Acne Vulgaris: The Influence of Marriage, Pregnancy and Childbirth

Ratzer, Maria A (1961) Acne Vulgaris: The Influence of Marriage, Pregnancy and Childbirth. MD thesis, University of Glasgow.

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SUMMARY. 1). It is difficult, time consuming, and in many cases impossible to get the co-operation of a large group of patients in a large industrial town, where movement of population is bound to be great, particularly in the 15-25 age group. Many of the questionnaires, though very simply worded were inadequately filled in. 827 addresses were collected, over 1100 letters were sent out and almost 100 homes visited personally, yet only 415 forms were finally collected. 2). The treatment given by a skin department, where only relatively stubborn and rather severely affected cases are treated would seem to shorten the duration of acne vulgaris, an important consideration in reassuring young women of marriageable age. See Table I. 3). Disfiguring scarring would appear to lessen a girl's chance of marriage. See Table II. 4). Marriage has an undeniable influence on the course of acne vulgaris. 43.4% in the series improved, 53%, however, noted no change in their skin condition, only 3.6% deteriorated following matrimony. The widely held belief of a universally beneficial influence of marriage on this complaint, while certainly true in a considerable percentage of women, has not been confirmed by this survey. See Table III. 5), Pregnancy, on the other hand, has a markedly beneficial influence on acne vulgaris according to this survey. See Table IV, This isthought to be due to an increase in secretion of oestrogens, progesterone and gonadotrophins during gestation, all of which have a beneficial effect on acne by suppressing the activity of the pilosebacecus apparatus. Androgen, the hormone which stimulates sebaceous gland activity is at a lower level than normal during gestation. The psychological, possibly hypothalamic influence of pregnancy leading to a happier, better balanced out-look would all appear to bring about an amelioration and often a permanent remission of acne vulgaris. 6). The largest percentage of patients improved after the birth of their baby. See table VI. Lactation appeared not to have further influenced the course of events. See Table VII. An analogy can be drawn between dysmenorrhoea and acne vulgaris, both conditions of varied aetiology, commonest in adolescents and both in many instances finally cured by child-birth. It is postulated that this final cure of acne vulgaris is due to a finally established ideal hormonal balance, only achieved by the hormonal stimuli of pregnancy and parturition. Other aetiological factors would appear to be only of secondary importance. A suggestion is made to qualify Plenck's dictum "Matrimonium varos curat" to "Non matrimonium sed infantes varos in feminas curant". 7). From experience in this and other skin departments the results of hormonal therapy are often disappointing and unpredictable and may give rise to unpleasant, though rarely dangerous side-effects. More, and if at all possible, controlled trials are necessary in this field, to find a more satisfactory and safer approach to the internal and external treatment of acne vulgaris with hormonal substances. 8). It is stressed that acne vulgaris must not be taken lightly, the presence of a disfiguring and usually all too obvious skin condition in a susceptible adolescent not only leads to psychological upset and trauma, but also may interfere with a young person's work and career, as well as jeopardizing a girl's chances in marriage.

Item Type: Thesis (MD)
Qualification Level: Doctoral
Keywords: Medicine
Date of Award: 1961
Depositing User: Enlighten Team
Unique ID: glathesis:1961-79382
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 05 Mar 2020 10:29
Last Modified: 05 Mar 2020 10:29

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