Acne is a multifactorial disease, the onset of which is mainly related to endocrine factors, abnormal keratinization of hair follicle sebaceous gland ducts, infection by microorganisms, immunological factors, and other factors such as genetics and spicy diet. Endocrine factors affect the development of acne in this way: after puberty, androgen secretion increases or androgen and estrogen levels secrete abnormally. These bacteria can hydrolyze the triglycerides in sebum to produce free fatty acids, which stimulate the sebaceous glands of the hair follicle to proliferate and keratinize, blocking sebum secretion channels and causing poor excretion.
In addition, some low molecular peptides produced by Propionibacterium acnes can chemotactic neutrophils, and the hydrolytic enzymes produced can cause damage to the hair follicle wall and rupture the hair follicle contents into the dermis, causing deep inflammation around the hair follicle in varying degrees, resulting in a range of clinical manifestations from inflammatory papules to cysts.
It should be said that acne is caused by natural endocrine changes in the body during puberty. Without such changes in hormone levels, people would not be able to thrive so well during puberty.