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[Acne and hormones].

Michel Faure1

  • 1Clinique dermatologique, Hôpital Edouard-Herriot 69347 Lyon. michel.faure@chu-lyon.fr

La Revue Du Praticien
|June 11, 2002
PubMed
Summary

Acne in women often stems from cutaneous androgenization, potentially linked to idiopathic skin hyperandrogenism or hormonal imbalances. Hormonal therapies aim to counteract androgen effects on sebaceous glands, offering treatment options for various acne severities.

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Area of Science:

  • Dermatology
  • Endocrinology
  • Reproductive Medicine

Context:

  • Acne vulgaris in women is frequently associated with androgen excess or sensitivity.
  • Cutaneous androgenization, whether idiopathic or related to systemic hormonal disorders, plays a key role in acne development.
  • Understanding the link between androgens and sebum production is crucial for managing female acne.

Purpose:

  • To explore the role of androgens and hyperandrogenism in the pathogenesis of acne in women.
  • To discuss diagnostic approaches for identifying underlying endocrine abnormalities contributing to acne.
  • To outline hormonal treatment strategies for managing acne in women, considering different severities and underlying causes.

Summary:

  • Androgens stimulate sebum production, a key factor in acne development. Female acne can manifest as cutaneous androgenization, often due to idiopathic skin hyperandrogenism or elevated ovarian/adrenal androgen secretion.
  • Conditions like polycystic ovary syndrome (PCOS) or nonclassical 21-hydroxylase deficiency may be indicated by acne in women, necessitating hormonal assays and imaging for diagnosis.
  • Hormonal therapy for acne targets androgen effects on sebaceous glands. Options include anti-androgens (cyproterone acetate, aldactone) for severe cases and hormonal contraceptives for milder acne, sometimes combined with other treatments. Glucocorticoids are used for severe inflammatory acne.

Impact:

  • Provides insights into the hormonal basis of acne in women, aiding in diagnosis and management.
  • Highlights the importance of considering endocrine evaluation in women with persistent or severe acne.
  • Offers a framework for selecting appropriate hormonal therapies based on acne severity and potential underlying hormonal imbalances.

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