Reduce Sebum Production Naturally

Oily Skin Solution

If you know what the annoyances of oily skin are, you will want this book; no question about it. If you struggle with skin that just always feels a little bit greasy no matter what and is constantly fighting acne, you will want this guide. This ebook gives you the ingredients to start making your skin feel a little more like every else's, and gets rid of the unsightly blemishes as a result of acne or other oily side-effects. Patricia Evens shows you that tradition, commercial moisturizers really won't do anything for you You will not be able to fight skin grease with those. Learn what you Really need to do to start repairing your skin and getting better-feeling skin. You don't need to spend a lot of money to help you All it takes is the information in this book! Don't suffer from oily skin Start improving now! Read more...

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Estrogens and Sebum Production

Very little is known about the role of estrogens in modulating sebum production. Any estrogen given sys-temically in sufficient amounts will decrease sebum production. The dose of estrogen required to suppress sebum production however is greater than the dose required to suppress ovulation. Although some patients acne will respond well to lower-dose agents containing 0.035-0.050 mg of ethinyl estradiol or its esters, higher doses of estrogen are often required to demonstrate a reduction in sebum secretion 39 . The major active estrogen is estra-diol which is produced from testosterone by the action of the enzyme aromatase. Aromatase is active in the ovary, adipose tissue and other peripheral tissues. Estradiol can be converted to the less potent estrogen, estrone by the action of the 17P-HSD enzyme. Both aromatase and 17 P- HSD are present in the skin 26, 40 . As in the case of androgens, it is not known if circulating estrogens or locally-produced estrogens are important in...

Androgens and Sebum Production

Acne Vulgaris

An essential role for androgens in stimulating sebum production is supported by the following clinical evidence (1) androgen-insensitive subjects who lack functional androgen receptors do not produce sebum and do not develop acne 7 , and (2) systemic administration of testosterone and dehydroepiandrosterone increases the size and secretion of sebaceous glands 8 . Several clinical observations point to the importance of androgens in acne. The development of early acne in the prepubertal period has been associated with elevated serum levels of dehydroepiandrosterone sulfate (DHEAS), a precursor of testosterone 9, 10 . For example, acne occurs near the time of puberty. In fact, investigators have demonstrated that acne begins to develop at the time of adrenarche when the adrenal gland begins to produce large quantities of DHEAS 9, 10 . This hormone can serve as a precursor to the production of more potent androgens within the sebaceous gland. The rise in serum DHEAS in prepubescent...

Sebaceous Glands in Acne

Pathogenesis Acne

It is generally accepted that sebaceous glands were not innervated and the peripheral nervous system has no effect on the sebaceous biology. Indeed, nerve fibers, as documented immunohistochemically using the general neuronal marker PGP 9.5, were rarely observed around the sebaceous glands in normal facial skin. In contrast, facial skin from acne patients shows numerous fine nerve fibers not only around but also within sebaceous acini 19 . Numerous nerve endings were also observed in close apposition to the sebaceous glands ultrastructurally. Such increase in the number of nerve fibers, some of which are even invading into sebaceous acini, may result from increased expression of NGF on the sebaceous glands of acne-prone facial skin since NGF is essential for the survival, development, differentiation and function of peripheral sympathetic and sensory neurons, and acts as a neurotrophic molecule stimulating the sprouting of nerve fibers also in the skin 20 . Immunohistochemical study...

Effects of SP on the Sebaceous Glands

To examine whether cutaneous neurogenic factors affect the morphology of sebaceous glands, we used electron microscopy to observe alterations of the sebaceous glands in organ culture by several kinds of NPs and nerve growth factor (NGF), the best-characterized member of the neu-rotrophin family 20 . The ultrastructure of the sebaceous glands with medium alone was identical to that of intact sebaceous glands. From the exterior aspect to the interior, the sebaceous glands consisted of the germinative, the undifferentiated and the differentiated sebaceous cell layers. The sebaceous glands stimulated with SP showed that most sebaceous cells contained numerous lipid droplets even in the peripheral area of the glands. These observations indicate that SP may accelerate lipogenesis. There were numerous free ribosomes and mitochondria, followed by densely packed smooth-surface membranes of the endoplasmic reticulum in sebocytes, suggesting the active phase of lipid synthesis. Morphometric...

Sebaceous Glands

Sebaceous32 (see-BAY-shus) glands produce an oily secretion called sebum (SEE-bum). They are flask-shaped, with short ducts that usually open into a hair follicle (fig. 6.11c), although some of them open directly onto the skin surface. These are holocrine glands with little visible lumen. Their secretion consists of broken-down cells that are replaced by mitosis at the base of the gland. Sebum keeps the skin and hair from becoming dry, brittle, and cracked. The sheen of well-brushed hair is due to sebum distributed by the hairbrush. Ironically, we go to great lengths to wash sebum from the skin, only to replace it with various skin creams and hand lotions made of little more than lanolin, which is sheep sebum.

Anatomy And Function Of Skin

The dermis is predominantly formed of connective tissue and is responsible for the skin's elasticity and strength. The dermis is vascular, and supplies nutrients to the avascular epidermis. It also contains hair follicles, sweat glands, sebaceous glands and nerve endings.

Options for Hormonal Therapy

Within the class of androgen receptor blockers, the drug options are spironolactone, cyproterone acetate, and flutamide. In the United States, spironolactone is the drug most commonly used. Oral spironolactone decreases sebum excretion rate and inhibits the type 2 17P-HSD 48, 49 . Recommended doses for the treatment of acne are 50-100 mg, taken with meals 50 . However, many women respond well to 25 mg twice daily, and some even respond to just 25 mg a day. These low doses in healthy young women are well tolerated. However, if this drug is used in older women with other possible medical problems, or if higher doses are used for conditions such as hirsutism or androgenic alopecia, serum electrolytes should be monitored. Side effects to be aware of include breast tenderness and menstrual irregularities. Oral contraceptives contain two agents, an estrogen (generally ethinyl estradiol) and a progestin. In their early formulations, oral contraceptives had high concentrations of over 100 g...

New Developments and Future Trends

Leukotrienes Inflammatory Mediators

Low-dose isotretinoin (0.1-0.3 mg ml day daily or intermittent use) can effectively control acne, also being cost-effective. Nevertheless, the daily dose is too low for the cumulative dose obtained to be definitively curative. Although studies have been centered on the use of low doses only in older patients with exceptionally oily skin or in patients with long duration acne 76-80 , there is a trend by practicing dermatologists to use low-dose isotre-tinoin in adolescent acne with a tendency to become inflammatory or in moderate acne as replacement of systemic antibiotics. The suggested rationale of such use is the effective control of inflammation with the final objective of preventing inflammation and the resulting scars. The approach taken is that of control and not of absolute resolution, since this resolution will occur in the majority of patients naturally. The simultaneous use of an effective topical therapy is mandatory. Since a large percentage of patients to be treated with...

Hosttargeted acaricides

Another recent approach, using bait boxes for the topical treatment of rodents with fipronil, is being evaluated for the control of I. scapularis on wild white-footed mice (patents pending, Aventis Environmental Science and Centers for Disease Control and Prevention). Discovered in 1987, fipronil is the first of a new class of insecticides, the phenyl pyrazoles, labelled for a broad range of insect pests on more than 50 crops and various non-crop uses (Aventis, 2000). Fipronil is a reversible inhibitor of the gamma-aminobutyric acid (GABA)-regulated chloride channel that displays selectively tighter binding in insects than in mammals. Percutaneous passage of the compound is low, with the compound concentrating in the epidermis, hair follicle and sebaceous glands (Cochet et al., 1997). Fipronil is commercially available for the control of fleas and ticks on

Senescence of the Organ Systems

Senescence Saladin

Two-thirds of people aged 50 and over, and nearly all people over age 70, have medical concerns or complaints about their skin. Senescence of the integumentary system often becomes most noticeable in the late 40s. The hair turns grayer and thinner as melanocytes die out, mitosis slows down, and dead hairs are not replaced. The atrophy of sebaceous glands leaves the skin and hair drier. As epidermal mitosis declines and collagen is lost from the der-

Mast Cells in Acne Inflammation

Human Inflammation Cells Pcr

Increasing attention has been directed towards interactions between components of the nervous system and multiple target cells of the immune system. Communication between nerves and MCs is a prototypic demonstration of such neuroimmune interactions. Several studies have demonstrated that MCs are often found in close contact with nerves and that there may be a functional interaction between mast cells and the nervous system 28 . In addition, recent evidence suggests that SP is an important mediator in intimate nerve-mast cell cross talk 29 . When organ-cultured normal facial skins were exposed to SP uniformly degranulated MCs adjacent the sebaceous glands were observed at the electron microscopic level. Venules around the sebaceous glands of specimens stimulated with SP showed expression of ELAM-1 on the endo-thelia after subsequent culture. Furthermore, preincuba-tion of explants with the SP analogue or with cromolyn sodium, one of the MC inhibitors, abrogated the ability of SP to...

Introductionacne Vulgaris

Both clinical observation and experimental evidence confirm the importance of hormones in the pathophysiology of acne. Hormones are best known for their effects on sebum excretion. It has also been suggested that hormones may play a role in the follicular hyperkeratinization seen

Benign Calcifications

Milk Calcium Breast Calcifications

Skin calcification is commonly related to sebaceous glands and appears as lucent, centered rings in a peripheral location (Figure 3-13A). Skin calcification may be punctate or irregular, and may appear to lie within the breast parenchyma on standard views. Therefore, a tangential view skin localization study (Figure 3-13B) may be necessary to prove a cutaneous location. Calcium in warts, moles, scars, and dermal lesions as well as pseudocalcifications due to tattoos, talc, deodorant, or film artifacts can be misleading (Figure 3-14).

Therapeutic Targets and Acne Drugs

Several clinical observations point to the importance of androgens in acne 23 . Androgens play an essential role in stimulating sebum production androgen-insensitive subjects who lack functional androgen receptors do not produce sebum and do not develop acne. Moreover, systemic administration of testosterone and dehydro-epiandrosterone increases the size and secretion of sebaceous glands 24-27 . Sebosuppression, i.e. suppression of sebaceous gland hyperactivity, can classically be achieved by systemic administration of anti-androgens or isotreti-noin 19, 24-26, 28, 29 (table 2).

Spontaneous and Transplanted Tumors 18901911

Woglom's (1913) treatise provides an extensive and detailed literature up to that point (Dunn, 1945 Woglom, 1913). He provides amusing pro and con arguments as to whether the mouse mammary tumors were epithelial or endothelial, even suggesting that the German pathologists did not know the anatomy of the mouse mammary glands (10, not 2, glands) or the location of the sebaceous glands (limited to the footpads). He also records early proof of metastases and, thus, malignancy with camera Lucida drawings of tumor emboli. Judging from the attribution to an illustrator, J. R. Ford, these illustrations are from the Bashford monographs.

Ocular Surface

The skeleton of the eyelid is a collagen plate called the tarsus (Fig. 1.2). It contains a row of branched alveolar sebaceous glands, unrelated to the eyelashes. These tarsal or Meibomian glands have punctated openings along the free edge of the eyelid close to its posteroir margin. They produce a lipid material whose synthesis is dependent on neuronal, hormonal, and vascular factors 7 . This lipid material is fluid, spreads easily, is a surfactant as well as an aqueous barrier, and must remain functional after a blink. To satisfy these requirements, the Meibomian lipids have a specific composition. Even after delivery, it may be modified by lipases produced by ocular bacteria, and

John S Strauss

Acne Vulgar

A basic theme that runs throughout the nine papers is the importance of the four principles of treating acne, proposed many years ago by Kligman and myself. These include correcting the altered pattern of keratinization, the inhibition of Propionibacterium acnes and the production of extra-cellular pro-inflammatory products, the inhibition of sebum, and producing an anti-inflammatory effect. Almost all of the therapeutic approaches summarized in the presentations are related to these principles, and as is often mentioned, while we have made tremendous strides and are eminently successful in the management of acne, we cannot rest on our laurels. The management of acne will change in the future, and indications of this are contained in the papers. My second point relates to the report by Toyoda and Morohashi, who have found immunoreactive nerve fibers containing substance P in close apposition to the sebaceous glands, and have also found the expression of neural endopeptidases in the...

Epidermal Cysts

Two cystic conditions may be encountered externally, each in a different location. Epidermal inclusion cysts, traditionally known as sebaceous cysts, are usually located low in the postauricular crease. They represent backed-up oil glands and occur in individuals with oily skin and acne. These patients tend to have them behind both auricles and in other facial areas as well. Their usual content is cheesy sebum, but at times they may swell up and abscess, often infected with staph. If they are infected, the treatment is an antistaphylococcal antibiotic. Often the infection will resolve, but incision and drainage may be necessary. Troublesome recurrences can be surgically excised, when not infected, taking care to remove the entire cyst lining. Even then, they may reappear.


In one study the sebum excretion rate was shown to increase by 22.5 after 1 or 2 months of treatment with 5 benzoyl peroxide. This was felt to be due to the come-dolytic activity and thus influence the pooling of sebum in the upper parts of the pilobaceous duct 54 . Nevertheless, today any activity on sebaceous gland activity and direct comedolytic activity can be excluded.


There is ample clinical evidence suggesting that the nervous system such as emotional stress can influence the course of acne. We examined possible participation of cutaneous neurogenic factors including neuropeptides, neuropeptide-degrading enzymes and neurotrophic factors, in association with inflammation in the pathogenesis of acne. Immunohistochemical studies revealed that substance P (SP)-immunoreactive nerve fibers were in close apposition to the sebaceous glands, and that neutral endopeptidase (NEP) was expressed in the germina-tive cells of the sebaceous glands in the skin from acne patients. Nerve growth factor showed immunoreactivity only within the germinative cells. In addition, an increase in the number of mast cells and a strong expression of endothelial leukocyte adhesion molecule-1 on the postcapillary venules were observed in adjacent areas to the sebaceous glands. In vitro, the levels and the expression of stem cell factor by fibroblasts were upregulated by SP. When...


In a penetration study, substantial amounts of topically applied isotretinoin were delivered via the follicular route to the sebaceous glands, resulting in comparable concentrations to those observed after oral application 28, 29 . After 42 days of excessive application of 0.1 isotretinoin cream in patients with photodamaged skin, the plasma levels of isotretinoin were compared to pre-treatment levels. The results suggested systemic absorption, but to a lesser extent than that reported after the US recommended daily allowance of 5,000 IU of vitamin A supplementation. The systemic availability of topical iso-tretinoin is negligible and should thus not produce systemic toxicity.

The Dermis

The dermis ranges from 0.2 mm thick in the eyelids to about 4 mm thick in the palms and soles. It is composed mainly of collagen but also contains elastic and reticular fibers, the usual cells of fibrous connective tissue (described in chapter 5), and blood vessels, sweat glands, sebaceous glands, hair follicles, and nail roots (see fig. 6.1). It also contains sensory nerve endings, discussed later in this chapter (p. 199), and muscular tissue. Smooth muscle cells associated with hair follicles make the hairs stand on end in response to cold or fear, cause goose bumps, and wrinkle the skin in areas such as the scrotum and areola in response to cold or touch. In the face, skeletal muscles attach to dermal collagen fibers and produce such expressions as a smile, a wrinkle of the forehead, and the wink of an eye.

Lamin Linked RD

The knock-in mouse model Lmna L530P, a substitution that causes EDMD in human, seems to recapitulate more faithfully the cell and tissue alterations observed in HGPS patients (Mounkes et al. 2003). Homozygous mice show a severe growth retardation, several developmental abnormalities, and die prematurely (4-5 weeks after birth). Their phenotypic characteristics include abnormal dentition, joint stiffness, epidermal hyperkeratosis, lipodystrophy, a reduction of hair follicles and sebaceous glands, muscular atrophy, generalized osteopenia, and scapular hypoplasia. Conversely, compared to human, these mice do not develop generalized atherosclerosis nor acro-osteolyses. In these mice, a complex splicing defect (either skipping of exon 9 or retention of part of intron 9) causing a reduction of about half of the lamin A C wild-type content, has been shown to cause the phenotype, in contrast to human, in which the simple p.L530P substitution is supposed to occur. Indeed, this lamin A C...

The Anal Canal

Anal Penetration Diagram

Adjoining the valves is the pecten, a smooth zone of pink shiny skin that lacks hair and sebaceous glands, and which extends distally to the caudal margin of the internal sphincter. At the orifice and in the surrounding skin, hair follicles and sebaceous glands appear. The skin is puckered by the pull of the coattails of the longitudinal muscle of the bowel wall and, in this puckered perianal area, the skin is brownish in color.


Male External Reproductive Organ

The testes are contained in a pendulous pouch, the scro-tum17 (fig. 27.10). The left testis is usually suspended lower than the right so the two are not compressed against each other between the thighs. The skin of the scrotum has sebaceous glands, sparse hair, rich sensory innervation, and somewhat darker pigmentation than skin elsewhere. The scrotum is divided into right and left compartments by an internal median septum, which protects each testis from infections of the other one. The location of the septum is externally marked by a seam called the perineal raphe18 (RAY-fee), which also extends anteriorly along the ventral side of the penis and posteriorly as far as the margin of the anus (see fig. 27.6).

Anatomy Of Penis

Cavernosa Dan Corpus Spongiosum

The skin is very loosely attached to the shaft, allowing for expansion during erection. It continues over the glans as the prepuce, or foreskin, which is often removed by circumcision. A ventral fold of tissue called the frenu-lum attaches the skin to the glans. The skin of the glans itself is thinner and firmly attached to the underlying erectile tissue. The glans and facing surface of the prepuce have sebaceous glands that produce a waxy secretion called smegma.27


As more is learned about the hormones involved in acne, their source of production and the mechanisms by which they influence sebaceous gland growth and sebum production, new opportunities will arise for the development of novel therapies aimed at the hormonal aspects of acne.

What is acne

Acne lesions develop from the sebaceous glands associated with hair follicles on the face, external auditory meatus, back, chest, and anogenital area. (Sebaceous glands are also found on the eyelids and mucosa, prepuce and cervix, where they are not associated with hair follicles.) The sebaceous gland contains holocrine cells that secrete triglycerides, fatty acids, wax esters, and sterols as sebum . The main changes in acne are an increase in sebum secretion Androgenic hormones increase the size of sebaceous glands and the amount of sebum in both male and female adolescents. Oestrogens have the opposite effect in prepubertal boys and eunuchs. In some women with acne there is lowering of the concentration of sex hormone binding globulin and a consequent increase in free testosterone concentrations. There is probably also a variable increase in androgen sensitivity. Oral contraceptives containing more than 50 micrograms ethinyloestradiol can make acne worse and the combined type may...

Groin And Pubic Area

The penile skin often contains visible Fordyce glands, which are sebaceous (fat-producing) glands (Swartz, 2002) to keep the penile skin lubricated. They can be easily mistaken for genital warts or molluscum contagiosum, despite being little fatty lumps under the skin. The sebaceous glands can become blocked or form into sebaceous cysts, and rarely may become infected. The patient needs to be reassured about their presence.

Acne Genetics

Sebum excretion also correlates with acne susceptibility, and sebum excretion rates are similar in identical twins 33 . Several chromosomal abnormalities, including 46XYY genotype 34 , 46XY+ (4p+ 14q-) 35 , and partial trisomy 13 36 have been reported to be associated with nodulocystic acne. MUC1 is a glycoprotein secreted from various epithelial glands including sebaceous glands. Studies of the respiratory and digestive systems suggest that MUC1 is involved in the defense system against bacteria by inhibiting their adhesion to epithelium. The MUC1 gene and the molecule produced exhibit extensive polymorphism attributable to a variable number of tandem repeats. A higher frequency of longer repeat length of tandem repeats has been observed in severe acne patients 43 . In conclusion, the pathogenesis of acne is multifacto-rial and a greater number of genes than those cited above are probably related to the condition. Genes affecting ker-atinization and desquamation are suspected to be...

Prepubertal Acne

Acne could be the first sign of pubertal maturation and associated with increase in sebum and urinary excretion of androgenic steroids. A high frequency of acne was found in a longitudinal study of adolescent boys, where the prevalence and severity of acne correlated well with advanced pubertal maturation 24 . A similar study of the same authors in early adolescent girls concluded that acne can be the first sign of pubertal maturation significant elevations of DHEAS correlated well in girls with come-donal and inflammatory acne. The most common locations of acne in this group were the midforehead, nose and chin 25 . present a statistically significantly earlier menarche (12.2 years) compared to those with moderate and mild disease (12.4 and 12.7 years). They also concluded that the number of comedones were predictive for the severity of late inflammatory acne. Mid-pubertal girls with severe come-donal acne showed more comedones even three years before menarche. This group also showed...


Flutamide does not interfere with ovulation and is generally well tolerated. The only common complaint of patients given flutamide is dry skin, attributable to reduced sebum production. Liver toxicity is an uncommon, but potentially severe, risk with this drug (24). On the whole, from several points of view, flutamide is probably the best available antiandrogen drug. However, this drug should be used with caution for the treatment of hirsutism, and in these cases serum transaminases should be carefully monitored.

Neonatal Acne

The pathogenetic mechanisms of neonatal acne are still unclear. A positive family history of acne supports the importance of genetic factors. Familial hyperandroge-nism including acne and hirsutism give the evidence that maternal androgens may play a role through transplacen-tal stimulation of sebaceous glands 4 . There is a considerable sebum excretion rate during the neonatal period which decreases markedly to almost not detectable levels following the significant reduction of sebaceous gland volume up to the age of 6 months 5-7 . There is a direct correlation between high maternal and neonatal sebum excretion suggesting the importance of maternal environment on the infant sebaceous glands 8 . Neonatal adrenal glands produce a certain amount of P-hydroxysteroids that prepare the sebaceous glands to be more sensitive to hormones in the future life 1 . In males from 6 to 12 months there are increasing levels of luteinizing hormone (LH) and as a consequence of testosterone these...

Glands in Acne

Immunohistochemical staining for NEP in normal facial skin was negative within the sebaceous glands. On the other hand, NEP was highly expressed in the sebaceous glands of acne patients in which immunoreactivity for NEP in the sebaceous glands were restricted to the germi-native cells. There was a statistically significant difference in the percentage of NEP-positive sebaceous acini to all acini between acne patients and controls 26 . We next examined effects of SP on NEP expression in the sebaceous glands using organ-cultured skin in vitro. Although normal facial skin specimens supplemented with medium alone showed no expression of NEP in sebaceous cells, skin specimens stimulated with SP revealed prominent NEP staining in the germinative cells of the sebaceous acini, which appeared to be analogous to the staining pattern of the sebaceous glands in acne patients. In addition, SP induced NEP expression in sebaceous glands in a dose-dependent manner 26 . Taking into account the lack of...

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