Beyond the Surface - Skin Community - Systems - Decreased Endocrine System Function

Hormonal Imbalance and Acne: The endocrine system regulates the body's hormones. When it doesn't function properly, it can lead to hormonal imbalances, which are a primary cause of acne. Conditions like insulin resistance and polycystic ovarian syndrome (PCOS), which are associated with endocrine dysfunction, have been linked to an increased occurrence of acne
Role of Androgens and Sebaceous Glands: Excess production of certain hormones, especially androgens, can lead to increased acne development. The skin, including sebaceous glands, is influenced by these hormones. Androgens promote the production of sebum, an oily substance, in these glands. Acne is considered an androgen-mediated dermatosis
Mechanism of Acne Formation: Acne is caused by clogged pores, which occur due to excess sebum production. This oil, produced in greater amounts due to hormonal changes, interacts with bacteria on the skin, leading to acne. Factors contributing to clogged pores include excess sebum, dead skin cells, and bacteria

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Common causes: Hormonal Imbalances: These can be due to various factors such as stress, poor diet, or underlying health conditions, leading to disruption in hormone production. Autoimmune Disorders: Conditions like Hashimoto's thyroiditis or type 1 diabetes, where the immune system attacks endocrine glands, impairing their function. Genetic Disorders: Certain inherited conditions can affect endocrine glands. For example, Turner syndrome can impact ovarian function. Infections or Inflammation: These can damage endocrine tissues, affecting gland functionality. Tumors or Nodules: Both benign and malignant growths can disrupt normal endocrine function by damaging glandular tissue or producing excess hormones.

1. Androgens (Elevated levels can stimulate sebum production, leading to acne)

Adrenal Glands: Produce androgens like testosterone and DHEA.

Ovaries/Testes: Major sources of androgen production.

Skin: Sebaceous glands in the skin produce sebum.

2. DHEA/DHEAS

Adrenal Glands: Primary site of DHEA and DHEAS production.

Gonads: Convert DHEA to other sex hormones.

Skin: Utilizes DHEA for local hormone synthesis affecting skin health.

3. DHT (Dihydrotestosterone)

Prostate: A significant site of DHT action, affecting growth and function.

Adrenal Glands: Produce precursors that are converted to DHT.

Skin: Hair follicles and sebaceous glands are highly responsive to DHT.

4. Androstenedione

Adrenal Glands: Produce androstenedione.

Ovaries/Testes: Convert androstenedione to other sex hormones.

Liver: Metabolizes androstenedione.

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5. Estrogens (particularly Estradiol) and Progesterone (Imbalances can affect skin health)

Ovaries: Primary source of estrogen and progesterone production in women.

Adrenal Glands: Produce small amounts of these hormones.

Skin: Responds to hormonal changes affecting health and appearance.

6. Hormone (LH) and Follicle-Stimulating Hormone (FSH) (Important for understanding overall hormonal balance)

Pituitary Gland: Produces LH and FSH.

Ovaries/Testes: Target organs of LH and FSH, critical for reproductive function.

Hypothalamus: Regulates the release of these hormones through GnRH (Gonadotropin-releasing hormone).

7. Cortisol

Adrenal Glands: Produce cortisol in response to stress.

Liver: Metabolizes cortisol.

Brain: Hypothalamus and pituitary gland regulate cortisol production through the HPA axis (hypothalamic-pituitary-adrenal axis).

8. Growth Hormone (GH)

Pituitary Gland: Produces and secretes growth hormone.

Liver: Converts GH to IGF-1 (Insulin-like Growth Factor 1), mediating many of GH's effects.

Bones and Muscles: Primary targets for growth and development effects.

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Cappel, M., Mauger, D., & Thiboutot, D. (2005). Correlation between serum levels of insulin-like growth factor 1, dehydroepiandrosterone sulfate, and dihydrotestosterone and acne lesion counts in adult women. Archives of dermatology, 141(3), 333–338. https://doi.org/10.1001/archderm.141.3.333 (edited)

"The early development of comedonal acne may be one of the best predictors of later, more severe disease. The adrenal hormone DHEAS appears to play an important role in the initiation of acne. DHEAS, testosterone, and FT are associated with the perpetuation of severe comedonal acne" Lucky, A. W., Biro, F. M., Simbartl, L. A., Morrison, J. A., & Sorg, N. W. (1997). Predictors of severity of acne vulgaris in young adolescent girls: results of a five-year longitudinal study. The Journal of pediatrics, 130(1), 30–39. https://doi.org/10.1016/s0022-3476(97)70307-x