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Stress Hormone Tied to Acne, Baldness

Study says it increases oil production

MONDAY, May 13, 2002 (HealthDayNews) -- If you fret about your acne, you may make your problem skin worse.

A key stress hormone linked to anxiety and depression also appears to be an important signaling chemical in the skin's oil (or sebaceous) glands, a new German study has found. The substance, called corticotropin-releasing hormone (CRH), orders oil glands to ramp up production, possibly leading to acne and excessively oily skin.

The researchers also found the number and variety of CRH receptors in skin cells depends in part on the male sex hormone, testosterone, and growth hormone. That suggests a possible role for CRH in male pattern baldness, front and back thinning that affects both sexes. However, experts say that link is preliminary.

The findings appear in tomorrow's issue of the Proceedings of the National Academy of Sciences.

CRH is a kind of master molecule that helps coordinate the body's "fight-or-flight" stress response. The chemical is produced in the brain, and exerts its influence over other tissues through receptors on the surface of cells. However, mounting evidence suggests it may also be made by certain cells away from the brain, including those in the skin.

A research team led by Christos Zouboulis, of the Free University of Berlin, looked for signs of CRH activity in human skin cells cultured in the lab. In particular, the group analyzed sebaceous glands, which sit near hair follicles.

The hormone was present in several forms, and increasing concentrations of the substance boosted fat production by the oil glands.

Dr. Samuel McCann, an endocrinologist at Louisiana State University's Pennington Biomedical Research Center in Baton Rouge and a co-author of the study, says the work needs to be replicated in people.

However, if it survives that test, McCann said, it might be "very useful" for the treatment of skin conditions. Not only could oily skin be cleared up with drugs that suppress CRH, but dry patches might vanish with the help of the stress hormone.

Some skin doctors have dismissed the connection between stress and acne as a myth; even the American Academy of Dermatology's Web site says so. However, Dr. Diane Madfes, a New York City dermatologist, says the link makes sense.

"When I think of acne, I think of the oil glands in the skin turning on or off. Some people have a higher tendency to turn them on, or they have larger ones, or they have denser clusters" of the glands, says Madfes, who is also a clinical instructor at New York's Beth Israel Medical Center.

So, hormones like CRH that spur sebaceous glands to pump out more oil might lead to blocked pores and pimples.

Dermatologists now treat certain skin problems by modifying a patient's hormones. "When we use different medications we want to hit it two ways: decrease the production [of hormones that influence the oil glands] and change the on-off signal" in glands themselves, Madfes explains.

The delicacy here, however, is trying to soothe the skin while avoiding other problems. Although it's often safe to muzzle testosterone in women, for example, doing so in men can lead to enlarged breasts -- a trade-off most men wouldn't be happy to make.

Dr. Jerome Litt, a dermatologist at Case Western Reserve University in Cleveland, has coined an acronym to describe the impact of emotions on the skin: SWAT, short for stress, worry, anxiety, tension.

"Stress sets off a cascade of responses that prepare the body for action," says Litt, author of the book, Your Skin From A to Z. "A stressed body concentrates on sending blood to its most vital organs rather than to the skin. In times of stress, skin gets the short end of the stick."

Chronic stress slows skin cell turnover, worsening problems like dryness and allowing harmful byproducts to accumulate. When stress leads to a rush of testosterone, the result can be hair loss, he adds.

What To Do: For more on skin conditions, try the American Academy of Dermatology. For more on stress and hormones, try the National Institute of Mental Health.

SOURCES: Samuel McCann, M.D., professor, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge; Diane Madfes, M.D., clinical instructor, Beth Israel Medical Center, New York City; Jerome Litt, M.D., assistant professor, dermatology, Case Western Reserve University, Cleveland; May 14, 2002, Proceedings of the National Academy of Sciences
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