Role of Androgens and Hormones in Acne and Androgenetic Alopecia

In this presentation, Dr. Larry Green, a clinical professor of dermatology, discusses the role of androgens and hormones in acne and androgenetic alopecia. The session includes a breakdown of the pathogenesis of these conditions, focusing on the mechanisms by which hormones like testosterone and its derivatives affect skin physiology and sebaceous gland function. Dr. Green highlights the importance of anti-androgens in treating acne, emphasizing their ability to address various aspects of acne production by influencing follicular desquamation, reducing inflammation, and regulating sebum production. He describes the oral and topical anti-androgen therapies available, including the use of oral contraceptives and spironolactone, noting their mechanisms of action and efficacy. The talk details the safety of these treatments, including the risks associated with oral contraceptives and spironolactone, while emphasizing the therapeutic role of spironolactone across all acne types, not just hormonal acne in women. Furthermore, the discussion touches upon antibiotic stewardship in acne treatment, advocating for limited antibiotic courses and the potential benefits of probiotics. The presentation concludes with a call to ensure that treatment options effectively address the multifactorial nature of acne without relying solely on antibiotics.