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Acne & androgenic progestins?
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Acne & androgenic progestins?

Hello, I am 29 yo considering OC to help hormonal imbalance (not so much pregnancy prevention).  I have cystic acne along my jawline.  I have been using spironolactone 50mg daily about a year.  Overall, it's improved about 50%, but will worsen during pre-mentraul flare ups. However, my derm is hesitant about increasing my dose and suggested adding on OC.

Any reccomendation on what estrogen/progestin combo to try for acne?  

I'm thinking starting on low dose of estrogen with the LEAST androgenic progestin.  Do I have the right idea?  LO Loestrin...I've been told that its 1mg of norethindrone is still pretty androgenic especially for those who already have an imbalance.  Would Mircette be an option with desogestrel being less angrogenic?  Also, any experience with prescribed HALF tab of OC?  (ie. instead of Loestrin 1/20.. use 0.5/10 for hormonal imbalance?)  Just concerned about initial breakout.

Just some background... I have not used OC previously. I have no family history of breast cancer, no hypertension, non-smoker, and had 2 migraines in the past 5 years.
603463_tn?1220630455
Hi!
Yes, you are on the right track with your ideas about OCs.  If you were
my patient, I would recommend the Orthocyclen products OR Mircette.
Really, the action of the medication is to increase the levels of Sex Hormone binding globulin in your system, which then binds up the extra androgens that cause acne.  Any of the OCs will do this for you. You may or may not experience that initial breakout, but overall, I suspect that you will be happy with the results within 2-3 months at most.
Good luck!
Dr B
2 Comments
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Thanks! I appreciate the info, Dr. Brown
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