Acne

Hormonal effect on the skin

Every organism has a number of substances that maintain and regulate bodily functions. This also include hormones. They carry out a variety of tasks. Sexual hormones, for instance, primarily control the development and function of the sexual organs and also influence other organs and tissue, such as the sebaceous glands and hair roots.
Accordingly, there are both male and female sexual hormones that are formed in different quantities, depending on gender. Of course, this means that women also produce male sexual hormones (androgens).

How 'male' hormones (androgens) influence the development of acne:

Influence of the androgens on the sebaceous glands

The influence of male hormones results in a faster growth of the horny cells in the excretory duct of the sebaceous follicle and thus, to an increased accumulation of horny cells. A plug of horny cells is formed that prevents the sebacous gland secretion from being discharged.

Male sexual hormones also stimulate growth and the sebum production of the sebaceous glands.

The sebaceous glands react in a sensitive way to androgens. If more androgens are produced, they also produce more sebum and vice versa. It is also possible that the sebaceous glands also react to androgens in a very sensitive manner by themselves.

An increased sebum production and a cornification disorder in the sebaceous follicle excretory duct considerably aid the development of open and closed blackheads (comedones).
Other factors (bacterial colonisation of the sebaceous gland secretion and complex inflammatory reactions) can also cause inflammatory acne symptoms, such as spots.

Influence of the androgens on the hair roots

The hair roots are also influenced by androgens. In men, the sexual hormones are responsible for the characteristic body hair. Under certain conditions, the hair on the face, sexual and body area can be strongly pronounced in women, and resemble the pattern in men (see also hirsutism).

The formation of androgens varies depending on the individual. Some women produce slightly more, others slighter fewer androgens. This can also be noticeable in the skin's appearance. However, in most cases, the sebaceous glands and hair follicles simply react in a more sensitive manner to androgens or hormonal fluctuations.

How 'female' hormones have an effect on the skin:

The female hormones that the body produces include oestrogen and progesterone. Both hormones primarily control the menstruation cycle in women. In the organism, however, they also have a series of other functions and also have an effect on the skin, among other things.

Oestrogens – by that, we mean natural oestrogen, as well as oestrogens produced in the laboratory – act as counter-players to the male sexual hormones (androgens). Their influence means that the quantity of the androgens freely circulating in the blood is reduced. The growth and the sebum production of the sebaceous glands are thus reduced. They also have a stabilising effect on the female cycle and reduce fluctuations in the cycle.

Gestagenes, such as natural progesterone, are also female sexual hormones. They influence the female cycle in a variety of ways. In sufficiently high quantities, they prevent ovulation and change the viscosity of the cervical mucus. These properties mean that they have a contraceptive effect when used as tablets.

The effect of gestagenes can also vary (e.g. on the skin). They are consequently divided into gestagenes with so-called anti-androgenic sub-effects and those with androgenic effects.

Gestagenes that have an anti-androgenic component are suitable for treating acne. They can block the effect of male sexual hormones in the sebaceous glands that cause acne.

Hormones for the treatment of acne

Through female hormones, it is therefore possible to reduce an increased production of sebum, which contributes to the development of acne (the hair is also less greasy).

That is why there are anti-baby pills that have been specifically developed to combat acne and more minor forms of hirsutism. They contain a combination of an oestrogen and a gestagen.

Women and teenage girls should ask their dermatologist or gynaecologist whether hormone treatment can be considered for them, in particular, if they are also interested in an additional contraceptive effect.

Further information can also be found in the acne guide 'Hormones for beautiful skin'