What is a Connection about Androgens (Testosterone) & Acne

Most people know that there is some form of relationship between hormone levels and acne. Women often experience acne breakouts before and during their menstrual cycle or when they stop taking oral contraceptives.  Men during puberty or those who may take anabolic steroids know about acne breakouts as well.  The best way to understand the relationship between hormone levels and acne is to understand what are the primary causes of acne and how acne blemishes form.

Acne is the visible manifestation on the surface of your skin resulting from an internal imbalance.  This imbalance leads to overproduction of sebum (skin oil) by sebaceous glands. This extra sebum tends to clog the pores of the skin leading to an accumulation of dead skin cells and dirt which creates an ideal condition for bacteria to grow.  In more severe cases of acne the body mounts an attack on the bacteria leading to local inflammation and possible damage to the skin. On the surface of the skin acne appears as: comedones (whiteheads and blackheads) pimples, pustules and most painful -cysts.

The most common factor causing the internal imbalance and the over production of sebum is fluctuating hormone levels; in the case of male acne androgen related hormones.  The androgen related hormones that are most often associated with increasing sebaceous gland secretions are testosterone, and its analogs DHT and DHEAS.  These male hormones directly impact the sebaceous glands and increase sebum production thus initiating the acne cascade.  In most cases the developing pimples are “walled off” by the body and restricted to a single pore. In some cases, however, the local inflammatory response spreads under the surface of the skin to cause “bumps” which are the sign of acne cysts.  With cystic acne there is damaged to the underlying layers of the skin and any attempt to “squeeze” these bumps will only further damage the skin.

Understanding that androgen related hormones can influence sebaceous gland secretions is only part of the story. What most people do not understand is that only 1-2% of these hormones circulate freely in the blood; the other 98% are bound to a protein produced by the liver called Sex Hormone Binding Protein (SHBP). If the androgen hormones are bound to SHBP in the blood they are less likely to cause acne. It is primarily the “free form” of DHT and DHEAS that can cause the sebaceous glands to make more sebum.  Since men naturally have more testosterone related hormones in their bodies, it is more likely that more of the analogs (DHT & DHEAS) may be found in the free form leading to an increased risk of acne. 

Another issue that is often misunderstand is that women have circulating levels of androgens as well.  In fact some women have a type of acne called “androgen induced acne” that is due to excess androgen being produced by their adrenal glands.  In this case many women are prescribed spironolactone, but that is another story for another time.  Similarly men have low levels of what might be considered female hormones such as estrogen in their bodies as well.

Understanding that these analogs of testosterone impact sebaceous gland secretions also helps explain why men who take anabolic steroids are prone to acne as well.  Anabolic steroids do not bind to SHBP therefore they are free to bind to androgen receptors and stimulate sebaceous gland secretions. Addition of anabolic steroids to the body disrupts the balance between normally occurring androgens and SHBP thereby causing new acne to form or exacerbating existing mild or moderate acne.

AcnEase does not directly impact androgen hormone levels; rather it prevents hormone fluctuations from adversely impacting sebaceous gland secretions and may influence the levels of “freely circulating” (non-bound) androgens.  For those individuals who have androgen induced acne (men and women) attributable to testosterone, DHT or DHEAS, AcnEase can help prevent the influence of these naturally occurring androgens on sebaceous gland secretions. This will brake acne cycle and stop the can cascade, allow old blemishes to heal and skin returning to its healthy and beautiful condition.