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ORIGINAL CONTRIBUTIONS
Year : 1991  |  Volume : 57  |  Issue : 3  |  Page : 138-140

Relationship of acne with menstrual period




Correspondence Address:
Vaswani Neena Khanna


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  Abstract 

The study was undertaken to compare the pre-menstrual and post-menstrual profile of women with adolescent acne. The non-inflammatory and inflammatory acne lesions in thirty two women patients with adolescent acne were counted at weekly intervals over a total of 96 menstrual periods. The mean of the acne lesions in the pre-menstrual phase was compared with that in the post-menstrual phase. In 67.71% of the periods observed, there was a decrease in the noninflammatory acne lesions. There was a mean reduction in the non-inflammatory and inflammatory lesions count of 2.30±4.89 and 3.69±2.92 respectively and this reduction was statistically highly significant (p<0.0001). These findings corroborate the general notice that there is an improvement of acne in the post-menstrual phase.


Keywords: Acne vulgaris, Menstrual period


How to cite this article:
Khanna VN, Pandhi K R. Relationship of acne with menstrual period. Indian J Dermatol Venereol Leprol 1991;57:138-40

How to cite this URL:
Khanna VN, Pandhi K R. Relationship of acne with menstrual period. Indian J Dermatol Venereol Leprol [serial online] 1991 [cited 2019 Oct 14];57:138-40. Available from: http://www.ijdvl.com/text.asp?1991/57/3/138/3650


Acne vulgaris, a multifactorial disorder of the pilosebaceous apparatus, is an almost universal problem in the adolescent. It is now an established fact that the development and the secretory activity of sebaceous glands in man are strikingly influenced by hormonal factors. The role of androgens seems unequivocal.[1]

The effects of estrogens and progester­one on sebaceous glands have also been studied extensively. In large pharmacologic doses estrogens do oppose the sebaceous gland stimulating effect of androgens, in both men and women.[2] They are, however, un­likely to have any role in inhibiting the seba­ceous gland activity physiologically. In men, estrogen, levels are any way too low to have an effect on the sebaceous gland activity and even in male patients with hepatic cirrhosis who have an increased circulating levels of estrogen, the sebum production remains nor­mal.[3] In women, too, a sebosuppressive role of estrogens is suspect, because sebaceous gland secretions actually decline after meno­pause. The action of progesterone on seba­ceous glands has, remained controversial. For many years, progesterone was considered the hormone responsible for stimulating seba­ceous gland activity in women.[4] Later studies have, however, shown that physiological doses of exogenous progesterone in prepu­bertal boys and girls did not stimulate the sebaceous glands.[5] The fact that sebum se­cretion does not change significantly through­out the menstrual cycle, even with fluctuating levels of progesterone provide further evi­dence that the hormone is not responsible for maintaining sebaceous gland secretion in women.[6]

Equally confusing is the relationship of acne with the menstrual cycle. Cunliffe and Cotterill[7] observed that sixty to seventy per­cent of women notice a deterioration of their acne in the week before menstruation. Their lesions remained more prominent for the next 7-10 days. However, there has been a re­markable lack of precise information detailing the changes of severity of acne with the menstrual period. We, therefore, undertook to compare the premenstrual acne profile of women with adolescent acne that in the post­menstrual phase.


  Materials and Methods Top
:

Thirty two women patients, with acne vulgaris and regular menstrual cycles were included in the study. Women who were tak­ing either any form of standard anti-acne therapy or any hormonal preparations were excluded from the study_ The women were informed of the nature of the study and a consent obtained. The patients also agreed not to use any from of treatment for their acne, while participating in the study.

The subjects were asked to report to the skin OPD every week. Spot counting of the non-inflammatory (NI) and inflammatory (IN) acne lesions was done at weekly intervals by the same observer. The observer was un­aware of the time of the menstrual period of the subject. Each' patient was followed up for 3 menstrual cycles. Counts within 9 days prior to the onset of the menstrual (premenstrual phase) and within 9 days after the onset of the period (postmenstrual phase) were in­cluded for evaluation. In subjects in whom 2 counts had been done either in the premen­strual or in postmenstrual phase, the mean of the 2 values was used for statistical analysis.

The mean of all the lesion counts in the premenstrual phase and the post-menstrual phase was then calculated separately for the NI and IN lesions. A paired samples test was then used to evaluate the change of the mean lesion count in the postmenstrual phase as compared to that in the premenstrual phase.


  Results Top
:

Thirty two women subjects were observed over a total of 96 menstrual periods. In the postmenstrual phase, out of the total of 96 periods observed, in 65 (67.71%) periods there was a decrease, in 3 (3.13%) there was no change and in 28(29.17%) there was an increase in the NI lesion count. For IN lesions, in 82(85.42%) periods there was a decrease in the acne lesions in the postmenstrual phase, while in only 10 (10.42%) periods was there an increase in the IN lesions and in 4 (4.17%) there was no change.

[Table - 1] shows the mean NI and IN le­sion counts in the premenstrual and postmenstrual phase, in the 32 patients ob­served over 96 menstrual periods. The mean NI lesion count in the premenstrual phase was 33.19 + 10.15. This declined to 30.89 + 9.14 in the postmenstrual phase. This decline (2.30 ± 4.89) was statistically highly significant (paired t = 5.02, P> 0.001). The mean IN le­sion count similarly declined from a mean of 14.32 ± 6.25 in the premenstrual phase to a mean of 10.63 ± 5.30 in the postmenstrual phase. This decline (3.69 ± 2.92) was also statistically highly significant (paired t = 12.39, P< 0.001).


  Comments Top


Hormones play a pivotal role in the pathogenesis of acne. The role of androgens has been established.[1] The role of estrogens and progesterone continues to remain contro­versial. Similarly the variations of the sebum excretion rate during the menstrual cycle also have not been clearly defined .[6],[8]

Cunliffe and Cotterill[7] observed that about 60-70% of women notice a deterioration in acne in the pre-menstrual week. In our patients we found that in 67.71% of the menstrual periods observed, there was a de­crease in the NI lesion count and in 85.42% in IN lesion count in the postmenstrual phase. The mean reduction in the NI and IN lesion count during the postmenstrual phase was 2.30 ± 4.89 and 3.69 ± 2.92 respectively and this decline was statistically highly significant (P< 0.001). This study, therefore, corroborates the general notion that there is an improve­ment of acne in the postmenstrual phase.

 
  References Top

1.Pochi PE and Strauss JS : Endocrinologic control of the development and activity of the human se­baceous gland, J Invest Dermatol, 1974, 62 : 191­201.  Back to cited text no. 1    
2.Strauss JS and Pochi PE : The human sebaceous gland: Its regulation by steroidal hormones and its use as an end organ for assaying androgenicity in vivo, Recent Prog Horm Res, 1963; 19 : 382-444.  Back to cited text no. 2    
3.Green RS, Pochi PE and Strauss JS : Seba­ceous gland secretion in cirrhosis, Brit J Dermatol, 1970; 85 : 247-249.  Back to cited text no. 3    
4.Haskin D, Lasher N and Rothman S : Some ef­fects of ACTH, cortisone, progesterone and tes­tosterone on sebaceous glands in white rates, J, Inest Dermatol, 1953; 20 : 207-212.  Back to cited text no. 4    
5.Jarett A : The effects of progesterone and testos­terone on suface sebum and acne vulgaris, Brit J Dermatol,1959; 71 : 102-116  Back to cited text no. 5    
6.Strauss JS and Kligman AM : Effect of progester­one and progesterone like compounds on the human sebaceous gland, J (nest Dermatol,1961; 36 : 309-318.  Back to cited text no. 6    
7.Cunliffe WJ and Cotterill JA : Acne : Clinical fea­tures, pathogenesis and treatment. in : Major problems in Dermatology, Volume 6, Editor Rook A : WB Saunders Co,London, 1976,Vol.6, p 13.  Back to cited text no. 7    
8.Hodgson-jones IS, Mackenna RMB and Wheatley VR : The study of human sebaceous activity, Acta Dermatol Venereol 1952; 32 (Suppl 29) 155-161.  Back to cited text no. 8    


    Tables

[Table - 1]

This article has been cited by
1 Profile of acne vulgaris-A hospital-based study from South India
Thappa, D.M., Adityan, B.
Indian Journal of Dermatology, Venereology and Leprology. 2009; 75(3): 272-278
[Pubmed]
2 Dermatological problems in adolescents
George, A.E.
Indian Journal of Practical Pediatrics. 2007; 9(2): 142-149
[Pubmed]



 

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