Pathogenetic Peculiarities of Neuroendocrine and Metabolic Disorders in Patients With Acne Associated With Chronic Stress

Abstract

Introduction: Acne is a chronic relapsing skin condition with multifactorial nature associated with disorders of sebaceous glands activity, psycho-emotional disorders and slow response to treatment. The aim: To study a pathogenic role of chronic stress and certain metabolic and neuroendocrine disorders in the development of acne in women depending on the duration of the disease. Materials and methods: A total of 119 women with acne were examined. Index insulin resistance (іndex HOMA), serum cortisol and prolactin, level of Reactivity-Personal Anxiety and Dermatology Life Quality Index (DLQI) was determined. Results: Possible changes in serum cortisol level depending on duration of the disease (increased in women with duration of the disease less than 1 year and decreased in women with duration of the disease 1-5 years), increased index of serum prolactin and HOMA, with more significant changes in women with duration of the disease 1-5 years. The DLQI was determined in all examined patients. An increased level of anxiety, characterized by higher levels of personal anxiety, was also observed, especially in a group of women with duration of the disease 1-5 years. Conclusion: The changes in certain neuroendocrine and metabolic indices, which are the markers of chronic stress, worsening of life quality and significant levels of reactivity and personal anxiety, were observed in women with acne. A strong and moderate correlational relationship between the nature of changes in the abovementioned indices and duration of the disease was detected.

Exploring Stress-Induced Mechanisms in Acne Pathogenesis

“…The relationship between cortisol and androgens is multifarious. Elevated cortisol can lead to increased secretion of androgenic hormones by the adrenal glands, amplifying the effects of each hormone in promoting acne [22]. This interaction between cortisol and androgens contributes signi cantly to the development and exacerbation of acne during times of stress, highlighting the interconnected nature of hormonal in uences on skin health [23].…”

Indicators of Phagocytosis in Women With Acne During Comprehensive Treatment That Included PRP- And Ipl-Therapy

“…Acne is one of the most common dermatological diseases. It may have a chronic course, leaving permanent marks (scars, blemishes, emotional disorders), and in recent years has been tending to have more and more severe clinical course with widespread skin lesions, formation of resistance to drugs of etiotropic treatment, leading to the chronic course, decrease or loss of patient's capacity and social activity which signifies important medical and social aspects of the problem and justifies the topicality of improving treatment studies [1,7,9,14]. According to recent studies, the development of acne is due to the combined effect of endogenous and exogenous factors, among which endocrine diseases should be pointed out, as well as disorders of metabolic processes [8,10], reduced systemic immunity and phagocytic ability of mononuclear phagocytes and granulocytes at various stages of phagocytosis of pyogenic cocci, which contributes to more severe clinical course, and frequent relapse of this diseases [5,9].…”

“…It was also proved that the colon microbiota plays an important role in the formation of homeostasis and immune response [3,4]. A relationship between the conditions of the colon microbiota, indices of systemic immunity and phagocytosis and nature of clinical manifestations of acne justifying differentiated administration of probiotics and immunomodulation therapy in the comprehensive therapy were found [1,6,10,13]. According to modern standards [2,6,8,10], the treatment of acne is carried out in various ways: patients with mild acne are prescribed an external antibacterial and anti-inflammatory therapy (topical antibiotics, topical retinoid medicines, azelaic acid, benzoyl peroxide) only, but in case of moderate and severe forms, comprehensive treatment including systemic antibacterial, immunotropic, anti-inflammatory drugs, oral retinoid, low-dose birth control pills and other therapies are applied.…”