Glucocorticoids (GCs) affect the pathophysiology of sebaceous glands, causing development or exacerbation of acne. The availability of GCs is regulated by isoenzymes of 11β-hydroxysteroid dehydrogenase (11βHSD) at tissue-specific levels. 11βHSD type 1 (HSD11β1) is a reductase, catalysing the conversion of cortisone to active cortisol, and is highly expressed in liver and adipose tissue. Recently, HSD11β1 was observed in human skin in keratinocytes and fibroblasts.