Functional Considerations: The Role of Sebum
The role of sebum is not clearly defined. Various investigators have ascribed bacteriostatic, emollient, barrier, and phero-mone functions to sebum. Sebum does appear to play a critical role in the development of acne. The amount of sebum secreted increases significantly at puberty in both males and females. Triglycerides contained in sebum are broken down to fatty acids by bacteria on the skin surface, and the free fatty acids liberated may be an irritant in the formation of acne lesions. On histologic examination, acne is characterized by retention of the sebum in the isthmus of the hair follicle, with variable lymphocytic infiltration. In severe cases, dermal abscesses may form in association with inflamed hair follicles.
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