Since adult skin is much different than adolescent skin, treatments that are effective for adolescent acne are usually unacceptable for adults, particularly adult women.

There has to be a whole new bag of tricks to treat acne in the adult female. Each woman is also unique in many different ways – and these differences may all converge to bring about the onset and flare-ups of acne.

Although acne is the same systemic inflammatory disease in both adolescents and adults, the precipitating events leading to its onset differ greatly between teens and adults.

Changing hormone levels affect the onset of acne. It’s known that the sebaceous glands can be stimulated by hormones to produce sebum. The male hormones (androgens) stimulate oil production by binding to a special receptor on the oil gland. An enzyme present in the gland breaks down these androgen-type hormones, such as testosterone, into a more powerful hormone called dihydrotestosterone (DHT).

Doctors differ in their opinions about the role of estrogen in acne. Some physicians believe that as levels of the hormone progesterone decrease in women as they age, the estrogen comes to predominate, and may cause a problem. Other physicians believe that estrogen is helpful.

Simply measuring the testosterone level in the blood does not tell us much because some testosterone is bound to a protein and only the unbound kind can have an affect on the oil glands. We must also bear in mind that a woman’s ovaries can also produce androgens . In addition, androgens can be produced by the adrenal gland in the form of DHEA.

The androgens produced by the ovaries and the DHEA produced by a female’s adrenal glands can then affect the oil glands, causing them to convert the androgens into a more potent form.

Studies have been conducted to ascertain how many women with acne actually have abnormal levels of circulating hormones. The results of one study showed that about half the women did; another study indicated that the incidence was much higher – between 60 and 90 percent.

In layman’s terms, the male hormones, called androgens, stimulate the oil glands to produce more sebum, and that may contribute to the development of acne in some people.

Scientists have devised ways of treating acne by altering hormone levels. One of the inexpensive ways for women to do this is to use oral contraceptives. By taking a birth control pill, a woman can increase the levels of proteins that bind the male hormone testosterone.

Women who took a prescription oral contraceptive called Ortho-tri-Cyclen, had levels of unbound testosterone almost 50 percent lower than the levels in women who took other birth control pills. However, because of their other risks they shouldn’t be recommended as a first line of treatment.

Additional methods, known as anti-androgen chemicals, have been devised to influence hormones. One of these, spironolactane, is actually a diuretic, or water pill. Spironolactane binds to the androgen receptors preventing the conversion of testosterone to the more powerful hormone DHT.

But its side effects may include increased urination, abnormal menstrual periods, weight gain, breast tenderness, dizziness and headaches. Diuretics can also drain the body of potassium, another dangerous side effect.

While there is controversy regarding the effects of estrogen and progesterone on acne, it is known that altering the hormone status to prevent hormone surges can be therapeutic to some women. Many oral contraceptives do have an androgenic effect on the body, causing it to become more acne prone. The newer oral contraceptives have been designed to avoid the androgenic effect.

Yet, while some physicians believe that taking oral contraceptives is helpful to women acne sufferers, others believe that the most effective and safe course of treatment is to control hormonal surges and acne flare-ups through an anti-inflammatory diet and with anti-inflammatory nutritional supplements.