Module 1: Understanding acne

 

1.2 Causes – Hormones

Hormones have a huge part to play in the production of acne.

In section 1.1.1 we covered two potential reasons for cells clogging the follicle, and thus causing acne. These were 1. the production of too many skin cells, and 2. hyperkeratinization. Researchers suspect that hormones are involved in keratin levels, and hormones are known the control the rate of skin cell growth.

In this section we’ll examine one of the main culprits in causing acne, testosterone, and look at many different hormonal influences that can cause breakouts.

1.2.1 Testosterone and DHT

Testosterone is a natural hormone that is found in the bodies of both men and women. The average adult male has between 4 times to 75 times more testosterone than the average adult female. This hormone is essential for sexual behavior, building protein, bone formation, the production of blood cells, liver function and carbohydrate metabolism. In women, it is produced in the ovaries.

DHT (Dihydrotestosterone-alpha) is a natural steroid, produced in the gonads in men. (It is also present in women, but to a much lesser extent). It is an androgen (male) hormone, and is responsible for the biological characteristics of males, such as increased muscle mass, hair on the chest and a deep voice. 5% of free testosterone is converted into DHT, by the 5-alpha enzyme. DHT is about five times more potent than testosterone, and is considered a very potent androgen.

DHT can cause acne because it over stimulates the sebaceous glands, the same oil glands that cause your skin to product more sebum. This can result in more acne as pores become clogged. This is not always the cause of acne, but it can be, particularly in females.

1.2.2 Periods

Women can experience menstrual acne, which is a flare up on the skin that coincides with their period. Generally, the acne will start to be more severe around seven to 10 days before the period begins, and will subside when bleeding starts. Around 63% of women who are acne-prone experience these flare ups, according to a study in the Archives of Dermatology.

The reason for this is hormonal changes. In the first half of the cycle, estrogen is the main hormone, while in the second half, progesterone is dominant. As the period approaches, the levels of both hormones fall significantly. Testosterone stays at a constant level throughout the month, and when the other hormones dip, it becomes dominant and makes the oil glands produce more sebum, which increases breakouts.