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Talk about one young woman’s breakout role.
Last week, one brave blogger decided to share her pre- and post- acne face shots on Imgur. According to her short announcement, she’d been taking the prescription Prednisone (a common steroid used to treat a number of inflammatory conditions, such as allergy disorders and psoriasis), and believes this drug was the cause of her severe, painful-looking acne.
And while her dermatologist recommended Accutane, a popular med for nodular acne, she opted instead for the Pill. And the transformation is clear.
This blogger, known as “seventytimes,” had such an overwhelming response that she posted a follow-up message with the humorous title, “When your face is birth control enough…”
But this young lady is not alone. According to the American Academy of Dermatology, acne is the most common skin condition in the United States, affecting up to 50 million Americans annually.
“When the female hormones are off, the levels of testosterone go up,” Misbah Khan, MD, founder and president of MKhan Dermatology and clinical assistant professor of dermatology at Weill Cornell Medical College New York Presbyterian Hospital, tells Yahoo Beauty. “And this imbalance results in male-pattern acne, which is this large, cystic acne affecting the face, chest, and back. So what the Pill does is equalize — or normalize — these female hormone levels, so as the testosterone goes down, the acne goes down.”
It takes three months, on average, before the skin begins to clear. However, not every version of the Pill is a guaranteed solution.
“Some forms of birth control can have a reverse effect making acne worse,” Kally Papantoniou, MD, a board-certified dermatologist at the Advanced Dermatology Center for Laser and Cosmetic Surgery in New York and a clinical instructor at Mount Sinai Dermatology, tells Yahoo Beauty. “Birth control that are progesterone only — for example, the methods that reduce the number of periods per year — can have a very negative impact on skin.”
And while this blogger was hesitant to take Accutane, it’s understandable why her doctor recommended the treatment. Dr. Papantoniou explains it’s the brand name for the drug isotretinoin, a pill derived from a high-strength Vitamin A.
“It may have a lowering effect on testosterone, and addresses hyperactive oil glands in acne-prone patients,” she says. “Since oil harbors bacteria, decreasing the oil clears blemishes. And people see results pretty quickly.”
Dr. Khan adds that it’s deemed “the magic drug.”
“It’s one of the strongest medications on the market that offers a cure for cystic acne,” she states. “But keep in mind that in the U.S., the regulations are enormous for prescribing it — and that’s because the list of side effects are very long.”
For one thing, Accutane has been linked to severe birth defects. “The risk of miscarriage is very high, and if the baby is born, it will be severely deformed and have a number of congenital abnormalities,” continues Dr. Khan. “The baby may not be able to make it. This explains why a female patient has to be using at least two forms of birth control and must take a pregnancy test every month before a new prescription of Accutane is given.”
Additional reports have indicated that this med has caused skin dryness, severe depression (even suicidal thoughts and attempts), as well as long-term stomach issues. “Some studies had found that people on Accutane can suffer from chronic diarrhea and constipation, as well as trigger Crohn’s Disease and ulcerative colitis,” she says.
Dr. Papantoniou concurs, noting, “It’s also very harsh on the kidneys and liver, so doctors typically require a monthly blood test to make sure the drug isn’t causing internal damage to these organs.”
Now here’s the good news: There is hope for women who cannot — or will not — be prescribed birth control and/or Accutane.
“I’ve hardly prescribed Accutane because I have been able to manage my patients’ acne without it,” admits Dr. Khan. “There is a long list of topical medications that are safe to use during pregnancy. These treatments do require a little more diligent work and you do have to see your doctor more often, but there are no side effects.”
Spironolactone, originally formulated to treat hypertension and a few other cardiovascular conditions, is a drug that can help with hormonal acne, says Dr. Papantoniou. “It is widely used by many dermatologists for those not on birth control, and the application remains off label (meaning the FDA doesn’t include this use on the drugs label),” she states.
Above all, Dr. Khan stresses discussing your options — along with your issues and concerns — with a dermatologist.
“For the person who has bad acne, I would not recommend receiving advice from an aesthetician,” she says. “Make sure to consult with a trusted practitioner.”
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