中国结合医学杂志（英文版）Chinese Journal of Integrative Medicine

It is believed that acne is a multifactorial dis-ease, and its clinical expression depends on the in-teraction of several factors: (1) increased produc-tion of sebum and enlarged sebaceous glands as theresult of androgenic stimulation; (2) obstructionof the follicular duct, due to keratinization of thesebaceous follicle, retention of sebum and blockageof hair follicles by keratinized epithelium, leadingto the formation of a microcomedo; (3) propaga-tion of Propionibacterium acnes(P. Aches); and (4)release of lipases by P. Acnes, resulting in hydrol-ysis of sebum triglycerides into free fatty acids,which irritate the wall of follicle, leading to rup-ture of follicle, irritate the surrounding dermis andinduce inflammatory changes.