The high sensitivity of the skin and its derivatives to the processes occurring in the body, is well known. One of the brightest figures is the changing nature of body hair growth on the face and body, hair growth on the scalp and oily skin in the hormonal balance. The extreme expression of these symptoms can become ill, in particular, skin diseases such as acne.
Acne (Acne Vulgaris) is a chronic skin disease mul′tifaktornoe, associated with the excessive production of sebum, pathological follicular Hyperkeratosis and a secondary bacterial pneumonia. Acne is the most common skin diseases and occurs in 85% of persons aged 12 to 25 years [10]. Peak clinical manifestations of acne comes from 14-17 years, hence the emphasis on treatment of the disease in adolescents.
In the pathogenesis of acne involves excessive production of sebum, follicular Hyperkeratosis channel, genetic predisposition, resulting from intensive colonization of the ducts of the sebaceous glands of Propionibacterium acnes and perifollicular inflammatory reaction in the development zone, as well as the modified hormonal background [13].
Secretion of sebum is regulated by several mechanisms, among which are the overwhelming effects of estrogen and stimulating androgen influence fat products, progesterone and glucocorticoids. Of particular importance in increasing the Sebaceous excretions is range of actions of androgens is to increase the size of sebocytes, enhancing their secretory activity, increased cell proliferation and desquamation of keratinocytes. With an excess of androgens can cause blockage of the ducts and hair follicles at the mouth of non-inflammatory acne. Accession bacterial microflora leads to inflammation and formation of inflammatory elements. In addition to acne, excess of androgens in female body manifests and other signs of damage to the skin and its appendages (Seborrhea, HIRSUTISM, androgenzavisimaâ alopecia), in conjunction with the term "United androgenzavisimaâ dermopathy";. Symptoms of excess androgens are marked by 10-30% of women in the population [5] and become a significant cosmetic defect, affecting the neuro-psychological status of women, causing irritability, depressive States, reducing quality of life and causing social problems in the form of restrictions in the choice of profession and employment [6].
High frequency of acne in teenagers quite logically related to changes in the hormonal balance in the body. Among the many causes of excess production of androgens in women first of all physiological increases secretion and probably of biological activity of androgens at the end of puberty.
Primary ovarian androgens are testosterone and androstenedione, which is regulated by LH secretion and insulin as sinergista LH.
In the period of puberty changes in metabolism taking place under the banner of the physiological decrease the sensitivity of tissues to insulino. In the context of insulin resistance is increased secretion of insulin the pancreas. This mechanism is probably included in the process of puberty increase androgen biosynthesis in the ovaries.
Androgens circulating in the blood as a complex with sex steroids binding globulin (PSSG), medium was demonstrated primarily by the liver. Insulin influences the secretion of the PSSG, reducing its level in the blood stream. In the context of insulin resistance reducing PSSG could increase androgen biological activity.
Nadpočečnikovyh androgen secretion also has age-specific peculiarities. Before puberty the net area of the adrenal cortex is underdeveloped and poorly identified. But in a period of 5 to 10 years is its activation with increased production of DEA and DÈAS, which is called "adrenarhe". Throughout the period of puberty, hormone secretion netted the zone of adrenal cortex gradually increased, reaching a peak at the end of puberty. Thus, it is in the later puberty is physiologically determined precedent relative excess androgens.
But in the period of puberty is not only physiological but also pathological causes of androgen excess, becomes the basis that in this situation receives the title of giperandrogenii. The frequency of the syndrome of giperandrogenii among all gynecological diseases ranging from 1.3 to 4%; reproductive health disorders caused by hormonal imbalance, peculiar to this syndrome are menstrual dysfunction, anovulâciû, infertility, increased risk of hormone dependent organs pathology [4].
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