Cushing's Syndrome and Oily Skin
Yes, Cushing's syndrome can cause oily skin due to the effects of excess cortisol on sebaceous gland activity and skin physiology. The hypercortisolism characteristic of Cushing's syndrome affects multiple skin functions, leading to various dermatological manifestations.
Mechanism of Oily Skin in Cushing's Syndrome
- Hormonal Imbalance: Excess cortisol stimulates sebaceous gland activity, leading to increased sebum production 1
- Altered Skin Barrier: Hypercortisolism affects skin barrier function and epidermal turnover
- Androgen Effects: Cortisol excess can lead to increased androgen activity, which further stimulates sebum production
Common Skin Manifestations in Cushing's Syndrome
Primary Dermatological Features
- Facial plethora (redness and fullness) due to increased skin perfusion 1, 2
- Violaceous (purple) striae, especially on the abdomen (present in 77.7% of pediatric cases) 2, 3
- Easy bruisability due to skin thinning and capillary fragility 2
- Hirsutism (excessive hair growth, especially in females) 2, 3
- Acne (present in 58.3% of pediatric cases) 3
Secondary Skin Changes
- Increased susceptibility to fungal infections (11.1% of pediatric cases) 3
- Hyperpigmentation (16.6% of pediatric cases) 3
- Acanthosis nigricans (27.7% of pediatric cases) 3
Clinical Significance
- Oily skin and acne in Cushing's syndrome often affect the face, contributing to the characteristic "moon face" appearance 1
- These skin changes typically resolve after successful treatment of the underlying hypercortisolism 2, 3
- Most skin manifestations improve dramatically within 3 months after correction of hypercortisolism 3
- Complete resolution of most skin changes occurs within the first year after treatment, though light-colored striae may persist longer 3
Diagnostic Considerations
- The presence of multiple skin manifestations (oily skin, acne, striae, easy bruising) should raise suspicion for Cushing's syndrome 1, 4
- Interestingly, the severity of skin manifestations does not correlate with biochemical indices of hypercortisolism 2, 3
- In children, the combination of weight gain with decreasing height velocity is particularly suggestive of Cushing's syndrome 5
Treatment Impact on Skin Manifestations
- Facial plethora and oily skin resolve quickly after successful treatment 2
- Acne typically improves within months after normalization of cortisol levels 3
- First-line treatment for endogenous Cushing's syndrome is surgical removal of the source of excess cortisol production 4, 6