The view is advanced that sebum as originally produced must contain materials, other than lipids, which may serve as a selective substrate for growth of bacteria and yeasts. Growth of large numbers of P. acnes and P. granulosum in some follicles is considered to place those follicles at risk of undergoing pathological changes. Deleterious products of bacterial growth could be not only lipase and free fatty acids, but also other enzymes as well as bacterial antigens and unspecified toxins or irritants. The possibility is suggested that follicles heavily infested with P. acnes and P. granulosum may be identified by their reddish fluorescence under ultraviolet light, thus permitting identification and study of those which are at risk. Antibiotics may be helpful in reducing the formation of harmful bacterial products during continued growth of the organisms. The eventually self-limiting nature of the disease may be due to the immune response to bacterial products, or to an accommodation of the follicular epithelium to the long-continued presence of irritant materials within the follicle.
有一种观点认为，最初产生的皮脂必定含有除脂质以外的物质，这些物质可能作为细菌和酵母菌生长的选择性底物。一些毛囊中大量痤疮丙酸杆菌和颗粒丙酸杆菌的生长被认为会使这些毛囊面临发生病理变化的风险。细菌生长的有害产物可能不仅是脂肪酶和游离脂肪酸，还包括其他酶以及细菌抗原和未明确的毒素或刺激物。有人提出一种可能性，即被痤疮丙酸杆菌和颗粒丙酸杆菌严重感染的毛囊在紫外线下可能会呈现微红荧光，从而便于识别和研究那些有风险的毛囊。抗生素可能有助于在微生物持续生长过程中减少有害细菌产物的形成。该疾病最终的自限性可能是由于对细菌产物的免疫反应，或者是毛囊上皮对毛囊内长期存在的刺激性物质的适应性变化。
