40, with acne like a teenager

[40stinks]

I hope there is someone out there that can help. I am a 40 year old woman with acne on my face, neck and back. I believe it is related to hormones, and to support that theory here is some info about me. As a teenager, I NEVER had zits. I had my first child at 30 and had some acne on and off after that. I had my last child at 37 and have had horrible problems ever since. I recently had lumps in my breasts and after 3 very scary months I found out that I did not have breast cancer, just cystic breasts. The thing about that is when I start my cycle they disappear. Then as the month progresses they come back and are unbearably sore by the time I start my period again, and they disappear. I also have very bad men. cycles, lasting 10-14 days with bad bleeding, cramping and flu-like symptoms for the first 3-5 days. I went to my ob/gyn a few months ago and she suggested I try a low dose bcp. (she recommended a low dose bcp because of the risk factors at my age). I first tried Yaz (little sister to Yasmin) and I bled for 1 1/2 months. She then switched me to Loestrin 24Fe and I am about 3/4 of the way through my first pack. My acne seems to be getting worse. (Oh, I have also been to a dermatologist who had prescribed minocyclene and Retin-A, which I have used for approx. 1 year). I really feel that this has to do with my age and hormones, but I can't really find any website that addresses my problem specifically. I wondered if anyone out there has had similar problems and has had luck with any other bcp, or possibly any other hormone therapy. HELP!

[skimom]

Originally Posted by 40stinks

I hope there is someone out there that can help. I am a 40 year old woman with acne on my face, neck and back. I believe it is related to hormones, and to support that theory here is some info about me. As a teenager, I NEVER had zits. I had my first child at 30 and had some acne on and off after that. I had my last child at 37 and have had horrible problems ever since. I recently had lumps in my breasts and after 3 very scary months I found out that I did not have breast cancer, just cystic breasts. The thing about that is when I start my cycle they disappear. Then as the month progresses they come back and are unbearably sore by the time I start my period again, and they disappear. I also have very bad men. cycles, lasting 10-14 days with bad bleeding, cramping and flu-like symptoms for the first 3-5 days. I went to my ob/gyn a few months ago and she suggested I try a low dose bcp. (she recommended a low dose bcp because of the risk factors at my age). I first tried Yaz (little sister to Yasmin) and I bled for 1 1/2 months. She then switched me to Loestrin 24Fe and I am about 3/4 of the way through my first pack. My acne seems to be getting worse. (Oh, I have also been to a dermatologist who had prescribed minocyclene and Retin-A, which I have used for approx. 1 year). I really feel that this has to do with my age and hormones, but I can't really find any website that addresses my problem specifically. I wondered if anyone out there has had similar problems and has had luck with any other bcp, or possibly any other hormone therapy. HELP!

Hi there, there is a lot on this board about hormones, bc pills, Yasmin. Click on the search button and type in your search word. I am always on here blathering on bc pills and hormone therapy so here I go again and will probably continue till somebody tells me to shut up. Years ago my acne went away with homone therapy and now my child is having the same issues and the same cure is what is helping her.

Yes, you have a hormone problem. The fact is that all female acne is caused by hormones. Even if your hormones are normal your skin can still be affected. I would recommend you get Dr. Geoffrey Redmond's book called The Hormonally Vulnerable Woman. He also has a web site that has a ton of info on it. I can't give you the address here so, again, you can do a search. I am also fascinated by the bio-identical hormones that seem to be all the rage now but I know little about them. For now, in my family, Yasmin and low dose spironolatone seems to be working when even accutane, diet changes, colon therapy, antibiotics, no sugar, peels, topicals, pillow case changing, towel changing, screaming, yelling, no anything, did not.
For women who cannot take bc pill, they can still just take spironolactone. 100 mg - 200 mgs. is a normal dosage for control I hear/read.

BTW, acne can get bad at first and then straighten out with continued use.

[caymanbabes]

I too am in a similar situation - wouldn't you love to be able to use all those lovely anti-aging lotions and potions that your friends use rather than having to go down the "teenage skincare" aisle!! Like you, I never had acne in my teens, it started after I stopped breastfeeding my last baby.

I have tried various topicals from the dermatologist (Duac, Differin) which actually aged my skin, and although the acne got slightly better after 3 months of use (though not significantly), I feel that they changed my skin for the worse and I regret ever using them. Three months off them, and the only thing that works is a gentle salicylic acid wash and 2.5% benzoyl peroxide as a preventative treatment on acne-prone areas (I like the Neutrogena Advanced Solutions acne kit).

But this is not giving me the results I'd like, and is not a long-term treatment, and like you I am convinced my problem is my hormones. So, I am about to start on Yasmin. I researched every single birth control pill out there, both in the UK and the US, and believe this is the right choice. Of course everyone reacts differently and I will be watching for any side effects. Apparently Loestrin actually is quite an androgenic pill, likely to make acne worse. The progestin in Yasmin/Yaz is different from any other pill (Yaz has just been approved to treat PMS), its anti-androgenic. I think that the fact that you had breakthrough bleeding with Yaz indicates that you need a higher amount of estrogen (Yasmin has 50% more). My Dr didn't have a problem prescribing Yasmin to me, she said as long as I don't smoke and I'm not overweight it should be fine (though of course everyone is different). But I have to mention that Yaz isn't available where I live so it would have been an expensive hassle to get it, so that wasn't really an option.

Do a google search for "Which Oral Contraceptive Pill is Best for Me?", the page you need to look for is wdxcyber, the Women's Health Resource. It explains how the progestins in the different pills have different affects, and Loestrin is the top of the list of pills likely to cause acne. It says that for a pill to be good for acne, it needs to have higher estrogen and lower androgen capacity.

I hope you find one that your Doctor will prescribe, that works for you! Good luck!

[caymanbabes]

I just found this written by heartsicle (hope you don't mind my copying it here, but its very useful and informative!) on this website:

"Yasmin has 30mcgm of estrogen, and 3.0mg of progestin called "drospirenone". You might recognise the "spir" in it is similar to "spironolactone", which some women use to control their acne. Spironocultane (also known as "aldactone") is a potassium-sparing medication that was initially used to treat heart and liver failure. It was then discovered that spironocultane also had anti-androgenic properties. Some women take spiro. alone in high doses. In low doses it has no effect; i.e., Yasmin pills have a very low dose of spiro. But the Spironolactone derivitive WITH estrogen in the Yasmin pill is the magic potion that helps combat hirutism and other crappy side effects of androgens/male hormones, i.e., acne!"

If your Doctor won't prescribe Yasmin because she feels the estrogen is too high (though its still classed as 'low dose'), maybe you could try a combination of one of the pills with lower estrogen and low androgen activity, and spironolactone as well, as suggested by skimom? There are lots on discussions on this board about spironolactone on this board - just search for "spiro".

Good luck!

PS To skimom in particular, and everyone else on here who posts, this board is an incredibly useful resource, thank you thank you thank you! Here's hoping that Yasmin works for me!!

[skimom]

Thank you caymanbabe