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By Guy F. Webster, Anthony V. Rawlings

Addressing probably the most more often than not encountered stipulations visible through the dermatologist, this resource analyzes the pathophysiology, evaluate, prognosis, scientific good points, and keep an eye on of pimples. With full-color illustrations, this resource delves into the to be had remedies for tough instances of zits and scarring and gives specialist discussions of administration regimens together with topical and systemic remedies, laser remedies, and new drugs.

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J Invest Dermatol 1994; 102(2):221– 226. 107. Thiboutot D, Harris G, Iles V, Cimis G, Gilliland K, Hagari S. Activity of the type 1 5-alpha-reductase exhibits regional differences in isolated sebaceous glands and whole skin. J Invest Dermatol 1995; 105:209– 214. 108. Bayne EK, Flanagan J, Einstein M, et al. Immunohistochemical localization of types 1 and 2 5-alpha-reductase in human scalp. Br J Dermatol 1999; 141(3):481– 491. 109. Thiboutot DM, Knaggs H, Gilliland K, Hagari S. Activity of type 1 5 alpha-reductase is greater in the follicular infrainfundibulum compared with the epidermis.

Skin surface lipids are increased during combined HRT, possibly reflecting stimulatory effects of the progestogen component on sebaceous gland activity, while estrogen alone has a sebumsuppressive action (116). Local effects of estrogens have been demonstrated (115). Thus, ethinyl estradiol is capable of reducing sebum secretion when applied to the forehead. In addition, sebum secretion was reduced at sites on the forehead distal to the site of application. In agreement with a local effect, both a and b receptor subtypes for estrogens are detected in sebaceous glands of human terminal follicles in both basal and partially differentiated sebocytes (117).

Other compounds that inhibit cholesterol synthesis such as oral aluminum nicotinate and clofibrate had no effect on sebum production (75). Eicosa-5:8:11:14tetraynoic acid, given orally, suppressed squalene synthesis by 13% to 64% between subjects (76), but its site of action has never been determined. Free Fatty Acids Sebum contains numerous fatty acids and many are quite unique in structure, including a wide variety of straight, branched, saturated, and unsaturated fatty acids (77). In human sebum, about 27% of fatty acids chains are saturated, with the greatest proportion being unsaturated (68%).

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