Sebum production is stimulated by
androgens and is the key in the development of
acne vulgaris. Several investigators have looked for direct relationships between serum
androgen levels, sebum secretion rate and the presence of
acne. The presence of
acne in prepubertal girls and sebum production in both sexes correlate with serum
dehydroepiandrosterone sulfate (DHEAS) levels. Although increased serum
androgen levels correlate with the presence of severe nodular
acne in men and women, these levels are often within the normal range in mild to moderate
acne. This raises the question of whether there is an increased local production of
androgens within the sebaceous gland of patients with
acne vulgaris that leads to increased sebum secretion.