The pathogenesis of acne is not entirely understood, but new insights may yield new therapeutic targets in the near future.
"We now know that there are some other factors involved that had not been previously described," says Rachel Reynolds M.D., FAAD, an attending dermatologist at Beth Israel Deaconess Medical Center and Residency Training Director of the Harvard Combined Dermatology Residency Program, discussing the disease at AAD 2015.
One of the recent insights about acne pathogenesis is that inflammation actually precedes comedogenesis. "We used to think that comedones preceded inflammation, but we now know that inflammation is involved in the development of comedones," said Dr. Reynolds.
Via IL1-alpha, inflammation is recognized as preceding hyperkeratinization in comedone formation, and increased levels of IL1-alpha are found in open comedones, explained Dr. Reynolds.