The measurement of sebum excretion rate (SER) in the human has helped our understanding of the sebaceous gland, its disease and pharmacological manipulation. Several factors influence sebum production, but it is predominantly  hormonally  stimulated.  Androgens, especially from  the testes and adrenals, stimulate the sebaceous gland directly. Oestrogens exert a variable inhibitory effect in pharmacological doses. The action of oestrogen is chiefly indirect by inhibiting hormonal release from the pituitary and the effect of oestrogen is easily  overcome by relatively small doses of androgen. Progesterone probably has no major effect on  sebum excretion  rate in the adult.  The pituitary gland,  in particular the anterior lobe, has an important role in controlling sebaceous gland secretion. The anterior pituitary exerts  its effect through its target organs, in particular the gonads and adrenals.

 

  Sebum  excretion is significantly greater in patients with acne and attempts pharmacologically to reduce the SER are a logical approach to  the treatment of acne. Recently  anti-androgen  therapy and retinoids  have vastly  improved the treatment of the more difficult acne patients. This seborrhoea, which is so characteristic of acne, persists in patients who have had acne.