The Hormonal Hype: Unmasking Androgens in Acne

[madman]

Very thorough worthy of a sticky!

Really enjoyed this one!

 

[madman]

OBJECTIVES:

 

[madman]

The Complex Role that HORMONES play in the Pathogenesis of Acne Vulgaris

 

[madman]

4 PILLARS OF ACNE PATHOGENESIS

* Follicular Keritanization

* Inflammation

* C.Acnes

* Excess sebum production...due to Androgens

 

[madman]

Would steer clear of isotretinoin or any of the 5ARs (finasteride/dutasteride) due to side-effects (sexual/neurosteroids)!

Downfall here is isotretinoin is the most effective medication for treating acne especially moderate-severe cystic acne which can be devastating for many!

The need to prevent/minimize permanent scarring is critical!




* the only therapy that hits all 4 PILLARS with just one product is isotretinoin (Accutane) and we know that is the most effective treatment on the market today




TABLE. IMPACT OF TOPICAL AND ORAL MEDICATIONS ON FACTORS OF ACNE PATHOGENESIS

 

[madman]

SO...WHICH HORMONES ARE THE CULPRITS??

5AR activity/sensitivity of the hair follicle to DHT would be key here!


* Testosterone, DHT (5 times more potent than Testosterone!) and DHEA are the MOST POTENT ANDROGENS that we have within our bodies




HORMONES THAT CAUSE ACNE:

 

[madman]

HYPERANDROGENISM IN FEMALES: CAN BE CAUSED BY OVARIAN OR ADRENAL FACTORS

 

[madman]

Very serious condition some women face!



POLYCYSTIC OVARIAN SYNDROME

Pathophysiology of PCOS

 

[madman]

HORMONES ARE RESPONSIBLE FOR ALL STAGES OF ACNE

 

[madman]

Infantile Acne

INFANTILE ACNE:

TREATMENT FOR INFANTILE ACNE:

 

[madman]

Definitely all about the ANDROGENS here!




Pre-Teen & Puberty

PRE-TEEN & PUBERTY:

TREATMENT OF PRE-TEEN & PUBERTY ACNE VULGARIS:

PRE-TEEN & PUBERTY TREATMENT OPTIONS:

CABTREO (clindamycin phosphate, adapalene, and benzoyl peroxide).

Second most effective medication to treat acne that tackles 3 of the 4 pillars!

Start your acne treatment with CABTREO

A first-of-its-kind 3-in-1 topical acne treatment. For ages 12+.

www.cabtreo.com

Efficacy and Safety of Clindamycin Phosphate 1.2%/Adapalene 0.15%/Benzoyl Peroxide 3.1% Gel: Post Hoc Analysis by Baseline Disease Severity - PubMed

ClinicalTrials.gov identifier NCT03170388, NCT04892706, NCT04214639, and NCT04214652.

pubmed.ncbi.nlm.nih.gov

 

[madman]

FEMALE HORMONAL ACNE

"HORMONAL" ACNE...FEMALE

* Clascoterone 1% cream is the only TOPICAL to address Excess Sebum Production


TREATING THE ANDROGENS: TOPICALLY

TREATING THE ANDROGENS: SYSTEMICALLY

Dr. Julie Harper's Practice Approach to Prescribing Spironolactone

TREATING THE ANDROGENS: SYSTEMICALLY

 

[madman]

"NATURAL" ANTI-ANDROGENS??

TBD...




NATURAL WAYS TO REDUCE ANDROGENS

 

[madman]

* TREATMENT FEMALE HORMONAL ACNE: YOU ONLY HAVE 3 CHOICES!

 

[madman]

Adrenal Glands = Stress Induced Acne

ADRENAL HYPERANDROGENISM

 

[madman]

Do we need to do Hormonal Testing??

WHEN DO WE NEED TO TEST FOR EXCESS ANDROGENS?

HORMONAL TESTING:

IS "ORDERING TESTS" FOR HORMONAL ACNE AND/OR HORMONAL HAIR LOSS MAKING YOU ANXIOUS...

 

[madman]

YOU THINK THAT WE ARE FRUSTRATED...IMAGINE BEING A PATIENT

INTERNET HYPE

WHAT IS "THE INTERNET" TELLING ARE PATIENTS WITH HORMONAL ACNE??

ACNE IS THE MOST COMMON REASON PATIENTS SEEK TREATMNENT FROM DERMATOLOGY PROVIDER

 

[madman]

* we are just beginning to understand the complex immunology and all the inflammatory triggers that go on in acne




THE IMMUNOLOGY OF ACNE VULGARIS ADDS NEW LAYERS OF COMPLEXITY TO ACNE'S PATHOGENESIS

 

[madman]

Thread 'The primary role of sebum in the pathophysiology of acne vulgaris'

Dec 26, 2023

ABSTRACT

Background

Sebum physiology and its contributions to acne vulgaris (AV) pathophysiology have been long debated. Within the pilosebaceous unit, androgens drive sebocyte production of sebum, comprising mono-, di-, and triglycerides (the latter converted to fatty acids); squalene; cholesterol; cholesterol esters; and wax esters. Upon release to the skin surface, human sebum has important roles in epidermal water retention, antimicrobial defenses, and innate immune responses.


Aims

Alterations in sebum alone and with other pathogenic factors (inflammation...

• madman
• acne; pathophysiology; treatment; sebum
• Replies: 13
• Forum: Testosterone Side Effect Management

 

[madman]

Thread 'Are Androgen Hormones the Cause of Hair Loss and Acne ?'

Mar 29, 2025

Dr. Lawrence J Green from Skinalliance LDB discusses if androgen hormones cause hair loss and acne. Learn more about the effects of testosterone and creatine on your skin health.

In this informative video, Dr. Lawrence J. Green delves into the relationship between androgen hormones and common skin issues such as hair loss and acne. Are androgens really the culprits behind these conditions? Join us as we explore the science behind hormones, their effects on the skin, and the latest research findings.

Learn about the role of androgen hormones in the body...

• madman
• androgens; acne; dht; mpb
• Replies: 6
• Forum: Testosterone Side Effect Management