The development of acne during puberty is intimately associated with and dependent upon the sebaceous gland hypertrophy that occurs at this time. It is our feeling that sebum provides the "fuel" for the development in a susceptible individual of the inflammatory lesions characteristic of the disease.1 Our data indicates that the severest cases of acne occur in patients with large sebaceous glands and high sebum production.2 Although there are undoubtedly other governing factors in the pathogenesis of the disease, the fact remains that suppression of the large postpubertal glands can favorably alter the course of the disease. For example, fractional superficial x-ray therapy exerts its beneficial effect on acne by suppression of sebaceous gland size. However, the response is only temporary, and after completion of a safely tolerated course of x-ray, the glands promptly regenerate, and as such the disorder may reappear.3
It is well known that
STRAUSS JS, POCHI PE. Sebum Production During 16-Epiestriol Administration. Arch Dermatol. 1962;86(6):757–760. doi:10.1001/archderm.1962.01590120055009
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