Hormones & Acne.

Changing hormone levels affect the onset of acne. We know that the sebaceous glands can be stimulated by hormones to produce sebum. The male hormones (androgens) stimulate oil production by binding to a special receptor on the oil gland. An enzyme present in the oil glands breaks down these androgen-type hormones, such as testosterone, into a more powerful hormone called dihydrotestosterone (DHT).
Doctors still differ in their opinions about the role of estrogen in acne. Some physicians believe that as levels of the hormone progesterone decrease in women as they age, the estrogen comes to predominate, and may cause a problem. Other physicians believe that estrogen is helpful, because the increase of hormones like estrogen that bind up testosterone also reduces the production of testosterone and other androgens.
But simply measuring the testosterone level in blood does not tell us much because some testosterone is bound to a protein, and only the testosterone that is not bound has an effect on the oil glands. Also bear in mind that woman's ovaries can produce androgens (which are male hormones). In addition, androgen can be produced by the adrenal gland (a small gland on top of kidney), which also produces something called dehydroepiandrosterone (DHEA). The androgens produced by woman's ovaries and the DHEA produced by her adrenal glands can then affect the oil glands, causing them to convert the androgens into a more potent form, via the enzyme 5-alpha reductase type1.
Studies have been conducted to ascertain how many women with acne actually have abnormal levels of circulating hormones. The result of one study showed that about half the women did; another study indicated that the incidence was much higher-between 60 and 90 percent.
Scientists have devised ways of treating acne by altering hormone levels. One of the inexpensive ways for a woman to do this is to use oral contraceptives. By taking a birth control pill, woman can increase the levels of proteins that bind the male hormone testosterone. Woman who took a prescription oral contraceptive called Ortho-tri-Cyclen, had levels of unbound testosterone almost 50 percent lower then the levels in women who took other birth control pills.
Physicians have devised additional methods to influence hormones that are known as anti-androgen chemicals. One of these, spironolactone, is actually a diuretic, or water pill. Spironolactone binds to the androgen receptors, preventing the conversion of testosterone to the more powerful hormone DHT. But it's side effects may include increased urination, abnormal menstrual periods, weight gain, brest tenderness, dizziness, and headaches. Diuretics can also drain the body of potassium, another dangerous side effect. Flutamide, another androgen blocker that has been used to treat male pattern baldness, has not been successful in treating acne and should not be used for this purpose.