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1BChapter 2—The Truth About Acne 28 called cytokines. The immune system then produces an inflamed comedo inside the pilosebaceous unit. The above 4 causes are only the immediate causes of acne. The questions that need to be asked are: Why is there a hyperproliferation of keratinocytes in the first place that makes corneocytes become overly adherent and block the pore? Why are there excessive androgens in the bloodstream in the first place that trigger overproduction of sebum? Why is there an excessive immune response in the first place? Most conventional treatments are aimed at reducing the sebum oil production, killing the acne bacteria or lowering the frequency of dead cell buildup—all for the purpose of reducing inflammation. By doing so, these treatments merely touch the surface and completely ignore the real factors. An effective, long-term acne solution must focus on the deeper causes triggering the overproduction of sebum that leads to bacteria growth— resulting in acne formation. Acne is more than skin deep. Beyond inflammation, beyond your skin type (oily, dry, rigid), beyond the overproduction of sebum, beyond inflammation triggers, beyond blocked pores and beyond the acne bacteria, there are hidden factors that play a major role in the formation of an “acne environment.” Tackle these factors, and your freedom from acne is guaranteed. 2003 - 201 2 A c ne N o M or e- M ik e W a l d en - Page 28