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Q. Can hormonal acne indicate sensitivity to testosterone?

Answered by Dr. Shaikh Sadaf.

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Hi doctor,

I have been suffering from hormonal acne for almost nine years now. I do not have any other medical problems nor I am on any medications currently. I did some investigations to rule out what my problem is exactly, testosterone, DHEA, FSH, LH, progesterone, TFT, RBS and the results of all of them were within the normal range, except for prolactin that was slightly high. I could not do the DHT test. Am I hyperestrogenic? I do not know, but I can request for estradiol from my GP. I do not have the symptoms of excess estrogen though except for breast pain sometimes. I am breaking out 7 to 10 days prior to my periods each and every month, my periods are regular, so I thought that as in these days, the estrogen is the one which drops and the testosterone remain there and have a chance to cause more acne. I might be sensitive to testosterone? Although it is within the normal range as I have other symptoms of high testosterone like thick hair under my chin, on my chest, above my lips and hair shedding (I feel it is more than usual as I have thin hair) and of course oily skin. So that is why I was thinking of taking (Dim) for its anti-androgenic effects. Or shall I ask for Spironolactone? Will they prescribe it for me? Then is it better to check with a dermatologist or an endocrinologist?

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Dr. Shaikh Sadaf
Diabetology, Endocrinology


Welcome to icliniq.com.

I just read your query and from what you have mentioned it appears that you have acne. Usually, it is not recommended to do estradiol test for acne. However, you can visit your gynecologist for ruling out polycystic ovarian syndrome because that can give rise to acne given the history you have mentioned. If your PCOS is controlled well by a gynecologist, then no need to take any anti-androgen drugs like Spironolactone. It is an off label prescription for acne anyways. Yes, a dermatologist will also be beneficial once your gynecologist takes care of issues as well for your hair fall and acne.

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