7 Regulation of androgen receptor and 5α-reductase in the skin of normal and hirsute women

    P Mauvais-Jarvis
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    TLDR The exact cause of increased 5α-reductase activity leading to hirsutism in women is still unknown.
    The document discusses the role of androgen receptor and 5α-reductase in human skin, particularly in relation to hirsutism in women. It explains that 5α-reductase converts testosterone into dihydrotestosterone (DHT), which has a higher affinity for the androgen receptor, amplifying the androgen signal. The study found no significant differences in androgen receptor binding capacity between normal and hirsute women, or between normal men and women. However, 5α-reductase activity, which is crucial for androgen action, does show a sex difference in pubic skin, with males having higher activity than females. This activity is increased by DHT and is androgen receptor mediated. In hirsute patients, particularly those with idiopathic hirsutism, there is an observed increase in 5α-reductase activity without a corresponding increase in circulating androgens, suggesting that excess skin 5α-reductase activity may be a cause of hirsutism. The document concludes that the precise abnormality in the regulation of 5α-reductase and its genetic control in hirsutism still needs to be determined.
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