Hormones And Their Role In The Acne Drama

Hormones play a central role in the acne drama. Hormones are the body's chemical messengers. Without hormones, you wouldn't have acne, but you'd be in pretty bad shape, because hormones control just about every bodily function, from regulating your metabolism to ensuring that you can mature and have children.

 

In both males and females, a particular group of hormones, called androgens, are primarily associated with the formation of acne. The term androgen is a general term for hormones that have more masculinizing features. Androgens are responsible for the development of secondary sex characteristics in males (facial hair, increased muscle mass, the ability to reproduce, and so on). The androgen testosterone is the main male hormone. However, if you're female, you have androgens too, but they're produced in smaller quantities and are much weaker than in your male counterparts.

 

Estrogen and progesterone are the primary female hormones that control menstrual cycles and regulate pregnancy. Both of these hormones can have an affect on acne as well — albeit less than androgens — by their periodic monthly fluctuations.

 

The androgenic hormones help us regulate how much sebum our sebaceous glands produce. People who get acne aren't producing any more of these androgens than anyone else; it's just that their sebaceous glands are very sensitive to the hormone's message to increase production. The glands respond by pumping out excessive amounts of sebum. Your face, chest, and back contain the highest concentrations of sebaceous glands; that's why you're more likely to have acne on these areas.

 

Adolescence is generally the worst time for acne because androgens are increasing steadily during the teen years, and they signal your sebaceous glands to get larger and to generate more sebum. As adolescence ends, the amount of androgen secretion diminishes and acne tends to disappear for most teens by age 18 or 19. But for various reasons some women (and much less commonly, men) retain a heightened sensitivity to their androgens and continue to have acne beyond adolescence. Some women even get acne for the first time as adults.

 

Every day, millions of skin cells die off. You continually make new skin cells and get rid of dead ones. Your body has ingenious ways of getting rid of these dead cells. In the case of your skin, sebum carries the dead skin cells to the outside of the body where they flake off.

 

Sometimes, though, as sebum ferries dead cells from the inside of your hair follicle along the oily sebaceous ducts and out through the hair canal, the exit route of the follicle is blocked by the excess oil. This blockage causes the opening of your hair canal to narrow, and your pores, the tiny openings in your skin that serve as exits for your hairs, get clogged. The exit of oil is also often impeded by a process called abnormal follicular keratinization. That's a fancy way of saying that instead of flaking off with the sebum when they reach the skin's surface as they normally do, the dead skin cells and keratin clump together with the oil to further clog the sebaceous ducts and hair canals.

 

Acne is not caused by forgetting to wash the oil off, or even by eating loads of greasy French fries and junk food. It's not the oil in your tummy or on your skin; it's the oil in your skin.

 

The trapped sebum, cells, and keratin form a very sticky mixture — a real traffic jam that blocks the exit route. This plug acts just like a cork in a bottle, locking in all that stuff inside with nowhere to go, so that it can't exit onto the surface of the skin. The plug is called a microcomedo. You can't see a microcomedo with the naked eye; it's too small. Over time, the increasing amount of trapped sebum builds up a lot of pressure and the hair follicle blows up like a balloon and becomes a visible comedo.

 

There are the two types of comedones: