The basic cause of acne is still unknown. It seems to be a multifactorial disease in which interaction of several factors play an important part in the pathogenesis. The primary event may be (a) obstruction of the sebaceous duct due to alteration in the pattern of keratinization within the follicle, (b) abnormal sebum production with excess quantities or altered composition or (c) increased bacterial colonization (proprionibacterium acnes and staphylococcus epidermi¬dis of pilosebaceous follicles which furnish the lipases responsible for hydrolysis of sebum triglycerides into free fatty acids. All three mechanisms may be involved. Obstruction of duct leads to forma¬tion of a comedone, the initial lesion of acne. A comedone can be located either in a closed follicle as a 'white head' consisting of lipid and keratin, or in an open follicle as 'black head' consisting of keratin and lipid with melanin deposition. The continual accumula¬tion of keratin and lipid may lead to rupture of the follicular wall and release of its contents into the surrounding dermis provoking an inflammatory tissue reaction.
While one obviously doesn't want to interrupt such natural life development events as hormones, there are plenty of other acne factors that can be reduced to decrease the amount of teenage acne. The effectiveness in reducing these factors may be in large part determined by just how severe the acne is. When in doubt, it is always recommended that treatments be applied under the guidance of a doctor, preferably a dermatologist.
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