- Top of page
- Correlations between serum IGF-1 and acne
- IGF-1, insulin and sebaceous lipogenesis
- The GH-IGF-1 axis and androgen synthesis
- IGF-1 potentiates peripheral androgen-mediated signal transduction
- Pharmacological down-regulation of insulin- and IGF-1 signalling
- Interactions between IGF1R- and FGFR2b-signalling pathways
- Endocrine disorders with increased insulin- and IGF-1 serum levels and acne
- Aggravation of acne by dietary modification of insulin/IGF-1signalling
- Smoking and insulin resistance
- Persistent acne in adulthood – an indicator of increased risk of cancer?
- Conclusions and outlook
- Conflict of interest
Abstract: It is the purpose of this viewpoint article to delineate the regulatory network of growth hormone (GH), insulin, and insulin-like growth factor-1 (IGF-1) signalling during puberty, associated hormonal changes in adrenal and gonadal androgen metabolism, and the impact of dietary factors and smoking involved in the pathogenesis of acne. The key regulator IGF-1 rises during puberty by the action of increased GH secretion and correlates well with the clinical course of acne. In acne patients, associations between serum levels of IGF-1, dehydroepiandrosterone sulphate, dihydrotestosterone, acne lesion counts and facial sebum secretion rate have been reported. IGF-1 stimulates 5α-reductase, adrenal and gonadal androgen synthesis, androgen receptor signal transduction, sebocyte proliferation and lipogenesis. Milk consumption results in a significant increase in insulin and IGF-1 serum levels comparable with high glycaemic food. Insulin induces hepatic IGF-1 secretion, and both hormones amplify the stimulatory effect of GH on sebocytes and augment mitogenic downstream signalling pathways of insulin receptors, IGF-1 receptor and fibroblast growth factor receptor-2b. Acne is proposed to be an IGF-1-mediated disease, modified by diets and smoking increasing insulin/IGF1-signalling. Metformin treatment, and diets low in milk protein content and glycaemic index reduce increased IGF-1 signalling. Persistent acne in adulthood with high IGF-1 levels may be considered as an indicator for increased risk of cancer, which may require appropriate dietary intervention as well as treatment with insulin-sensitizing agents.