The direct and potent stimulatory effect of testosterone, and more significantly its potent metabolite dihydrotestosterone (DHT), on the sebaceous glands in the skin, leading to increased secretion of sebum. Sebum is an oily, waxy substance that lubricates the skin and hair, but its overproduction can contribute to acne and pore blockage. This physiological interaction is a key clinical consideration in managing androgen levels, especially in hormonal optimization protocols.
Origin
This phenomenon is a well-established principle in dermatology and endocrinology, observed clinically during puberty when androgen levels surge. The relationship is fundamental to understanding the skin’s response to hormonal fluctuations and forms a core consideration in the management of acne vulgaris, which is often an androgen-driven dermatological condition.
Mechanism
Testosterone itself has an effect, but the primary driver is its conversion to the more potent androgen, DHT, via the enzyme 5-alpha reductase, which is highly expressed in the sebaceous glands. DHT binds to the androgen receptors on the sebocytes, initiating a cascade of gene expression that dramatically increases the size and secretory activity of the gland. Managing this effect often involves targeting the 5-alpha reductase enzyme to reduce local DHT concentration in the skin.
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