Acne comes in many different forms. For example, acne with only blackheads and whiteheads, is technically called humor, called humor acne while the presence of very large, deep pimples filled with pus is called follicle acne.

Another particular form of acne that occurs in women usually in their 20s and 30s is called Hormonal acne. The best treatment for each type of acne can be different. In this post, we discuss the best treatment for hormonal acne and compare the two most effective options, Accutane and spironolactone.

Hormonal acne is a type of acne that tends to appear on the lower face and along the jawline and upper neck area of ​​women. Although all forms of acne can be caused by hormones, but hormonal acne Labeling given to a specific form of acne can be easily identified as it is common in young women with a tendency to worsen with each monthly menstrual cycle.

Hormonal acne is a very stubborn type of acne, which disappoints many women because it seems to be resistant to any treatment. By the time people with hormonal acne seek help from a dermatologist, they’ve often tried a variety of topical prescription treatments as well as oral antibiotics, none of which have worked. Despair sets in and they are often willing to try something much more powerful as a last resort.

Effective control of hormonal acne often involves more than conventional or first-line acne treatments. Patients often see multiple dermatologists and receive many variations of the same treatments. Topical acne medications are often prescribed but are often very ineffective.

Many patients with hormonal acne often use many different topical and topical medications without much improvement. Likewise, adding oral antibiotics to their regimen is not usually very helpful but is often prescribed.

Some women opt to use birth control pills that contain acne-friendly hormones to combat acne-causing hormones in the hope of curing the burn. While this strategy can sometimes work, it is often not powerful enough to produce satisfactory improvement.

The time it takes for people with hormonal acne to try these different methods can be months or years before realizing that something more effective is needed. Considerable time and effort trying these unsuccessful therapies can often lead to more frustration and anxiety. While some patients resigned to learn to live with incessant flare-ups, others continued their quest for an effective treatment.


One of the most successful therapies for hormonal acne is a drug called spironolactone. This oral drug was originally developed many years ago as a blood pressure pill and is still used today. However, it turns out that spironolactone also has the ability to block the main hormones that cause acne. This is why spironolactone can be a very effective and successful hormonal acne treatment.

The side effects of this drug are usually mild in most women taking it, making it a desirable choice for women who don’t want to go for something more aggressive. Unfortunately, not all providers are skilled in using spironolactone to the fullest extent. This can lead to lost hope in women who have been treated with spironolactone and who expect only one effective result to once again be met with the disappointment of another failed treatment.

There are many reasons for this undesirable result such as using the drug at the wrong dose or not using it for a long enough time. This can often be remedied by an experienced acne specialist skilled in the use of spironolactone. But even in the hands of an expert, spironolactone isn’t always effective and fuels the need for something more potent.

Isotretinoin (Accutane)

The most effective treatment for hormonal acne is isotretinoin, commonly known by its original brand name Accutane. Accutane works by “minimizing” or disabling the oil glands in acne-prone pores, thereby preventing overactivity of the oil glands needed for acne to develop. While Accutane can be a very effective option, it is a more aggressive treatment and has different requirements for women using it.

For example, one of the most important aspects of Accutane in women is the need to prevent any risk of pregnancy. This is because Accutane can cause serious birth defects if taken while pregnant. As a result, women are required to comply with a government registry program known as the iPledge Program that monitors pregnancy tests during treatment and is required to comply with pregnancy prevention requirements. pregnant. Various additional information including potential side effects of Accutane is also important to understand before starting treatment with this prescription drug.

What is the best hormonal acne treatment?

So which hormonal acne treatment is best, spironolactone or Accutane? Well, the answer is… it depends. For some women, the response to spironolactone can be very good, often resulting in completely clear skin. Because of its effectiveness, many women have relied on spironolactone to maintain their clear skin in the long run. Remember, spironolactone was originally developed as a blood pressure medication so there is a precedent for taking it for a very long time. Also, because spironolactone’s side effect profile is quite mild compared to Accutane, many women prefer to use it as the initial treatment option.

However, spironolactone is not always effective for every woman taking it. In addition, the need to continue taking it to maintain its effects is a shortcut for many women, who prefer a more definitive treatment with a definite endpoint. For these women, Accutane is more attractive. Also, for women who start using spironolactone and don’t get good results, they often turn to Accutane as a last resort.

While spironolactone is very effective and preferred by many, treatment with Accutane remains the gold standard in the treatment of most forms of acne, including hormonal acne. Almost all women have very effective results. This treatment can be life-changing for women who have long suffered from hormonal acne that has not gone into remission. This is why many women accept the higher intensity and more aggressive nature of Accutane treatment and end up choosing Accutane therapy.

Ultimately when deciding which option is best, some want to jump straight to the most effective treatment and choose Accutane while others feel more comfortable starting with spironolactone as the next step and will only decided to choose Accutane when all other options were exhausted. In the end, there is no right or wrong decision when it comes to choosing which drug is best. Both drugs can be very effective and can be chosen based on comfort with risks and benefits for each.


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