The primary hormones that contribute to pimples (acne) are androgens.
While various factors contribute to acne development, hormones, particularly androgens, play a significant role by stimulating the production of sebum (oil) in the skin's sebaceous glands.
Androgens and Acne: A Closer Look
- Androgens: This group of hormones, including testosterone and dehydroepiandrosterone (DHEA), are primarily responsible for the increased sebum production associated with acne. DHEA was found to be the most frequently elevated androgen in women with hormonal acne in one study.
- Sebum Production: Increased levels of androgens cause sebaceous glands to enlarge and produce more sebum. This excess sebum, combined with dead skin cells, can clog hair follicles, creating an environment conducive to bacterial growth.
- Inflammation and Bacteria: The clogged follicles become inflamed, and Cutibacterium acnes (formerly Propionibacterium acnes), a bacterium that naturally resides on the skin, thrives in this environment. The bacteria further contribute to inflammation, leading to the formation of pimples, blackheads, whiteheads, and cysts.
Evidence from Studies
- A 2013 study involving 835 women with hormonal acne revealed that 55% had elevated androgen levels, with DHEA being the most frequently elevated.
- Another study in Turkey (2017) found that 55% of 207 women with acne had elevations in at least one androgen.
Other Hormonal Influences
While androgens are the primary culprit, other hormones can also influence acne:
- Estrogen: Estrogen generally has a protective effect against acne by suppressing sebum production. Fluctuations in estrogen levels, such as those experienced during menstruation, pregnancy, or menopause, can contribute to acne flare-ups.
- Progesterone: Similar to androgen, Progesterone can stimulate sebum production. Some synthetic progestins found in certain birth control pills can also increase acne.
- Insulin and IGF-1 (Insulin-like Growth Factor 1): These hormones, related to blood sugar regulation and growth, can also indirectly influence acne by increasing androgen production and sebum secretion.
In Summary
Androgens, especially testosterone and DHEA, are the key hormones that directly contribute to pimple formation by stimulating sebum production. Other hormones, such as estrogen, progesterone, insulin, and IGF-1, can indirectly influence acne development through various mechanisms.
