Mirena and Acne: Why Does Mirena Cause Acne?

Adult acne is caused by hormonal imbalances due to peri-menopausal changes and often medication induced disturbances. Rosacea is a condition that is often confused with adult acne and sometimes it is difficult to tell the difference, especially since the exact cause of Rosacea is unclear. However sometimes we place too much emphasis on finding a name for a condition rather than simply searching for a solution to the problem. Both acne and Rosacea can be caused or exacerbated by inflammation.

Why is inflammation an important factor in balancing hormones?

Inflammation is regulated by hormones called prostaglandins. Anti-inflammatory prostaglandins function to regulate other hormones and have an inhibitory effect on androgens. Androgens include progestogens which are the active component in the Mirena device. The Mirena releases synthetic progestogens into the body resulting in an overall excess. The body then experiences a hormonal imbalance that can produce abnormal conditions such as ovarian cysts or even polycystic ovarian syndrome (PCOS) and acne amongst other known side effects all of which the manufacturer acknowledges. In general, progestogen-only products like Mirena are known to worsen or induce acne. Mirena-induced ovarian cysts can also lead to increased natural androgen secretion by the ovaries. Whether it is the synthetic androgen contained in the Mirena, or the stimulus on the ovary to increase androgen production, that leads to acne is not clear. In any case, the androgen excess needs to be addressed.

How does this hormonal imbalance cause acne?

Dermatologists have determined that excess androgens are converted to a male hormone called DHT (5 alpha dihydrotestosterone) which is responsible for increased oil production leading to acne. The androgens are transported to the receptors on oil producing skin cells where it is then converted to DHT by an enzyme present in these cells. Acnehelp report that dairy products can exacerbate acne.

How can we prevent the hormonal imbalance from causing acne?

An anti-androgen like spironolactone can prevent DHT from binding to the receptors on the oil-producing cells in the skin by blocking access to the receptor. It also inhibits the enzyme that converts androgens to DHT. However this drug is primarily prescribed as a diuretic and has some side effects. Other anti-androgens include Accutane but this is also a chemical that may work in some people but has some associated side effects. In any case, simply blocking the androgens means you have to keep taking the medication continually, and is not dealing with the problem of the initial hormone imbalance which can have a negative impact on health in other ways.

Correcting the hormonal balance naturally is a more intelligent approach since it aims to treat the cause of the problem and not just the symptoms. How to treat the cause of acne? Can adult acne caused by Mirena be treated naturally, or should the Mirena device be removed? Read on.