Hormonal Acne: A Paradigm Shift in the Management of Acne
Acne vulgaris, the most common skin condition observed in the dermatologist's office, is a multifactorial disease of the pilosebaceous unit, produced by the interaction of four pathogenic factors: abundance of sebum production; increased formation of keratin in the follicles; amplified growth of colonization of Propionibacterium acnes within the pilosebaceous unit and inflammation. Hormonal acne refers to conditions where, during periods of hormonal excess or imbalances, acne flares up due to the combined effects of excess sebum or oil secretion and higher androgen levels in the body.
Endocrine, paracrine, juxtacrine, autocrine and intracrine pathways are ways by which hormones can exert their actions. On account of its capacity to synthesize miscellaneous hormones and express diverse hormone receptors, the pilosebaceous unit can be considered an endocrine organ in the skin. Among these hormones, androgen is clinically significant. The cutaneous features of hyperandrogenism are due to overexpression of androgenic enzymes or hyper-responsiveness of receptors.
Introduction
Acne vulgaris, the most common skin condition observed in the dermatologist's office, is a multifactorial disease of the pilosebaceous unit, produced by the interaction of four pathogenic factors: abundance of sebum production; increased formation of keratin in the follicles; amplified growth of colonization of Propionibacterium acnes within the pilosebaceous unit and inflammation. Hormonal acne refers to conditions where, during periods of hormonal excess or imbalances, acne flares up due to the combined effects of excess sebum or oil secretion and higher androgen levels in the body.
Endocrine, paracrine, juxtacrine, autocrine and intracrine pathways are ways by which hormones can exert their actions. On account of its capacity to synthesize miscellaneous hormones and express diverse hormone receptors, the pilosebaceous unit can be considered an endocrine organ in the skin. Among these hormones, androgen is clinically significant. The cutaneous features of hyperandrogenism are due to overexpression of androgenic enzymes or hyper-responsiveness of receptors.
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