1.There is increase multiplication with retention of skin cells at tip of oil secreting glands(sebaceous glands) known as ductal hypercornification ,which presents histologically as micro-comedones, and clinically as blackheads and whiteheads.So,comedones represent the retention of hyperproliferating ductal keratinocytes/skin cells in the duct. Several factors have been implicated in the induction of hyper proliferation, and include sebaceous lipid composition, androgen's, local cytokine production and bacteria. There is also increase in secretion of sebum from the sebaceous glands.
2.Acne is not infectious. The major organisms isolated from the surface of the skin and the duct of patients with acne are Propionibacterium acnes .Pimples/acne are associated with a significant increase in P. acnes, but there is little or no relationship between the number of bacteria on the skin surface or in the ducts and the severity of acne.
3.Inflammation/redness in acne lesions are due to pro-inflammatory mediators present within the skin producing inflammatory acne.
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