hi guys welcome back to the channel I'm here again with Doctor Kishan and today
we're gonna be talking about hormonal acne
mm-hmm so some do talk about acne lesions coming onto their face
around about the time the period or just after and that can be due to hormonal
decline quite a sharp hormonal decline a little bit like the PMS situation so
we've got a rapid decline towards the end of the cycle and progesterone and
estrogen and then this whole thing starts again gradually but acne can
present just at the end just before the period and after and to soften that and
sometimes to treat the acne we can use progesterone to help stabilize the skin
prevent those acne breakouts becoming quite so frequent so other methods of
treating hormonal acne yes so I mean as with anything there's so many different
ways to treat acne so we can grab everything from topical to
tablets for example so they've got things we can put on our skin like
benzoyl peroxide salicylic acid and then we can take things like antibiotics or even
vitamin A derivatives roaccutane or oral isotretinoin and we can do all
but there's so many different options to us I just find that if we have someone
who's got quite an obvious cyclic or pattern to their acne it might it's
worth trying small amounts of progesterone to see if that will balance
out the hormone sufficiently so that they don't get the frequent recurrence
of acne so what would you say to those patients who maybe been prescribed the
oral contraceptive pill like diannette or like yasmin to try and control
these acne associated with the cycle I was taking Dianette for years
yeah I mean that's definitely a recommended licensed pharmaceutical way
of managing recurrent acne and certainly it works and there's there's good case
reports there's good evidence to show that it works however it's still a
synthetic hormone it's not something that I have a special interest in you
and we are both aware of how synthetic hormones are totally different in terms
of how they were interacting receptors in comparison to body identical hormones
and you're well aware of the side effects of these things certainly weight
gain nice big issue and actually some of these these birth control pills that are
recommended for acne control actually have the absolute opposite effect
sometimes people will say to me this is something I've been put on for acne
and they'll have a worsening of their symptoms well that actually happened to
me later in life when I tried it again and so again it might be that the cause
is something different now it might be that you know balance isn't exactly
there or wasn't there now that you want now the treatment
things are a lot better I think and there can be some other courses as well
of acne so for example when I took the progesterone only pill for a time which
is a synthetic progesterone but I've never had so some of some of the
progesterone only pills and by the way that is a kind of a misnomer so just to
be nitpicking progesterone only pills will be progestogens or progestins which
are basically a synthetic form of progesterone so what that means is that
they interact with the receptor completely differently to the body's
natural progesterone so the side effects you get from progestins or synthetic
birth control pills or progesterone only fills a completely unique to the type of
pill that you're given some of them have much more androgenic effects so they can
make even your body hair growth worse they
can make your scalp thinning hair symptoms worse whereas there are other
progesterone only pills which are much gentler and don't have the same
androgenic effect and actually reduce the occurrence of spots or even
hirsutism as well the shock it will have to take thing so once they look to treat
another problem from another pill and it just goes on and this is why I
think if we can try to streamline and try to simplify treatments for our
patients that's so much the better what would you say to patients taking
the spironolactone well spironolactone is a very good treatment which is basically
it's a treatment that's used to treat blood pressure but in
women who are not looking to be fertile or to bear children and
because it's a teratogen it basically would causes birth defects in women in
children it's a very good treatment to prevent excess body hair and also
prevents hair loss and it also prevents acne so it's effectively treating the
skin and it prevents the effects of tests or excess testosterone in on the
on the skin and the hair its a blocker it blocks at the skin cells yes so you know
one thing that's really interesting now is in a lot of the anti-aging
conferences that we go and a lot of the latest evidence is showing that health
is really a feature of so many different things like sleep nutrition hormones
stress management and then there's this huge component of the microbiome so if
the microbiome is in balance and that's the one or two kilos of bacteria that's
living in our intestines if they're in good balance and in beneficial balance a
lot of the health problems that come through our doors at tend to be
mitigated so if we've got a healthy microbiome that means at the very least
having a whole foods based diet and not and minimizing processed foods that
unprocess in your diet you can achieve microbiome
health and that can also prevent problems like skin issues like acne and
even eczema as well you ever done one of those stool tests yet that's next on the
list so I did one mmm do tell great this is just an aside yeah
it wasn't great we need to work on you have been popping pro-biotics and
everything like there's no tomorrow so the other evidence that is shown is that
probiotics are basic like travelers or like tourists so they're in your
intestines for a short time and then they are gone so your natural flora
regrow and apparently the things that influence your natural flora or your
natural by microbiome are much more prebiotics so it's the the foods that
you eat which should be rich in things that for example produce butyric acid
and feed the cells of your intestine blimey I feel like it's a shame you know
that it has these negative effects on oneself maybe we should do a separate
video about controversial but I think sometimes you know the ends justify the
means you know sometimes we've got we've got to exchange one risk for another
it's all about risk benefit analysis isn't it this is the thing about health
for medicine and whatever you want to call it every person's unique you've got
to really unpick and unpack what their unique situation is yeah okay all right
well that's it for this week I hope that you have enjoyed this series about
hormones maybe do some again so one thing to mention is
that if you are interested in actually just finding out much more about for
example specifically menopausal health and andropause in our website we have a
special link which will take you to a video series so this isn't anything to
do with me this is to do with an evidence base for testosterone
replacement and estrogen and progesterone and how it might benefit
people going through these times of their lives basically it's some other
dudes videos basically yeah but he's very knowledgeable and he's a
compounding pharmacist based in America who I've learned an awful lot from so
he's a recommended resource cool all right guys we'll see you later bye-bye