Your Skin Issues: Acne, Hormones, and Treatment Options

My skin issues?

Hello, doctor: I have had many spots on my face since childhood, especially on my cheeks, and I have tried various medications without success.
Additionally, I frequently experience acne between my chin and nose (especially noticeable before my menstrual period, but it persists even after menstruation).
I thought things would improve after giving birth, but it remains the same.
I would like to ask if my skin is dry or oily? Is this issue related to hormones? Should I see a dermatologist or a gynecologist? I once took medication prescribed by a dermatologist, but it made me feel very dizzy, and I had to remain upright or sitting.
Are there no other medical options? Is chemical peeling effective? I am very concerned about spending a lot of money and ending up with no results.
I would appreciate your advice.
Thank you!

Jiu Tao, 30~39 year old female. Ask Date: 2001/02/05

Dr. Zheng Lizhen reply Dermatology

Skin type, whether dry or oily, is determined by the amount of oil your skin produces, and not simply by the presence of blemishes or acne.
If your acne is predominantly located between the chin and the mouth, it is important to ensure that you rinse off fluoride toothpaste thoroughly after brushing your teeth, and to be mindful of any habits you may have of resting your chin or jaw on your hands.
Additionally, you should evaluate whether your skincare products, such as lotions, are too greasy.
Alpha hydroxy acids can help exfoliate dead skin cells at the pore openings, providing therapeutic effects for acne.
However, due to the multifactorial nature of acne, dermatologists often employ a combination of treatments.
It is essential to work closely with your dermatologist to achieve optimal results.
Some individuals may experience dizziness as a side effect of oral tetracycline antibiotics; if this occurs, please inform your physician, who will help you select an alternative medication.

Reply Date: 2001/02/05

More Info

Understanding skin issues, particularly those related to acne and hormonal fluctuations, can be quite complex. Based on your description, it seems you are experiencing a combination of symptoms, including persistent acne, dryness, and possibly hormonal influences, especially since you noted that breakouts are more pronounced before your menstrual cycle.
Firstly, determining whether your skin is dry or oily is essential for effective treatment. Acne can occur in both oily and dry skin types. Oily skin is characterized by excess sebum production, leading to clogged pores and breakouts. On the other hand, dry skin can also lead to acne if the skin barrier is compromised, causing irritation and inflammation. Given your symptoms, it might be beneficial to consult with a dermatologist who can assess your skin type and recommend appropriate products.

Hormonal fluctuations are indeed a significant factor in acne development, particularly in women. Hormones such as androgens can increase sebum production, leading to clogged pores and acne. This is often why women experience breakouts around their menstrual cycle. If you suspect that your acne is hormone-related, it may be worthwhile to discuss this with a healthcare provider who specializes in hormonal health, such as an endocrinologist or a gynecologist. They can evaluate your hormonal levels and suggest treatments that may include hormonal therapies, such as birth control pills, which can help regulate hormones and reduce acne.

Regarding the medications you have previously taken, it’s not uncommon for some acne treatments to cause side effects like dizziness or nausea. If you experienced significant side effects, it’s crucial to communicate this to your dermatologist so they can adjust your treatment plan accordingly. There are various treatment options available for acne that do not involve systemic medications, including topical treatments, which may be better tolerated.

As for chemical peels, such as glycolic acid peels, they can be effective for treating acne and improving skin texture. However, results can vary, and it’s essential to have these procedures performed by a qualified professional. They can assess your skin's condition and determine if you are a suitable candidate for such treatments. While chemical peels can be beneficial, they may not be a one-size-fits-all solution, and it’s crucial to have realistic expectations regarding the outcomes.

In addition to medical treatments, consider adopting a gentle skincare routine. Use non-comedogenic moisturizers and cleansers that won’t clog your pores. Incorporating products with ingredients like salicylic acid or benzoyl peroxide can help manage acne, but be cautious with their use, especially if your skin is sensitive or dry.

Lastly, lifestyle factors such as diet, stress management, and proper hydration can also play a role in skin health. A balanced diet rich in antioxidants, vitamins, and minerals can support skin healing and overall health. Staying hydrated helps maintain skin moisture and elasticity.

In summary, your skin issues may be multifaceted, involving hormonal influences and possibly a combination of skin types. Consulting with a dermatologist is a prudent step to tailor a treatment plan that addresses your specific concerns. They can guide you through the various options available, including topical treatments, hormonal therapies, and cosmetic procedures like chemical peels, ensuring that you find a solution that works for you without unnecessary side effects.

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