ACNE VULGARIS is associated with pilosebaceous irritative phenomena manifested as excessive oiliness, comedos, papules, pustules and cysts. These are aggregated wherever the sebaceous glands are most numerous: namely, on the face, chest and back. Only the adolescent type of acne is considered in this study.
Evidence that this disease is primarily an endocrine disturbance may be summarized as follows: (a) The usual incidence is at the time of puberty1; (b) the premenstrual flare-up of the lesions occurs when the estrogen level is lowest; (c) production of acne occurs in females who are given androgen; improvement follows on withdrawal of it, and recurrence is observed when it is given again2; (d) acne is not found in eunuchs, and (e) acne is much commoner in males.3 These observations indicate that androgens produce pilosebaceous activity, and further work suggests an increase in the ratio of circulating androgens to
SHAPIRO I. ESTROGENS BY LOCAL APPLICATION IN TREATMENT OF ACNE VULGARIS. AMA Arch Derm Syphilol. 1951;63(2):224–227. doi:10.1001/archderm.1951.01570020058007
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