Skin, hormones and acne

Hormones and acne treatment

The development and secretory activity of the skin's sebaceous gland are unquestionably under control of hormones and any means to manipulate this control could be of immediate importance in acne treatment. Human skin is a collection of androgen-responsive tissues, hair follicles, sebaceous glands, sweat glands, epidermis, dermis. Many practitioners and patients with adult acne believe that stress exacerbates the condition, delays the course of acne treatment and skin clarification. Since adrenocoticotropic hormone (ACTH) is produced in response to stress, some researchers have focused on its possible role in the development of adult 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 hormones especially androgens in development of hormonal acne suggests use of anti androgens to clear the 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. Theraputics with hormones provide valuable alternatives to standard adult acne treatments in selected individuals when there is evidence of hyperandrogenism.

In contrast, female hormones, estrogens and progestrone help clear the skin and sometimes are used in treatment of acne. Birth control pills does not cause acne and their use is associated with overall skin texture improvement. Birth control pills could be either combinations of estrogen and progestrone or each hormone by itself.

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Hormonal imbalance predispose the skin to development of adult acne.

Exercise and relaxation techniques are the most practical means to balance androgens and help alleviate skin breakouts. Many other stress related conditions can be attributed to imbalance in hormones and acne would be a consequence. Among them polycystic ovary disease which is associated with hirsutism and acne. Among hypothesis that explain how exercise and relaxation techniques change the androgen balance is an increase in microcirculation and overall improvement in cardiovascular functions. Also role of cytokines and suppressing inflammatory pathways in alteration of hormones could not be ignored.