The role of hypothalamus-pituitary-adrenal (HPA)-like axis in inflammatory pilosebaceous disorders

Dermatol Online J. 2020 Feb 15;26(2):13030/qt8949296f.


Skin is the largest peripheral endocrine organ and functions as a hormone target and endocrine gland. A cutaneous hypothalamus-pituitary-adrenal (HPA)-like axis enables the skin to respond to stress and regulates its steroidogenic activity. The pilosebaceous unit is a site for production and metabolism of a number of steroid hormones, including stress and sex hormones. This is an overview of the important role that the cutaneous HPA-like-axis plays in the pathogenesis and treatment of inflammatory pilosebaceous disorders, including acne, rosacea, seborrheic dermatitis, and hidradenitis suppurativa.

Publication types

  • Review

MeSH terms

  • Hidradenitis Suppurativa / drug therapy
  • Hidradenitis Suppurativa / metabolism
  • Humans
  • Hypothalamo-Hypophyseal System / metabolism*
  • Pituitary-Adrenal System / metabolism*
  • Rosacea / drug therapy
  • Rosacea / metabolism
  • Sebaceous Gland Diseases / drug therapy
  • Sebaceous Gland Diseases / metabolism*
  • Skin / metabolism