Acne is lesions of the pilosebaceous unit. In the canal of the hair follicle there is a shedding of hyperkeratinized epithelium occludes. This causes the bacteria that causes acne to grow and the triglycerides of the sebum to form glycerol and free fatty acids which are inflammatory in nature and cause the inflammation in the acne lesions. The sebum production is increased by the androgens in a persons body. Therefore, acne can be either initiated or aggravated by increased androgen levels.

Progressive Stages of Acne Lesions

Non-inflammatory lesions are closed comedo or whiteheads and open comedo or blackheads. The inflammatory type of acne lesions is the papule, pustule and nodule. If you have acne then the type of acne lesions need to be documented including the amount of non-inflammatory lesions you have including the specific number of whiteheads and blackheads. The inflammatory lesions should be documented in terms of how serious the outbreak is in the categories of papules, pustules and nodules. You should also check various parts of your body since acne lesions do not occur on the face alone. Acne can also occur on the chest and back.

Acne Medicines

There are a number of medical therapies to help stop the formation of whiteheads and blackheads. These medicines are known as comedolytics, antimicrobials, isotretinoin (commonly called Accutane), and various topical agents that can help to decrease the sebum or oil production in the skin. There is also the drug called hirsutism which can decrease acne.

Mild to moderate acne can be improved with oral birth control pills. The three most common types of birth control pills that are prescribed by doctors include Ortho Tri-Cyclen, Alesse and Estrostep.

Each of these birth control pills have three different contraceptive progestins called:

Norgestimate
Levonorgestrel
Norethindrone acetate

Through studies it has been determined that birth control pills are highly effect in the treatment of acne lesions.

However, oral contraceptives must be taken in conjunction with other traditional therapies such as topical acne lesion treatments, antibiotic prescriptions and in some of the more severe cases of acne Accutane. Almost all forms of acne treatment are pregnancy category C with the exception of Accutane and some other treatments for severe acne which are pregnancy category X. In pregnancy category X products the use of an effect method of birth control is recommended if pregnancy is deemed possible and two effective forms are required with the use of Accutane according to federal regulation standards.

However, a new form of acne treatment that is being developed is anti-androgens. These are drugs that help block the receptors in your body that allow the cells in your body to absorb the male androgen hormones. There are also drugs that are called androgen inhibitors which reduce the effects caused by excess androgen hormones without actually blocking the testosterone in your body. A good example of these types of medicine is finasteride which is a drug that inhibits an enzyme called 5 alpha reductase. The activity of the 5 alpha reductase enzyme is determined by measuring 5 androstanediol glucuronide through either the patients urine or blood. The type one of 5 alpha reductase occurs mainly in the skin. This enzyme then helps your body produce testosterone and dihydrotestosterone. Most of these types of drugs are not found in North America in wide use except for cyproterone acetate.

Forms of anti-androgens include

Cyproterone acetate
Spironolactone
Flutamide
Progesterone
Cimetidine

Forms of androgen inhibitors include:

Contraceptive pills
Finasteride
Ketoconazole.

The main side effects that come from taking anti-androgen products or androgen inhibitors is menstrual irregularity in women. You should not use these drugs if you are pregnant, have renal insufficiency, or abnormal menstrual bleeding. If you have a personal or family history of ovarian cancer, breast caner or uterine cancer then you should consult your doctor before taking any of these products.

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