Hormonal treatments

In females, acne can be improved with hormonal treatments. The common combined prostrogen methods of hormonal contraception have some effect, but the antiandrogen, Cryproterone in combination with an oestrogen (Diane 35) is particularly effective at reducing androgenic hormone levels. It is not available in the USA, but a newer oral contraceptive containing the progestin drospirenone is now available with fewer side effects than Diane 35 / Dianette. Both can be used where blood tests show abnormally high levels of androgens, but are effective even when this is not the case. Along with this, treatment with low dose spironolactone can have anti-androgenetic properties, especially in patients with polycystic ovarian syndrome.

If a pimple is large and/or does not seem to be affected by other treatments, a dermatologist may administer an injection of cortistone directly into it, which will usually reduce redness and inflammation almost immediately. This has the effect of flattening the pimple, thereby making it easier to cover up with makeup, and can also aid in the healing process. Side effects are minimal, but may include a temporary whitening of the skin around the injection point; and occasionally a small depression forms, which may persist, although often fills eventually. This method also carries a much smaller risk of scarring than surgical removal.

Care must be taken when using benzoyl peroxide, as it can very easily bleach any fabric or hair it comes in contact with. Other antibacterials that have been used include triclosan or chlosan or chlorhexidine gluconate are often less effective, but also have fewer side-effects.Prescription-strength benzoyl peroxide preparations do not necessarily differ with regard to the maximum concentration of the active ingredient (10%), but the drug is made available dissolved in a vehicle that more deeply penetrates the pores of the skin. Thus give removal from acne to the patient.