What actually initiates the sequence of events that lead to acne or what makes the follicle plug up is uncertain. One theory suggests that it is excessive sebum production that leads to all the other events. This theory has been called the glandular thoery because sebum is a glandular secretion.
According to this theory, sebum is the central factor from which all other events arise. The importance of sebum in acne has led to subum being called the 'oil of the acne fire'. Some evidence supporting this theory include the following:
- Sebum production increases after puberty and this is also the time that individuals develop acne.
- As a group, patients with acne produce more sebum than individuals without acne.
- Experiments have shown that sebum causes comedones when injected into the skin.
- Sebum is also irritating to the skin and causes inflammation when it is injected into the skin.
- Sebum is rich in nutrients for P. acnes. Enzymes (lipases) from these bacteria break down sebum into fatty acids which are even more potent causes of inflammation.
- Hormones which control the activity of sebaceous glands also affect acne.
- Drugs which reduce sebum secretion also benefit acne.
NO MORE PIMPLES, A SELF-CARE GUIDE, DR. LIM KAH-BENG
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