Androgens Stimulate Sebaceous Glands: Mechanism & Acne Link
Androgens (testosterone, DHT, DHEAS) bind nuclear receptors in sebocytes → ↑ lipogenesis, cell proliferation, sebum secretion.
Pathway
- Androgen (T/DHT) enters sebocyte → binds androgen receptor (AR).
- AR translocates to nucleus → upregulates genes for lipid synthesis (FAS, SCD1, DGAT).
- Sebum production ↑ (squalene, wax esters, triglycerides).
- Excess sebum + follicular hyperkeratinization + C. acnes → inflammation → acne.
Clinical Correlates
- Puberty: Adrenarche/gonadarche → sebum surge → acne onset.
- PCOS: Hyperandrogenism → acne, hirsutism, seborrhea.
- Androgen-secreting tumors: Sudden severe acne + virilization.
- Transgender men (T therapy): Acne flare common.
- Anti-androgens (spironolactone, cyproterone, oral contraceptives) reduce sebum → treat hormonal acne.
Key Point
Sebaceous glands are androgen target tissues. Modulating androgen signaling is central to acne therapy in appropriate patients.
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