The peculiarities of medical specialization have separated doctors trained to treat skin problems from those trained to treat hormonal problems. Acne is hardly mentioned in textbooks of endocrinology but gets extensive coverage in dermatology books. The simple fact that as medical specialization arose, the endocrine nature of acne was not recognized for the hormonal disorder it is. And dermatologists are used to dealing with skin problems, whereas endocrinologists are not. This situation is unfortunate.
Hormones cause acne, and treatment directed at the normonal cause is most effective.
Knowledge from the two specialities needs to be combined for the benefit of acne patients. Let us look further at how hormones trigger acne. Skin changes in puberty in both boys and girls are due to the actions of androgens. These hormones act on the sebaceous gland to increase its production of sebum. Without androgens, there is only scanty sebum and no acne.