Hormonal acne is a type of acne that you see in women, usually in their 20s, 30s, or 40s. It has to do with hormonal imbalances. There may be too much testosterone, or there may be abnormal ratios of other hormones like LH or FSH, as well as DHEAS. Hormonal acne looks different from normal acne in that it takes place on the lower half of the face, especially the chin, the jawline and the neck. It tends to be worse around a woman's period, but not always. It's very important to have a doctor who recognizes hormonal acne, because the treatments are quite different from regular, teenage acne.
Some things that help are the following. One is birth control pills. Every birth control pill will help hormonal acne to one extent or the other, but there are some that work better than others and are FDA-approved for this.
The second thing is spironolactone. Spironolactone is a wonderful medicine that interferes with testosterone metabolism at the skin. Basically, there ends up being less testosterone in the skin to stimulate the oil glands. I like spironolactone, because it has very few side effects and can be very effective in hormonal acne.
I should mention that hormonal acne can take place in the setting of polycystic ovaries, but just because you have hormonal acne doesn't mean you have polycystic ovaries. Last, I want to mention an herbal supplement called Chasteberry, also known as Vitex. This is an herb that's been used for long time to try to regulate the hormones, and I have found in some of my patients it can be very effective at either 175 or 225 mg for their hormonal acne.