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In females with recalcitrant acne Or acne not adequately controlled with traditional antiacne medications, irregular menstural cycles are an additional clue to underlying hormonal imbalance. Coarse facial hair/hirsutism is also common in females with underlying hormonal imbalance
If I was the treating doctor I would have ordered a few lab tests to document the hormonal imbalance i.e Serum
Testosterone levels (free and total), Serum DHEAS levels, LH/FSH ratio, Prolactin levels, Pelvic Ultrasound to loook for
polycystic ovaries etc.
Specific treatment for hormonal imbalance is with cyclical monthly hormonal pills (containing an estrogen and a progestational agent).
This specific hormonal treatment may be required to be continued for 6-9 months along with topical (topical clindamycin or
benzoyl peroxide and topical retinoids) and oral treatment (
oral antibiotics e.g doxycycline or azithromycin or minocycline etc) for acne as usual.
I would suggest that you visit a
dermatologist in your region. Your dermatologist will discuss in more details about these and prescribe you accordingly.
Regards