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Age-Related Changes in Sebaceous Gland Activity: Department Dermatology Rsity Hospital, Boston, Mass.
Age-Related Changes in Sebaceous Gland Activity: Department Dermatology Rsity Hospital, Boston, Mass.
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THE JOURNAL OF INVESTIGATIVE DERMATOLOGY, 73:108-111,1979 Vol. 73, NO.1
Copyright © 1979 by The Williams & Wilkins Co. Printed ill. U. S .A.
The sebaceous glands of man show age-related differ- comprising cross-sectional analyses in children before and after
ences in their activity as determined by quantitative and the age of 10, showed no increase in sebum secretion until the
qualitative examination of sebum. Sebaceous secretion mid teens, except in menarchal girls, in whom the increase was
is low in children and begins to increase in mid- to late evident somewhat earlier [5]. However, sebum production tests
childhood under the influence of androgens. This rise we performed twice yearly in each of 9 boys and 6 girls for a 3-
continues until the late teens, after which no further yr period showed an earlier increase in sebum production.
significant change takes place until late in life. Figure 1 illustrates our results. A gradual increment in the
In elderly men, sebum levels remain essentially un- amount of sebum secreted occurred; this increment became
changed from those of younger adults until the age of somewhat more abrupt at age 13. No obvious sex difference was
80. In women, sebaceous secretion decreases gradually apparent, either in the quantity of sebum produced at any given
after menopause and shows no significant change after age or in the slope of the line representing sebum secretion.
the 7th decade. The most likely explanation for the de- In actuality, one can observe an even earlier increase in
crease in sebaceous gland secretion with age in both sebaceous gland activity, before the age of 9, by determining
men and women is a concomitant decrease in the endog- the relative composition of skin surface lipids, which are mix-
enous prod.uction of androgens. tures of sebaceous and epidermal lipids [6]. As sebum secretion
Although surface lipid levels fall with age, paradoxi- begins to increase in late childhood, the amount of wax esters,
cally the sebaceous' glands become larger, rather than which are of sebaceous origin, increases relative to the amounts
smaller, as a result of decreased cellular turnover. None- of cholesterol and cholesterol esters, which are epidermal lipids.
theless, as the higher surface lipid levels after adminis- One can show that the wax esters/[ cholesterol+cholesterol
tration of fluoxymesterone (a synthetic testosterone de- esters] ratio increases at approximately 7 or 8 yr of age and
rivative) indicate, the glands have the capacity to re- these lipids approach an "adult" composition by age 10 or 11
spond to androgens. [7,8].
Published results of studies based on examinations of individ-
uals of different ages suggest that full sebaceous gland matu-
Sebaceous gland activity decreases with advancing age [ll ration is not attained until either late in the 2nd decade or early
The principal cause for this attrition appears to be diminished in the 3rd decade [4,5,9,10]. Figure 2 shows data obtained in a
hormonal stimulation, a reversal of the increase in glandular 13-yr longitudinal study of sebum secretion in 2 children, a boy
activity that occurs at puberty through augmented elaboration and a girl. Sebum production was measured in each of the
of androgenic steroids. This review is concerned with studies children 4 times yearly. Secretion clearly increased at age 12 or
on sebaceous gland activity in the aged and the correlation of 13, continued to increase gradually and steadily until age 17 or
these findings with hormonal alterations that occur in late 18, and then appeared to enter a stable phase. Our lack of
middle age and senescence. Data are also presented on the evidence for an earlier sebum increase in the girl was in contrast
developmental changes occurring from the time the glands to another report [5] which indicated greater production in 11-
begin to mature to the time they reach their adult state. to 15-yr-old girls, especially menarchal ones.
METHODS SEBUM STUDIES IN THE AGED
In our laboratories, sebaceous gland activity is measured by a method Once maturity has been achieved, little change in sebaceous
[2] that involves the absorption of surface lipids from a defined area of gland activity takes place until middle age and thereafter. Table
the forehead onto absorbent papers for a period of 3 hr. The lipids
collected are extracted by ether and measured gravimetrically. The I shows sebum production values in women and men 40 yr or
determination of individuai lipid class components of forehead surface older. Average sebum production levels in the women fell by
lipids is made by thin-layer chromatographic separation and photoden- approximately 40% in the 6th decade, declined additionally in
sitometric quantification [3]. the 7th decade, and remained constant thereafter. In the men,
no change was observed until the 8th decade. At any age range
SEBACEOUS GLAND DEVELOPMENT examined, mean sebum values in the men exceeded those in
Human sebaceous glands develop during fetal life between the women. This finding of a drop in surface sebum levels with
weeks 13 and 15 of gestation; they attain fair size by the time of advancing age and of a greater decrease in women is in general
birth and then mostly shrink to comparatively small structures agreement with reports of other studies [5,10-15]' Reduced
during childhood [4]. With the onset of puberty and stimulation sebaceous gland activity, as evidenced by lower surface lipid
by androgens, there is glandular hyperplasia and an increase in levels, has also been demonstrated in vitro by diminished
the synthesis and secretion of sebum. Studies by Cotterill et al formation of squalene, and to a lesser extent of wax esters, from
glucose in skin biopsy samples from the backs of elderly men
[16]. .
Reprint requests to: Peter E. Pochi, M.D., Department of Derma- Study of the forehead surface lipid composition in 15 children,
tology, University Hospital, 75 E. Newton Street, Boston, Mass. 02118. 18 young adult women, and 10 postmenopausal women revealed
This work was supported by U.S. Public Health Service grant IROI- wax esters/[ cholesterol+cholesterol esters] ratios that were low
HD11632 (National Institute of Child Health and Development). in the children, high in the young adults, and low in the aged
Drs. Strauss and Downing are currently at the Department of
Dermatology, University of Iowa Hospitals, Iowa City, Iowa. women (Table II). These changes reflect the differences in
Abbreviations: sebaceous gland activity occurring at these various times of life.
T, = thyroxine The most probable explanation for the decrease in sebaceous
T" = triiodothyronine gland synthesis and secretion in the aged is a concomitant
TSH = thyroid-stimulating hormone (thyrotropin) . decrease in the production of androgens. In men, testosterone
108
July 1979 SEBACEOUS GLANDS IN THE AGED 109
1 .5 TABLE II. Comparison at different oges of wax esters/
[cholesterol+clwlestero l esters! ratios in forehead surface lipids
No. s ubjects Ratio
~ Children 15 0.35
:J
o
.r::
Young ad ult 18 7.47
M women
..... 1.0
Postmenopausal 10 1.46
E
u women
cr
fJJ
o
~
.....
"0
'is. In women, androgen sources for sebaceous gland stimulation
::;
Ol 0 .5 I- are the ovary and a drenal cor tex. We had assumed previously
~ that t he postmena pausal decrease in sebum production h ad
been t he resul t of ovaria n involutio n and th at the failure of
many subjects to reach prepubertal sebum levels had been du e
to persistent a drenocor tical androgen secretion [4]. However,
subsequent studies demonstrated t hat postmenopausal ovaries
retain a considerable androgen synt hetic capacity, In postmen-
9 10 11 12 13
opausal women, plasma testostero ne levels fall after bilateral
AGE (years) oophorectomy [21] a nd are lower in postmenopausal oophorec-
FIG 1. Sebum production in 15 children tested tw ice yea rly over a
tomized women than in no rmal contro ls [22]. Moreover, t h e
3-yr period. Height of each column represents the mean sebum value concentration of testosterone in t he ovarian vein exceeds t hat
of the results obtained at the age when tested. 0 = 6 girls; ~ = 9 boys. in the peripheral blood [23,24] and increases significantly after
administration of human chorionic gonadotropin [24]. However,
a drenocortical a ndrogen secretion must also decrease in women
(a nd men) with age since t here is a gradual decrease in urinary
3 .5
17-ketosteroid excretion a nd plasma concentrations of dehy-
droepia ncb'osterone (the principal a dl'enal a ndl'ogen) [25-27].
3 .0 I, Values for these acb'enal a ndl'ogens ar e greater in men tha n in
I ,
:;'" ---- - Mal e
I
I \
,
women, a nd t his differential persists un til a very late age, after
0
:I:
2 .5
- - Female / \ __ _- - ' , which they closely approach one another [25,28,29].
M I ...
"- I Alt hough it is proba ble t hat t he diminished sebaceous gla nd
E / ? - -' secretory activity occurring in the aged can largely be explained
u 2 .0
a by concomitant changes in androgen levels, the possible role of
fJJ
0
~
I
I
" such other hormones as glucocorticoids a nd t hyr oid hormones,
"-
"0
'0.
::;
Ol
1 .5
I
/
I
TABLE Ill. Planimetric m easurement of sebaceous gland size in T AB L E V. Shin. surface lipid measuremen ts in postmenopausal
facial biop sy specimens from men" women. with breast cancer"
Mean cross-secLiona l Breast cancel" l Normals" P value
Age No. s ubjects area (mm' )
Kran t et al [43] 2.11 (22) 1.02 (31) < .01
20-36 15 .2258 Burton et aJ [44] I.l 0 (20) 0.76 (20) < .05
47-53 5 .2532 Wang et al [45] 0.37 ( 19) 0.24 (1 9) < .03
64-74 21 .4003 Current study 1.29 (72) 0.96 (51) > .1
" Adapted from Plewig and Kligman, J Invest Dermalol 70:314, 1978 " Milligra ms per 10 cm 2 of s kin per 3 hr.
[37]. " Numbers of subj ects m·e in pa rent heses.
July 1979 SEBACEOUS GLAN DS IN THE AGED 111
lutional cha nge represents a loss of function t hat compromises 22. Vermeul en A: T he h ormon al activity of t h e postm enopausal ovary .
t he integrity a nd natmal defenses of t he skin. Functional attri- J Clin E ndocnnol M etab 42:247-253, 1976
23. Judd H L, J ud d GE, Lucas W E, Yen SSC: E ndocrine function of
bu tes of sebum include t he m ainte na nce of a protective emol- th e postmenopa usal ova ry: Concentration of a ndroge ns and es-
lient lipid film, retarda tion of water eva poration, a nd shielding trogens in ovaria n and perip hera l ve in blood. J Clin E ndocrinol
against bacterial a nd fun gal infections. M ost of t he availa ble Metab 39:1020-1024, 1974
evidence suggests t ha t, al t hough in other ma mmalia n species 24. G reenblatt HB, Colle M L, Mah esh VB: Ovari an a nd adrenal steroid
production in t he postmenopa usa l woma n. Obstet Gyneco l 47:
sebum coats th e fm (to prevent overwetting and hea t loss) a nd 383-387, 1976
provides a sexu al attractan t a nd te rri torial marker [49,50], in 25. P incus G, Do rfm an HI , Ho ma noff LP, H ubin BL, Bloch E, Carl o J ,
huma n beings it provides lit tle or no such protection [49]. Yet, Free ma n H: Steroid metabo lis m in aging men a nd women. Hecent
were sebum to h ave demonstr ated importance in ma n, it might P rog H orm Hes 11:307-34 1, 1955
26. Brooks bank B WL, Saloka ngen A: F ractiona l a na lysis of urinary
be difficult to ascribe a ny par ticular aging cha nge seen clinically neut ra l 17-ketoste roids in r elatio n to age. Acta E ndocrinol (Kb h )
to a diminu tion or loss of sebum because of other involutional 30:231-241, 1959
skin tissue cha nges occmring at t he sam e time. On t he ot her 27. Trout EC Jr, Arn ett W , Hume EB, McGavack T H : Excretion
ha nd, after t he age of 50, decreased sebaceous gla nd activity in patterns of androgenic ste roids in t he elde rly: Effect of th yro id
ho rmone. J Ge rontol 25:229-235, 1970 .
wom en occurs 10 to 20 yr em'lier t ha n in men; therefore, a ny 28. Vihko H: Gas chl'omatographic- mass spectro metric stud ies on sol-
possible sex differ ences in skin fun ction, especiall y as related to vo lyza ble steroids in huma n periphera l plasma. Acta E ndocrinol
dryn ess, sensitiveness, susceptibility to infection, etc., might be (K bh ) [S up pl] 109, 1966
attribu table to decreased sebum . H owever , t here is no clear 29. Migeon CJ , K eller AH, Lawrence B, S hepar d TH: Dehydroepia n-
d rosterone and a ndrosterone leve ls in human pl asma. Effect of
evide nce of such a specific sexual predilection. age and sex; day-to-day a nd diurnal variations. J Clin E ndocri nol
M etab 17: 1051-1062, 1957
REFERENCES 30. Pochi PE, Stra uss J S, M escon H : T he role of a dJ'enocor tica l steroids
1. Pochi P E, Strauss J S: Th e effect of aging on th e acti vity of th e in th e control of hu man sebaceous gla nd activity. J In vest Der-
se baceo us gla nd in ma n, Ad vances in B iology of Skin, Vol. VI. mato I 41:391-399,1963 .
E di ted by W M on tagna. Oxford , P ergamon P ress, 1965, pp 121- 3 1. W est CD , B rown H , S imons E L, Car te l' DB, K a magai LF, E nglert
127 E Jr: Adrenocortical fun ction a nd cortisol metabolism in old age.
2. Stra uss J S, Pochi PE: The qu a nt itative grav imetric determination J Clin E ndocrinol M eta b 21:1197-1207, 1961
of se bum prod uction. J Invest D ermatol 36:293-298, 196 1 32. Ro ma noff LP, M orris CW, Welch D, Rodriq uez HM, P incus G: T he
3. Downing DT: P h otodens itom etry in th e t hin · laye r chromato- meta bolism of co r tisol-4 -C'" in yo ung a nd elde rly men. 1. Secre-
gra phic a na lysis of neutra l li pids. J C hro matogr 38:91-99, 1968 t ion rate of cor tiso l and da ily exc retion of tetra hydrocor tisol,
4. Poc hi PE, Stra uss J S: E ndoc rinologic con trol of the deve lopmen t a ll otetra hydrocor t iso l, tetrahydrocor t isone a nd corto lone (20a
a nd activity of the huma n sebaceo us gla nd. J Invest Dermato l a nd 20f3). J Clin E ndocrinol M etab 21:1413-1425, 1961
62: 191-201, 1974 33. B lichert-Toft M: The a dr ena l gla nds in old age, Geriatric E ndocri -
5. Cotterill J A, Cunliffe WJ , Willia mson B, B ulusu L: Age a nd sex nology, Vol 5, Aging. E di ted by HB G reenblatt. N ew York. Have n
variation in s kin s urface lipid co mpos itio n a nd seb um excretion Press, 1978, pp 81-102
rate. B r J De rm ato l 87:333-340, 1972 34 . T hody AJ , S hu ster S: A study of t he relations hip between th e
6. D ownin g DT, Strauss J S : Syn thesis a nd compositio n of surface t hyro id gla nd a nd se bum secretion in the rat. J Endoc rinol 54:
lipids of huma n s kin . J Invest D erm ato l 62:228-244, 1974 239- 244, 1972
7. H amasastry P , Downing DT, Pochi PE, Stra uss J S: Chemica l 35. Goo lama li S K, Evered D, S huster S: Thy roid disease a nd sebaceous
co mpositio n of human skin surface lipids from birt h to puberty. function . B r M ed J 1:432-433 , 1976
J Invest D ermatol 54:139-144, 1970 36. Ingbar SH: Th e influ ence of aging on t he huma n thyroid hor mone
8. Pochi PE, Stra uss J S, Downing DT: S kin s urface lipid compositio n, eco no my, Geriatric E ndoc rinology, Vo l 5, Aging. Ed ited by H B
acne, pu bertal developme nt, a nd urina ry excretio n of testoster- Greenblatt. New York, Raven P ress; 1978, p p 13- 31 '
one a nd 17- ketosteroids . J In vest Der mato I 69:485-498, 1977 37. P lewig G, Kligma n AM : Pro li ferative activity of the sebaceous
9. Stra uss JS, Pochi PE: Th e cha nges in hu ma n sebaceous gla nd gla nds of the aged . J Invest De rmato l 70:314- 317, 1.978
activity wit h age, B iopath ology of Pattern Alopecia. Edited by A 38. Lee MMC: P hysical and structura l age changes in human skin.
Baccared da-Boy, G M oretti, J R Fr ey. Basel, S Karger, 1968, pp Anat Hec 129:473- 493, 1957
166- 170 39. K a llaprav it B: Hac ia l, age a nd regiona l differences in hu man seba-
10. Cunli ffe W J, S huster S: Path ogenesis of acne. La ncet 1:685- 687, ceo us glands of t h e h ead and neck. Am J P hys Anth ropol 21:121-
1969 133, 1963
11. KiJ'k E : Quanti tative determinations of t he skin lipid sec retion in 40. S mi th JG J r, B runot FH: H ormona l effects on aged human seba-
middl e-aged a nd old individu als. J Gerontol 3:25 1-266, 1948 ceo us gla nds . Acta Derm Venereol 41:61-65, 1961
12. Iversen K, Vide bac k A, Kirk J E : Casua l s kin lipid levels in individ - 41. Stra uss JS, Kligma n AM, Pochi PE: T he effect of an droge ns a nd
ua ls o f va rio us ages. J Geron to l 8:312-3 17, 1953 estrogens on hum a n sebaceo us gla nds. J In vest Dermato I 39:1 39-
13. B run H, E nde rlin K , D eW eck A: Variatio ns de la couche sebacee 155, 1962
d e I'ava n t- bras s ui van t l'age et Ie sexe. Acta Derm Venereol 35: 42. M ontagna W: M orph ology of the agin g kin: T h e cutaneo us ap-
3 11-317, 1955 pendages, Adva nces in B iology of S kin, Vo l. VI. E di ted by W
14. Grasset N , B run R: Etude du film s ebace de sujets sa ins et de Mon tagna, Oxfo rd , Pergamon P ress, 1965, pp 1- 16
patien ts atte in ts d 'ep ileps ie o u de ma lad ie de Parkinso n. De l" 43. K ra n t M D, Brandr up CS, G reene RS, Poc hi PE, Stra uss J :
mato logica 11 9:232- 237, 1959 Sebaceous gla nd activity in breast cancer. Nature 217:463-465,
15. Smit h J G J r: The aged huma n se baceo us gla nd. Th e effects of 1968
h ormone administra tion a nd a compa rison with a dolescent gla nd 44. B urton JL, Cunli ffe WJ , S huster S : In creased seb um exc retion in
fun ction. Arc h D ermatol 80:663-671, 1959 patients with breast cancer. B r M ed J 1:665-666, 1970
16. Cooper MF, M cG rath H , S huste r S : Se baceous lipogenesis in 45. Wa ng D Y, Bulbroo k RD, GuilJ ebaud J , Lewis A: The relation
huma n s kin . Varia bili ty wi t h age and wi th severi ty of acne. B r J between seb um prod uction a nd pl asma 17·oxosteroid levels in
De rmatol 94: 165- 172, 1976 normal wom en a nd in patients wit h breast cancer. E ur J Cancer
17. Pirke K M, D oerr P : Age related cha nges in free pl asma testoster- 8:38 1-385, 1972
one, dihydl'Otestoste l'One a nd oestradiol. Acta En docrin ol (Kbh ) 46. Wa ng D Y, B ul broo k HD, Th omas BS, F riedm a n M: Testostero ne
80:1 71-178, J970 levels in the plasm a of normal women and p atients with benign
18. Ver me ule n A, Rubens H, Verdo nck L: T estosterone secretion a nd breast disease or wi th breast cancer. E ur J Ca nce r 2:373-376,
m eta bolis m in ma le senescence. J Clin Endoc rin ol M eta b 34:730- 1966
735, 1972 47. B ird CE, F innis W , Boroom and K , M urph y J , Clark AF : K inetics
19. Steam s E L, M acD onn ell JA, K a ufma n BJ , Pad ua R, Lu cma n T S, of testosteron.e metabolism in norma l postmenopa usa l wo men
W in ter J S D , Fa im a n C: D eclining testi cular function wi th age. a nd wo men Wi th breast cance l'. Ste roids 32:323-335, 1978
Hormona l a nd cl inical co rrelates. Am J M ed 57:761-766, 1974 48. Goola mali S K , S huster S: A sebotrophic stimulus in benign a nd
20. Hall berg M C, Wiela nd RG, Zorn E M , F urst B H , Wi ela nd JM: ma li gna nt breast disease. Lancet 1:428-429, 1975
Impa iJ'ed Leydig cell reser ve a nd a ltered se rum a nd rogen binding 49. K li gma n AM: T he uses of seb um ?, Adva nces in B iology of Sk in,
in t he aging m ale. F ertil Ste ril 27:812-8 14, 1976 vol. I V. Ed ited by W. M on tagna, HA E llis, AF S il ver. Oxford,
21. J udd HL, Lu cas WE, Yen SSC: Effect of ooph orecto my on circu- Pergamon Press, 1963, pp 11 0- 124
lating testoste ro ne a nd a ndrostenedio ne leve ls in patien ts wi th 50. My kytowycz R, Goodr ich BS: S ki n gla nds as orga ns of commu ni-
e ndometri a l ca ncer. A m J Obstet Gyneco l 11.8:793-798, J974 cation in ma mma ls. J In vest De rm atoI 62: 124- 131, 1974