Does Accutane Work for Hormonal Acne?

I have pretty bad acne but it seems to flare up in cycles so I'm guessing it is brought on by my hormones. If I go on Accutane, will it stop the hormonal acne break outs?

Thx, Jaycee

Doctor Answers 5

Accutane for Hormonal Acne

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Most adult patients with hormonal acne can achieve clearance with a 5-8 month course of Accutane, but in my experience most patients relapse within the first year.  The goal of Accutane is to achieve durable remission and not just the temporary clearance that occurs while on this medicine.  I do not use Accutane for most of my patients with adult hormonal acne, rather OCPs and spironolactone are the two medicines I find provide the greatest benefit depending on each patients individual situation.  As always, I recommend being evaluated by a board certified dermatologist so an optimal treatment plan can be devised for your individual situation.

Houston Dermatologist

Hormonal acne treatment

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Hormonal acne that is severe would best be served by a combination of an oral contraceptive and a course of Accutane. Most oral contraceptive pills that contain estrogen are of benefit to acne, and your dermatologist can help you determine which ones specifically are the best for acne. As well, it may be worth doing some blood tests prior to starting any treatment to assess your hormone profile as sometimes an endocrinologist may be needed as well to help with treatment if there is an underlying hormone imbalance.

Benjamin Barankin, MD, FRCPC
Toronto Dermatologic Surgeon

Hormonal Acne treatment

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Accutane will not stop the hormones, but in most cases it will help the acne long term. The most accurate target treatment for hormonal acne is either an oral contraceptive or Spironolactone. Oral contraceptives help to steady the flux of monthly hormones, thus leveling the oil production in your skin.  This, in essence, stops the acne formation at its earliest stages and can be quite effective. Spironolactone is another medication and a favorite for home associated acne by many dermatologists. It is for women typically in their early to mid 20s, but can even by effective for those in their 40s, and even 50s.
Accutane is a vitamin A derivative. There is nothing better when it comes to long-term acne relief. Accutane's effectiveness comes from its ability to shrink oil glands. In hormonal acne, however, there still are hormones, so even after a 5-8 month Accutane treatment, there could be some return of acne. In most women the amount will be decreased and in my experience it is often much less. I have been seeing many more women opt for an Accutane course, as they want a cure for their acne, instead of a "band aid". Both Accutane and Spironolactone have their limitations, but if used appropriately, they can both be very effective. They are two of the most commonly used acne treatments for long-term improvement of hormonal acne.

David J. Myers, MD
Salt Lake City Dermatologic Surgeon

Hormonal acne and accutane

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For "hormonal acne" that flares with menstrual cycles, my preference is to use hormone-directed/hormone-regulating treatments such as oral contraceptive pills. Not all OCPs help with acne in fact, many can make your acne worse. Among the "acne-friendly" OCPs, the ones I most frequently recommend are Yasmin or Yaz. Another very good hormone-based therapy is called spironolactone (Aldactone). These medications work even better in combination. Consider speaking to your dermatologist and gynecologist whether these options would be appropriate for you.

As for Accutane, it does help with all forms of acne. In my experience though, it is not as useful for this particular form of acne as it is for acne that is not associated with menses.

Hope this helps.

Bryan K. Chen, MD
San Diego Dermatologist

Accutane and hormonal acne

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Accutane can help with hormonal acne, but there are other options that may be tried first or in combination such as Aldactone or birth control.

Joshua L. Fox, MD
Long Island Dermatologic Surgeon
5.0 out of 5 stars 22 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.