Prevalence of elevated testosterone levels among female patients of acne vulgaris
Keywords:
Serum testosterone, acne, chemiluminescence technologyAbstract
Background  Acne vulgaris is a frequently encountered skin disorder among patients of all ages. It is a source of significant psychosocial trauma and reduced self-esteem especially among females. Androgens, mainly testosterone, have a significant role in its pathogenesis. They mainly increase the sebum production that plays an important role in the formation of typical lesions of acne.  Objective To assess the frequency of increased levels of testosterone among female patients of acne.  Methods This cross-sectional survey was carried out at Department of Dermatology Services Hospital/ Services Institute of Medical Sciences, Lahore from 1st June, 2018 till 30th November, 2018. 3 ml of blood sample was drawn from each patient on 2nd day of menstrual cycle. Serum testosterone analysis was done using chemiluminescence technology. The level of serum testosterone >120 ng/dl was taken as high.  Results A total of 220 female patients of acne were enrolled. Mean age of the patients was 22.7±5.4 years. Mean duration of disease was 11.8±8.7 months, while mean BMI was 24.38±3.80 kg/m2. High serum testosterone level was observed in 22 patients (10%). Statistically significant effect of age, BMI, marital status and severity of acne was noted on elevated testosterone levels.  Conclusion It was observed that high serum testosterone was significantly associated with acne. Therefore, assessment of testosterone levels and androgen based treatments may help in better management of women presenting with acne. ÂReferences
George RM, Sridharan R. Factors aggravating or precipitating acne in Indian adults: A hospital-based study of 110 cases. Indian J Dermatol. 2018;63:328-31.
Kaminsky A, Florez-White M, Bagatin E, Arias MI; Iberian Latin American Acne Studies Group (GILEA - Grupo Ibero-Latinoamericano de Estudio del Acne). Large prospective study on adult acne in Latin America and the Iberian Peninsula: risk factors, demographics, and clinical characteristics. Int J Dermatol. 2019;58(11):1277-82.
Akinboro AO, Ezejiofor OI, Olanrewaju FO, Oripelaye MM, Olabode OP, Ayodele OE, Onayemi EO. The impact of acne and facial post-inflammatory hyperpigmentation on quality of life and self-esteem of newly admitted Nigerian undergraduates. Clin Cosmet Investig Dermatol. 2018;11:245-52.
Clayton RW, Göbel K, Niessen CM, Paus R, van Steensel MAM, Lim X. Homeostasis of the sebaceous gland and mechanisms of acne pathogenesis. Br J Dermatol. 2019;181(4):677-90.
Del Rosso JQ, Kircik LH, Stein Gold L, Thiboutot D. Androgens, Androgen Receptors, and the Skin: From the Laboratory to the Clinic With Emphasis on Clinical and Therapeutic Implications. J Drugs Dermatol. 2020;19(3):30-5.
Iftikhar U, Choudhry N. Serum levels of androgens in acne & their role in acne severity. Pak J Med Sci. 2019;35(1):146-50.
Pochi PE, Shalita AR, Strauss JS, Webster SB, Cunliffe WJ, Katz HI, et al. Report of the Consensus Conference on Acne Classification. Washington, D.C., March 24 and 25, 1990. J Am Acad Dermatol. 1991;24:495-500.
Uysal G, Sahin Y, Unluhizarci K, Ferahbas A, Uludag SZ, Aygen E, Kelestimur F. Is acne a sign of androgen excess disorder or not? Eur J Obstet Gynecol Reprod Biol. 2017;211:21-5.
Mehta-Ambalal S. Clinical, Biochemical, and Hormonal Associations in Female Patients with Acne: A Study and Literature Review. J Clin Aesthet Dermatol. 2017;10(10):18–24.
Rahman MM, Akram M, Sikder U et al. Association of Serum Testosterone with Acne Vulgaris in Women. BSMMU Journal. 2012;5:10.
Kaur P, Bajwa N, Gupta SK, et al. Study of Levels of Free Testosterone in Patients with Acne Vulgaris before and after Treatment. Indian J Med Biochem. 2021;25(2):47–50.
Nguyen PC, Nguyen HV, Vu VT et al. Assessment of serum testosterone, estradiol, and progesterone levels in female patients with acne vulgaris. F1000Research. 2022;11:23.
Ahmed YB, Fatin F. Assessment of serum testosterone in females with acne vulgaris in Erbil city. Zanco J Med Sci. 2016;20:1249-53.
Alan S, Cenesizoglu E. Effects of hyperandrogenism and high body mass index on acne severity in women. Saudi Med J. 2014;35(8):886-9.
Sanai M, Shaukat S, Ghias A et al. Efficacy and safety of spironolactone in moderate to severe acne in females. J Pak Assoc Dermatol. 2019;29(1):101-9.
