Acne panel

Does acne still trouble you in adulthood, alongside irregular cycles or excess hair growth? The acne panel checks the hormones most often behind such acne, making it easier for you and your doctor to decide whether the cause is hormonal and which treatment makes sense. The panel is available in versions for women and men.

Who the panel is for

• women with acne after the age of 25., particularly on the lower face;
• women whose acne is accompanied by irregular or absent periods, excess hair growth or thinning hair;
• for acne that appears or worsens suddenly in adulthood, or does not settle despite usual treatment;
• in suspected polycystic ovary syndrome (PCOS);
• before hormonal acne treatment, when a dermatologist or gynaecologist wants to base it on test results;
• men with sudden severe acne, particularly with testosterone or anabolic steroid use.

Most people with acne have normal hormones. For mild teenage acne without other symptoms, the panel is usually unnecessary.

What the panel detects

Both panels, for women and men, cover four hormones:

• DHEA-S is a male hormone from the adrenal glands. It shows whether excess male hormones originate there.
• FSH is a pituitary hormone stimulating egg maturation and sperm production.
• LH is a pituitary hormone stimulating ovulation and testosterone production. In PCOS, it is often elevated relative to FSH.
• Free testosterone is the active fraction of testosterone acting on the skin and sebaceous glands. It is an important indicator of excess male hormones.

Together, they show whether there is an excess of male hormones (androgens) and its source: the ovaries, adrenal glands or changes in pituitary function.

The procedure and preparation

Blood is taken from a vein. Because the panel contains free testosterone, come fasting in the morning, after 8 to 12 hours without food (water is allowed). Menstruating women have blood drawn on days 2.–5. of the cycle (most often day 2. or 3.) or as instructed by their doctor. Men have blood drawn between 7 and 10.

Hormonal contraception lowers male hormones, so tell your doctor you take it. If you started it for acne, do not stop it yourself: your doctor decides whether a break before testing is needed. If you take biotin (for example, hair and nail supplements), mention it at the blood draw. Drawing blood takes a few minutes.

What your result means

• Elevated free testosterone in women is most often a sign of PCOS. Less commonly, the cause is adrenal, and very high values with sudden symptoms require prompt investigation.
• Elevated DHEA-S points towards the adrenal glands. A mild increase is also common in PCOS, and a doctor may additionally request 17-hydroxyprogesterone.
• LH elevated relative to FSH is often seen in PCOS, but the ratio alone is insufficient for diagnosis.
• In men low LH and FSH with high free testosterone most often suggests testosterone use, and with low testosterone may also suggest use of other anabolic steroids.
• Normal result means the acne is probably not due to a hormonal disorder, so a dermatologist treats it in the usual way.

Reference values depend on age, sex and cycle phase and are printed on the report. A dermatologist, gynaecologist or endocrinologist interprets the result alongside examination and your symptoms.

How to arrange testing

You can have blood taken without an appointment or referral at one of our branches across Croatia (listed under Contact). Prices for all tests and panels are available in the price list. If you have irregular cycles alongside acne, a doctor may recommend the broader PCOS panel, which, in addition to these four hormones, includes testosterone, SHBG, 17-hydroxyprogesterone, oestradiol, TSH and prolactin.

Frequently asked questions

Is acne always hormonal?

No. Acne most often results from sebaceous glands sensitive to usual hormone amounts, so most people have normal hormone results.

Can I have the panel while taking contraceptive pills?

Yes, but the pill lowers male hormones, so the result may look better than without it. Tell your doctor and do not stop the pill without agreement.

On which cycle day should I have blood drawn?

Most often days 2.–5. of the cycle, usually day 2. or 3. If you have no periods or they are very irregular, blood can be drawn on any day, as advised by your doctor.

Is an examination needed alongside the panel?

Yes. Hormones show only part of the picture, and a doctor interprets them alongside skin appearance, cycle, weight and other findings.