Androgens and other hormonal changes

The development and secretory activity of the skin's sebaceous gland are unquestionably under hormonal control and any means to manipulate this control could be of immediate importance in acne treatment. Human skin is a collection of androgen-responvsive tissues, hair follicles, sebaceous glands which secrete sebum, sweat glands, epidermis, dermis. Many practitioners and patients with acne believe that stress exacerbates the condition, delays the course of treatment and clearing the skin. Since adrenocoticotropic hormone (ACTH) is produced in response to stress, somer researchers have focused on its possible role in the development of acne. According to Toyoda et al there is ample clinical evidence suggesting that the nervous system such as emotional stress can influence the course of acne. Adrenal gland dysfunction may be present in some patients with acne, particularly when there is associated hirsutism, abnormal menses and infertility. Androgen serum levels are normal in most adult patients with acne suggesting that hypersensitivity of androgen receptors in pilosebaceous duct may be associated with development of adult acne. Although, according to Carmina et al serum androsterone glucuronide (AoG) is a metabolite of circulating androgens under the influence of 5alpha-reductase activity and has been shown to be particularly elevated in adult women with acne. Their study suggests that serum AoG is a sensitive marker of acne in women.

The involvement of hormonal factors especially androgens in development of acne suggests use of anti androgens to clear skin from acne. However this approach sounds logical, normal serum androgens in most acne patients undermine the hypothesis. Hypersensitivity of androgen receptors in follicular ducts is another way to explain the role of androgens in adult acne. Hormonal therapies provide valuable alternatives to standard adult acne treatments in selected individuals when there is evidence of hyperandrogenism.

Related Information:

5 alpha reductase and acne

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