Hormonal Evaluation of Acne
These hormone tests are best taken between 8:00 and 10:00 am during the first half of the menstrual cycle. They may include:
- Testosterone
- Sex hormone binding globulin (SHBG)
- Free androgen index (FAI)
- Dehydroepiandrosterone sulfate (DHEAS)
- 17-hydroxyprogesterone
- Synacthen test of adrenal stimulation by adrenocorticotrophic hormone (ACTH)
- Luteinising hormone (LH) and follicular stimulating hormone (FSH)
- Prolactin
- Cortisol
- Dexamethasone suppression test
Hormonal testing and interpretation of testing is complex. A typical hormone-screening panel includes free and total testosterone, dehydroepiandrosterone sulfate (DHEA-S), androstenedione, luteinizing hormone, and follicle-stimulating hormone.49,51-54,165 Growth hormone, insulin-like growth factor, lipid levels, insulin, sex hormone–binding globulin, free 17-β-hydroxysteroids, free androgen index, prolactin, estrogen, and progesterone may also be abnormal in those with severe acne.52,54-56,165,169 Insulin resistance may also represent a risk factor for acne in certain patients.170 Patients with abnormal test results, or in whom there is a persistent concern for a hormonal disorder, should be further evaluated by an endocrinologist.