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The Four Pathogenic Factors Involved in AcneAn increase in the levels of androgens before and during adolescence leads to the production of greater amounts of sebum.The bacterium Propionibacterium acnes, which is resident on the skin of even healthy individuals, thrives on sebum. Increased sebum production in acne patients results in a proliferation of this micro-organism.Something goes awry in the infundibulum of the follicle in acne patients that causes cells from the follicle wall to clump together. This abnormal keratinization results in the clogged pores, or microcomedones, that can later proceed to other acne lesions.The presence of P acnes triggers the release of chemotactic factors that cause inflammation, as manifested by papules, pustules, and nodules.

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