When it comes to acne issues, women sometimes have a larger burden to bear. Lament it as we might, they’re often judged more on looks than men. Their hormonal systems make them more prone to developing acne at certain times. Treatment options can be more expensive for them and costs harder to meet.

During the teen years, girls tend to develop acne sooner than boys. On average most girls will start to develop acne by about age 11, as contrasted with age 13 for boys. The reason isn’t hard to find. Girls mature sooner. They tend to enter puberty a few months to a couple of years before boys.

During those years the human hormone system sees rapid increases in levels of a number of well known hormones, such as estrogen or testosterone. But there’s a class of hormones that are less well known by name, but more relevant at this stage to acne onset: androgens.

As the name suggests, these hormones are shared by both males and females. But, as noted, the rise in females occurs sooner. Once they reach puberty, the androgen levels rise higher in males, so they tend to suffer more severe acne.

About 2/3 of all teens will develop acne, at least in mild form. But for females, the condition tends to last longer, at least cyclically. As a woman enters her 20s, her menstrual cycle tends to raise the likelihood of developing at least mild acne. Since that occurs approximately once per month, so does the acne. The week prior to the onset of flow is typically the worst for almost 62% of women.

The problem persists for women throughout the years of reproductive capacity. Over 50% of women (as opposed to only 42.5% of men) between ages 20-29 develop acne. The numbers dip radically for the years 30-39 to 35.2% and 20.1% respectively. By the time she’s reached her 40s, the number has lowered to 26.3% (12% for men). For those aged 50 and older the numbers are about 15% and 7% for women vs men.

The severity follows a similar pattern. Between the third and fourth weeks of the menstrual cycle, inflammations increase about 25%. Even blackheads and whiteheads rise about 20% during this time.

Pregnancy offers some relief, but it mostly shifts the pattern. It doesn’t eliminate acne entirely. During pregnancy, breakouts can occur at random. Skin changes, even for those who have never had acne, are a common occurrence when a woman is carrying.

Here again, significant hormonal changes are taking place. The largest number of cases tends to occur during the first trimester. That shouldn’t be surprising, since this is the interval during which hormone levels are changing most rapidly from their usual amount and distribution. Delivering the baby will often put an end to the outbreaks, but they tend to persist longer in women who breastfeed.

Though a woman has to always be more careful about what medications she takes, normal over the counter treatments are considered safe. Some studies have suggested, however, that isotretinoin (brand name: Accutane) and tetracycline (doxycycline), treatments for severe acne, should be avoided during pregnancy. They may cause birth defects or development problems in the fetus.

When in doubt, consult a dermatologist.

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