Can hormonal issues cause long-term resistant acne at 28?

Question

Hello doctor,

I am 28 years old and have been struggling with persistently oily, acne-prone skin for nearly eight years and have tried countless over-the-counter products, prescription topical treatments, and two separate courses of oral antibiotics that have all provided only temporary and partial relief before my skin inevitably returns to its previous severely inflamed and breakout-prone state within weeks of stopping any treatment.

Can a general physician help a 28-year-old female patient with chronic treatment-resistant acne investigate whether an underlying hormonal imbalance, such as elevated androgens or polycystic ovarian syndrome, could be the primary driver of her persistent skin condition that has never adequately responded to any purely topical or antibiotic-based treatment approach tried over eight consecutive frustrating years?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through your query and understand your concern.

I am sorry you have had to deal with this for so long, because persistent, treatment-resistant acne can be both physically and emotionally draining. A general physician can absolutely be a helpful starting point in a situation like yours, especially when acne has not responded to standard topical treatments and antibiotics over many years.

In adult women, it is reasonable to look for an underlying hormonal contribution, particularly conditions like polycystic ovary syndrome or elevated androgen levels, which can drive excess oil production and ongoing inflammation.

A GP (general practitioner) can take a detailed history, ask about menstrual regularity, hair changes, and other symptoms, and arrange initial blood tests to check hormone levels such as testosterone and related markers, as well as refer you to a dermatologist (a skin specialist) or endocrinologist (a hormone specialist) if needed.

At the same time, it is important to know that not all persistent acne is caused by a clear hormonal disorder, but even in the absence of a diagnosable condition like polycystic ovary syndrome, hormonal therapies can still be very effective. These might include medications that reduce androgen effects, such as certain oral contraceptives or other anti-androgen treatments, which are often used when antibiotics and topical therapies have failed.

Given how long you have been dealing with this, and the limited response.

I hope I have answered your question.

Let me know if I can assist you further.

Thank you.