|Year : 1991 | Volume
| Issue : 3 | Page : 138-140
Relationship of acne with menstrual period
Vaswani Neena Khanna, KR Pandhi
Vaswani Neena Khanna
Source of Support: None, Conflict of Interest: None
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
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.
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. 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. 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. Later studies have, however, shown that physiological doses of exogenous progesterone in prepubertal boys and girls did not stimulate the sebaceous glands. 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.
Equally confusing is the relationship of acne with the menstrual cycle. Cunliffe and Cotterill 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|| |
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|| |
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|| |
Hormones play a pivotal role in the pathogenesis of acne. The role of androgens has been established. 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 .,
Cunliffe and Cotterill 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|| |
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[Table - 1]
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