Bloch,1 in discussing the cause of acne, stated:
It is well known that the development of a typical case of acne has two chronologically separate phases. The first is characterized by the formation of comedones. This (according to Unna) is caused by a thickening of the corneous layer at the outlet of and within the follicular duct, behind which the secretion of the sebaceous gland is blocked up. Only this phase of acne can be brought into direct relation with the endocrine processes in the sexual glands. The second phase of acne is characterized by an inflammatory and suppurative process on a basis of infection. . . . There is no consensus as to the actual cause of the infective inflammation.
If Bloch's thesis is correct, it logically follows that destruction of the comedos would prevent the pustular phase of acne vulgaris, and benefit greatly if not cure those with comedos and
NOMLAND R. TREATMENT OF ACNE VULGARIS WITH COMEDOS BY MONOTERMINAL ELECTRODESICCATION. Arch Derm Syphilol. 1943;48(3):302–304. doi:10.1001/archderm.1943.01510030055008
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