Characterization of cutaneous sex steroid hormone production through analysis of skin secretions

Importance: Systemic sex steroid hormone aberrations often manifest in skin disease. The sebaceous, apocrine, and eccrine glands all play an important role in the response and production of these hormones in the skin. However, our ability to quantify hormonal secretions at the skin surface is limited. Objective: Our study aims to characterize the hormonal landscape of the skin at different anatomical sites and between the sexes through analysis of skin secretions. Design: In this observational pilot study, we collected skin secretions from twelve male and ten female control subjects using commercially available, Sebutape®, from the antecubital fossa, forehead, back, and axilla. We then developed a method to extract and quantify the amount of sex steroid hormones from these secretions through liquid chromatography tandem mass spectrometry (LC-MS/MS). Setting: Outpatient clinic. Participants: 34 participants were enrolled in the study, with 22 participants meeting criteria. Eligibility criteria included age of 18 to 40 and BMI between 15-35. Exclusion criteria included participants outside the ages of 18 to 40, use of antibiotics in the last 6 months, history of hormonal aberrations or chronic skin disorders, and use of hormone altering medications (except oral contraception). Results: Our study detected anatomical site differences most notably in elevated dehydroepiandrosterone in the axilla and androstenedione in the forehead. Several hormonal differences were also detected between male and females consistent with known systemic hormone differences between the sexes. Conclusions: We developed a method to quantify the hormonal levels in skin secretions using Sebutape®. Our approach found that hormonal composition varies based on sex and anatomical site. Additional studies will need to be completed to determine relevant hormonal shifts in clinical skin conditions.