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Hormonal Therapies for Acne: A Comprehensive Update for Dermatologists.

Courtney A Smith¹, Emily Gosnell¹, Turkan Banu Karatas¹

¹Department of Dermatology, Emory University School of Medicine, 1525 Clifton Road NE, Atlanta, GA, 30322, USA.

Dermatology and Therapy

|January 3, 2025

Summary

Hormonal therapies, including combined oral contraceptives (COC), spironolactone, and clascoterone, are effective for acne treatment. Dermatologists should personalize treatment plans considering patient needs and preferences for optimal outcomes.

Keywords:

Acne vulgaris Androgens Hormonal therapies Pathogenesis

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Area of Science:

Dermatology
Endocrinology
Pharmacology

Background:

Acne vulgaris significantly impacts quality of life, causing psychological distress and permanent scarring.
Hormonal therapies represent a crucial treatment modality for managing acne.
This review focuses on FDA-approved and off-label hormonal treatments for acne.

Purpose of the Study:

To provide dermatologists with an updated overview of hormonal acne treatments.
To discuss the efficacy and safety of combined oral contraceptives (COC), spironolactone, and clascoterone.
To address patient concerns and individualized care needs in hormonal acne management.

Main Methods:

Comprehensive literature review of hormonal acne treatments.
Discussion of patient-centered care, including shared decision-making.
Analysis of clinical trial data and safety profiles of hormonal agents.

Main Results:

Combined oral contraceptives (COC) demonstrate comparable efficacy across different formulations.
Spironolactone is a well-supported first-line treatment for female acne, with routine potassium monitoring generally unnecessary.
Topical clascoterone offers a safe and effective anti-androgen option for acne in both men and women, with minimal systemic hormonal impact.

Conclusions:

Hormonal therapies are indispensable for acne management.
Clinicians are encouraged to broaden the application of current and novel hormonal treatments for acne.