How hormones affect acne

How Hormones Affect Acne

Acne is a skin condition that occurs when your hair follicles become plugged with oil and dead skin cells. Acne most commonly appears on your face, neck, chest, back and shoulders. Acne can be distressing and annoyingly persistent. Acne lesions heal slowly, and when one begins to resolve, others seem to crop up.

Acne is a condition of the skin that shows up as different types of bumps.

These bumps can be blackheads, whiteheads, pimples, or cysts. Teens get acne because of the hormonal changes that come with puberty.

Acne formation process and the role of hormones Excessive sebum production is perhaps the key characteristic of acne.

Sebum production in the skin is handled by cells known as sebocytes. They are a bit like water balloons in that they gobble fatty acids and grow bigger and bigger. Once they mature they make their way into the hair canal where they burst and spill the sebum. Hormones stimulate the growth of sebocytes and thus sebum production.

Blockage of the hair canal (follicle) by dead skin cells is another key characteristic of acne. Cells known as keratinocytes are the most common cells in the outer layer of the skin. They form the walls of the hair canal. In a healthy skin they die and separate and are pushed out of the skin by the growing hair. In an acne-prone skin this process goes haywire for two reasons.

• Excess growth of skin cells.

• Condition known as hyperkeratinization. Keratin is a protein that binds these cells together, and when you have too much of keratin the bonds between the cells are stronger. So when the cells die they are more likely to stick together and block the hair canal.

There’s a good reason to believe hormones affect both of those. It’s known that hormones accelerate the growth of skin cells (thus more dead skin cells to eliminate), and researchers suspect that hormones up-regulate keratin levels (and thus hinder separation of dead skin cells). Once the hair canal is blocked by a sticky mixture of sebum and dead skin cells it starts to swell as more and more dead skin cells are pushed into the area. Oxygen levels plummet at the blocked pore, and this creates an ideal environment for P. Acnes bacteria to thrive.

Inflammation results as the immune system attacks the bacteria in the blocked pore. Acne patients have markedly stronger inflammatory response to acne bacteria than people with healthy skin.

To summarize, hormones affect all the primary causes of acne: sebum production, skin cell growth and separation and inflammation.

The culprits: Insulin, IGF-1 and androgens Now that we understand how hormones affect acne, let’s see which hormones are to blame. This discussion could get very complicated very quickly, as different hormones have somewhat different effects on different

cell types in the skin. But we don’t have to worry about what. So, in the interest of keeping things simple we can say that the primary hormones behind acne are: • Insulin is a storage hormone (among other things). It takes glucose (sugar) and amino acids (protein) from bloodstream to the cells.

Eating carbohydrates and protein (to lesser extent) will cause insulin levels to increase.

• Insulin like growth factor 1 (IGF-1) is a growth hormones. It often goes hand in hand with insulin, so anytime insulin increases so does IGF-1.

• Androgens are male sex hormones, of which testosterone is the best known. Other acne-relevant hormones are dihydrotestosterone (DHT) and dehydroepiandrosterone (DHEAS).

Here’s how these hormones affect Acne: IGF-1 stimulates the growth of sebocytes and thus increases sebum production. One study demonstrated correlation between IGF-1 levels and facial sebum production.

• Make skin cells grow faster • Stimulate the synthesis of androgens in the testes and ovaries • Make the skin more sensitive to androgens So while insulin and IGF-1 act on the skin directly their primary effect on acne comes from the fact that they multiply the effect of androgens.

Hormones affect all the steps in the acne formation process. They increase sebum production and skin cell growth, hinder separation of dead skin cells and increase inflammation.

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