Cited by 561Acne and Rosacea Treatments and EffectsDermatology and Skin DiseasesLipid metabolism and biosynthesis

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Acne and sebaceous gland function

Zouboulis, Christos C.·2004·Clinics in Dermatology

DOI 10.1016/j.clindermatol.2004.03.004

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Abstract

The embryologic development of the human sebaceous gland is closely related to the differentiation of the hair follicle and the epidermis. The number of sebaceous glands remains approximately the same throughout life, whereas their size tends to increase with age. The development and function of the sebaceous gland in the fetal and neonatal periods appear to be regulated by maternal androgens and by endogenous steroid synthesis, as well as by other morphogens. The most apparent function of the glands is to excrete sebum. A strong increase in sebum excretion occurs a few hours after birth; this peaks during the first week and slowly subsides thereafter. A new rise takes place at about age 9 years with adrenarche and continues up to age 17 years, when the adult level is reached. The sebaceous gland is an important formation site of active androgens. Androgens are well known for their effects on sebum excretion, whereas terminal sebocyte differentiation is assisted by peroxisome proliferator-activated receptor ligands. Estrogens, glucocorticoids, and prolactin also influence sebaceous gland function. In addition, stress-sensing cutaneous signals lead to the production and release of corticotrophin-releasing hormone from dermal nerves and sebocytes with subsequent dose-dependent regulation of sebaceous nonpolar lipids. Among other lipid fractions, sebaceous glands have been shown to synthesize considerable amounts of free fatty acids without exogenous influence. Sebaceous lipids are responsible for the three-dimensional skin surface lipid organization. Contributing to the integrity of the skin barrier. They also exhibit strong innate antimicrobial activity, transport antioxidants to the skin surface, and express proinflammatory and anti-inflammatory properties. Acne in childhood has been suggested to be strongly associated with the development of severe acne during adolescence. Increased sebum excretion is a major factor in the pathophysiology of acne vulgaris. Other sebaceous gland functions are also associated with the development of acne, including sebaceous proinflammatory lipids; different cytokines produced locally; periglandular peptides and neuropeptides, such as corticotrophin-releasing hormone, which is produced by sebocytes; and substance P, which is expressed in the nerve endings at the vicinity of healthy-looking glands of acne patients. Current data indicate that acne vulgaris may be a primary inflammatory disease. Future drugs developed to treat acne not only should reduce sebum production and Propionibacterium acnes populations, but also should be targeted to reduce proinflammatory lipids in sebum, down-regulate proinflammatory signals in the pilosebaceous unit, and inhibit leukotriene B(4)-induced accumulation of inflammatory cells. They should also influence peroxisome proliferator-activated receptor regulation. Isotretinoin is still the most active available drug for the treatment of severe acne.

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Frick, A. A., Girod, A., Moraleda, A., & Weyermann, C. (2021) · Springer eBooks · doi:10.1007/978-3-030-69337-4_7 · Cited by 5
Exploring Stress-Induced Mechanisms in Acne PathogenesisPreprint
Siddiqui, I., Rais, U., & Tahir, M. (2024) · Research Square · doi:10.21203/rs.3.rs-4477781/v1 · Cited by 5
Ludwigia adscendens (L.) Hara extract inhibits sebum overproduction and improves sebaceous gland function via the PPARγ/LXRα/SREBP1 pathway
Liu, Y., Liu, J., Xu, R., Yuan, Y., Sun, Q., Ding, S., Wang, F., & Qu, L. (2025) · Journal of Ethnopharmacology · doi:10.1016/j.jep.2025.120416 · Cited by 4
Androgenic Alopecia: Recent Understanding of the Androgenetic Receptor-Mediated Molecular Mechanisms and Current Pharmacotherapy
Suresh, P. K., & Ramkar, S. (2024) · Research Journal of Pharmacy and Technology · doi:10.52711/0974-360x.2024.00931 · Cited by 4
Akne Vulgaris ile Beslenme İlişkisi
Ömeroğlu, B., & Güneş, F. E. (2018) · Hacettepe Üniversitesi Sağlık Bilimleri Fakültesi Dergisi · doi:10.21020/husbfd.337532 · Cited by 4
A comprehensive classification and analysis of oily sensitive facial skin: a cross-sectional study of young Chinese women
Kuang, X., Lin, C., Fu, Y., Wang, Y., Gong, J., Chen, Y., Liu, Y., & Yi, F. (2025) · Scientific Reports · doi:10.1038/s41598-024-85000-z · Cited by 4
“High levels of porphyrins in oily sensitive skin may be due to excessive sebum secretion and changes in the microecological environment, providing more nutrients for bacteria such as Citibacterium acnes 72,73 .”
Evaluation of Sebum Control and Safety for Daily Use of a Cosmetic Elastomer Formulated with Vegetable Oils from Peruvian Biodiversity
Lozada, P., Tinoco, L. V., Muñoz, A. M., & Rojas, J. (2025) · Cosmetics · doi:10.3390/cosmetics12020066 · Cited by 4
Regional Difference of Inflammatory Acne Lesions According to β-Defensin-2 Expression
Choi, D. K., Li, Z. J., Chang, I. K., Sohn, K., Lee, Y., Seo, Y., Lee, Y., Shi, G., Kim, C. D., Lee, J. H., et al. (2014) · Journal of Investigative Dermatology · doi:10.1038/jid.2014.116 · Cited by 4
Network pharmacology‐based identification for therapeutic mechanisms of Dangguikushen pill in acne vulgaris
Yu, B., Diao, N., Zhang, Y., Li, X., Yu, N., Ding, Y., & Shi, Y. (2020) · Dermatologic Therapy · doi:10.1111/dth.14061 · Cited by 4
“For example, luteolin and formononetin mediated the downregulation of androgen receptor (AR) expression and exhibited an inhibitory effect on excessive sebaceous gland activity.(8) Also, we observed that one compound could regulate various targets.”
Background
Ocular surface characteristics in acne vulgaris
Muhafız, E., Öztürk, M., & Erten, R. (2021) · Clinical and Experimental Optometry · doi:10.1080/08164622.2021.1896336 · Cited by 4
Prevalence and psychosocial effects of acne vulgaris among secondary school students
Okwara, B. U., Ofili, A., Effiong, E. F., & Ekhator, U. (2021) · Sahel Medical Journal · doi:10.4103/smj.smj_32_20 · Cited by 4
Pediatric Acne
Gençler, B., Keseroğlu, Ö., Kartal, S. P., & Gönül, M. (2017) · InTech eBooks · doi:10.5772/66141 · Cited by 4
“Maternal androgens stimulate sebaceous glands by transplacental transmission instead of transmission by maternal milk [6].”
Background
Inhibition of lipogenesis and sebum secretion for Lotus corniculatus seed extract in vitro and in vivo
Cheng, L., Guo, J., & Lu, Y. (2022) · International Journal of Cosmetic Science · doi:10.1111/ics.12823 · Cited by 4
Evaluation of 30% supramolecular salicylic acid followed by 1565-nm non-ablative fractional laser on facial acne and subsequent enlarged pores
Han, Q., Zeng, J., Liu, Y., Yin, J., Sun, P., & Wu, Y. (2023) · Lasers in Medical Science · doi:10.1007/s10103-023-03751-z · Cited by 4
“Excessive secretion of sebum is not only linked to acne lesions but also to enlarged pores [6, 7, 17, 19].”
Background
Second to fourth digit ratio in female patients with acne vulgaris: Could it be a predictor of androgen receptor status?
Farag, A. G. A., Shoiab, M. A., Samaka, R. M., Abdou, A. G., Elnaidany, N. F., & Mansour, A. O. M. (2019) · Indian Journal of Dermatology Venereology and Leprology · doi:10.4103/ijdvl.ijdvl_35_18 · Cited by 4
Sebaceous Physiology
Firooz, A., Zartab, H., & Rajabi‐Estarabadi, A. (2017) · Springer eBooks · doi:10.1007/978-3-319-32383-1_13 · Cited by 4
Acne
Dessinioti, C., & Dréno, B. (2015) · Springer eBooks · doi:10.1007/978-3-662-45139-7_1 · Cited by 4
Photodynamic therapy for acne vulgaris
Katsambas, A., Kontochristopoulos, G., Sălăvăstru, C., & Dessinioti, C. (2011) · Prime · doi:10.1080/21598908.2011.601583 · Cited by 4
Retinoid Therapy of Acne and Sebocyte-Related Disorders
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Acne Scars: How They Form and How to Undo Them
Roh, M. R., & Chung, K. Y. (2019) · Springer eBooks · doi:10.1007/978-981-32-9791-3_8 · Cited by 4
Antimicrobial Lipids and Innate Immunity
Thormar, H. (2010) · doi:10.1002/9780470976623.ch6 · Cited by 4
Light therapies for acne
Car, J., Car, M., Hamilton, F. L., Layton, A., Lyons, C., & Majeed, A. (2009) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd007917 · Cited by 4
Acne
Layton, A., Eady, E. A., & Zouboulis, C. C. (2016) · Wiley eBooks · doi:10.1002/9781118441213.rtd0091 · Cited by 4
Self-citation
Growth Differentiation Factor 11 Attenuates Photoaging through Ferroptosis Pathway in SZ95 Sebocytes
Liu, Y., Zeng, J., Liu, X., Qin, Y., Zhang, Y., Zouboulis, C. C., & Xiao, Z. (2025) · American Journal Of Pathology · doi:10.1016/j.ajpath.2025.07.015 · Cited by 3
Self-citation
A Novel Cationic Niosome Formulation for Topical Delivery of Adapalene
Tabatabaie-Mehr, H., Haddadi, R., Isfahani-Nia, S., & Vafaei, S. Y. (2025) · BioMed Research International · doi:10.1155/bmri/8874333 · Cited by 3
“This sebum provides a favorable environment for the proliferation of a type of Gram-positive bacteria called Cutibacterium acnes , which triggers an in ﬂ ammatory response due to bacterial antigens and cytokines [3].”
Effects of metformin on experimentally induced acne on rabbit ear
Kamboj, P., Bishnoi, A., Handa, S., Dutta, P. R., Saikia, U. N., Pal, A., & De, D. (2021) · Experimental Dermatology · doi:10.1111/exd.14347 · Cited by 3
Discovery of small molecule ACC inhibitors: Potential treatment for excessive sebum secretion
Feng, X., Luo, X., Niu, X., Wang, S., Feng, M., Jiang, X., Chen, W., & Bai, R. (2025) · Bioorganic Chemistry · doi:10.1016/j.bioorg.2025.108438 · Cited by 3
Efficacy of Dissolvable Microneedle Patches with Skincare Actives in Acne Management: A Monocentric Clinical Study
Avcil, M., Klokkers, J., Jeong, D., & Çelik, A. (2025) · Biologics · doi:10.3390/biologics5020015 · Cited by 3
“…in sebaceous gland activity associated with excessive sebum production (hyperseborrhoea) and alterations in sebum fatty acid composition and skin surface lipids (i.e., the oxidant/antioxidant ratio) are considered the primary concurrent events associated with the development of acne [20].”
Molecular Aspects of Sebaceous Differentiation
Zouboulis, C. C., Nikolakis, G. D., & Dessinioti, C. (2014) · Springer eBooks · doi:10.1007/978-3-540-69375-8_3 · Cited by 3
Self-citation
Stammzellen und ihre Bedeutung in der Dermatologie
Zouboulis, C. C. (2009) · Aktuelle Dermatologie · doi:10.1055/s-0028-1119597 · Cited by 3
Self-citation
Effect of antioxidant treatment with n-acetylcysteine and swimming on lipid expression of sebaceous glands in diabetic mice
dos Santos, G. R., da Cunha, M. R., Caldeira, E. J., Galdeano, E. A., Prudente, R. C. S., & Pinto, C. A. L. (2021) · Scientific Reports · doi:10.1038/s41598-021-91459-x · Cited by 3
Structure of children’s skin and rules for its care – what’s new? Children’s skin structure
Garncarczyk, A. A., Adamczyk, K., Lubczyńska, A., Wcisło-Dziadecka, D. L., Antończak, P., & Jakubowska, M. (2022) · Pediatria Polska · doi:10.5114/polp.2021.112400 · Cited by 3
Outcomes of topical combination therapies of mild to moderate acne
Мансуровна, Х. И., Файзуллина, Е. В., Gusarova, E. M., & Nabieva, R. R. (2022) · Russian Journal of Clinical Dermatology and Venereology · doi:10.17116/klinderma202221041487 · Cited by 3
Seasonal changes in the scrotal skin histology in relation to thermoregulation and testosterone level in camel and buffalo bull
Ahmed, S., Qureshi, A. S., Usman, M., Rehan, S., Deeba, F., Ateeq, M. K., Younus, M., Naeem, M. A., Umar, Z., & Taseer, M. S. A. (2023) · Anatomia Histologia Embryologia · doi:10.1111/ahe.12933 · Cited by 3
Antioxidant and Anti-Propionibacterium acnes Activities of Citronella Oil and Clove Oil, and their Formulation Into Emulgel
Aji, N., Puspitasari, A., Nafisah, H., & Armilda, L. H. V. (2023) · PHARMACY Jurnal Farmasi Indonesia (Pharmaceutical Journal of Indonesia) · doi:10.30595/pharmacy.v0i0.12629 · Cited by 3
“The pathophysiology of acne occurs by the colonization of Propionibacterium acnes , follicular hyperkeratinization, inflammation, and increased sebum production (Zouboulis, 2004).”
Background
Exploring Complementary and Alternative Medicine Use for the Management of Acne Vulgaris Among University Students: Forms, Trends, and Information Sources
Taha, S., Taha, M. M. E., & Zyoud, S. H. (2025) · Journal of Cosmetic Dermatology · doi:10.1111/jocd.16775 · Cited by 3

Authors: Zouboulis, C. C.
Affiliations: Stiftung Charité (DE)
Corresponding author: Zouboulis, Christos C.
ORCID: Zouboulis, Christos C.
Venue: Clinics in Dermatology
Publisher: Elsevier BV
Published: 2004-09
Volume: 22
Issue: 5
Pages: 360-366
ISSN: 0738-081X (ISSN-L)
DOI: 10.1016/j.clindermatol.2004.03.004
OpenAlex: W2031661874
Cited by: 561
References: 85
Citations by year: 2026: 15 · 2025: 27 · 2024: 21 · 2023: 28 · 2022: 24 · 2021: 30 · 2020: 29 · 2019: 35 · 2018: 22 · 2017: 36 · 2016: 31 · 2015: 19 · 2014: 55 · 2013: 25 · 2012: 19
FWCI: 14.87
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Clinics in Dermatology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Dermatology › Acne and Rosacea Treatments and Effects
Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
Life Sciences › Biochemistry, Genetics and Molecular Biology › Biochemistry › Lipid metabolism and biosynthesis
Keywords: sebaceous glands, sebum production, androgens, peroxisome proliferator-activated receptors, sebaceous lipids, corticotropin-releasing factor, substance P, Propionibacterium acnes, skin barrier, epidermal differentiation, adrenarche
MeSH terms: Acne Vulgaris, Adolescent, Adult, Age Factors, Child, Dermatologic Agents, Humans, Neuropeptides, Sebaceous Glands, Sebum, Cytokines, Inflammation Mediators

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Acne and sebaceous gland function

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