The pathogenesis of acne is not well understood. Endocrine factors, the role of sebum, and microorganisms in the hair follicle are the main factors in the development of acne, and secondly, genetic factors are also an important factor in the development and severity of acne. Acne is closely related to the imbalance in the ratio of certain sex hormones, which are physiological and pathological. Acne, which rarely develops before puberty, does not develop in people who have lost or diminished sexual function, such as eunuchs who were castrated at the ancient court; people with reduced sexual function, such as those treated with testosterone, can also have acne in these non-pubertal age patients while playing a therapeutic role; when corticotropin or corticosteroids are used to treat internal diseases, they often cause acne rashes in the course of treatment; women Acne attacks often occur before menstruation, and acne symptoms are reduced during pregnancy, etc. Both men and women have androgens and estrogens. The organs that secrete sex hormones are the testes and adrenal glands in men, and the ovaries, placenta and adrenal glands in women. The latter may play an important role in early acne. Testosterone is converted into the more active 5-alpha dihydrotestosterone by the action of 5-alpha reductase in the skin, which stimulates sebaceous gland cell turnover and lipid synthesis, causing increased sebum secretion, producing thick and abundant sebum, which cannot be excreted completely and gradually accumulates in the mouth of the hair follicle. The epithelial cells shed on the wall of the follicle increase and mix with the thick sebum to become cheese-like material, which gradually accumulates in the mouth of the follicle to form acne, and later the tip exposed outside the mouth of the follicle gradually dries out, and after the oxidation of the air, the deposition of melanin, the pollution of dust and discoloration to form blackhead acne, the presence of acne rods, white staphylococcus and The presence of Acinetobacter, Staphylococcus and Bacillus ovalis in the hair follicle, especially Acinetobacter, contains esterases that make sebum decomposition, and the sebum in the hair follicle is decomposed by lipase to produce more free fatty acids, these free fatty acids can make the hair follicle and the hair follicle around the non-specific inflammatory reaction, when the very slight ulceration of the acne wall and free fatty acids into the nearby dermis, coupled with the blackhead acne squeeze the nearby cells, so that their antibacterial power is reduced and As a result, the patient develops papules, pustules, nodules, nodules and abscesses.