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. The sebum made by the gland has to get out of the skin surface. Often the skin surface protein, called keratin, is too sticky and seals off the opening of the sebaceous gland, so that fluid accumulates in it. This is a whitehead, or closed comedone.