation of acne. It doesn't usually matter which type of birth control pills are taken, as most of them can be used to effectively treat acne, but this may take several months.
Jacquie Grassie, a gynaecologist from Pretoria, South Africa, supports this claim. In most cases, the pill results in a 30% improvement in skin problems, relates Jacquie. She explains how acne is caused: "Acne is caused as a result of androgen action on the sebacious glands. Androgen is a male hormone." Many women experience an outbreak of pimples just before their menstrual cycle. "The premenstrual flare of acne may be a result of fluid retention which results in the obstruction of hair follicles. If your gynaecologist or dermatologist prescribes oestrogen, the secretion of fluid will be reduced and your premenstrual flare avoided. A pill that contains 30µg of oestrogen is ideal."
Jacquie also says that anti-androgen (anti-male hormones) may be added to the treatment to reduce sebum secretion and the formation of hair, and is often taken from day 5 to day 15 of a woman's cycle. There are also pills that contain anti-androgen such as Diane or Ginette, and these are ideal for the skin as they contained both oestrogen and anti-androgen, says Jacquie. The type of progesterone in the pill is also very important, she says. Pills that contain low levels of androgenic progesterone, such as Gestodene, Desogesten, Yasmin and Marvelon, are also favoured. The advantages of using the pill are varied, says Jacquie, and include: the control of your cycle, reduced bleeding, pain and menstrual tension. Using the pill also reduces your chances of developing endometriosis and ovarian cysts. Having said this, the pill can also reduce your libido and cause pigmentation. Pills that contain progesterone alone do not have a positive effect on the skin, and are referred to as the 'minipill'.
"Many people come to me and say: my dermatologist has put me on Diane for my skin, and now I need a pill for contraception," relates Jacquie. There is no need to take a pill for your skin, and a separate one for contraception as the pill is primarily a birth control measure. Dermatologists often prescribed a contraceptive method as a primary treatment for acne. The second step is to add an anti-androgen, or to prescribe Diane which contains an anti-androgen. The third step is to look at more drastic medication such as Roaccutane.
If your skin problem is caused as a result of using incorrect skin products, or lifestyle habits, the pill will not be an effective cure. Your skin problems must be acne-related for the pill to work, explains Jacquie. "If you are still struggling with skin problems after the age of 35, the chances that the cause is hormonal are unlikely. If your skin worsens after you come off of the pill, or start using another birth control method, you probably need oestrogen – in which case the pill will help," claims Jacquie. "If you start struggling with your skin for the first time at 50 years of age, you may want to investigate other possible causes, which are unlikely to include hormonal ones." (Health24, updated November 2010)
* Additional source: www.ehealthmd.com