Free fatty acids in the early inflammatory papule of acne vulgaris

The role of free fatty acids (FFA) in the pathogenesis of acne is disputed. Several studies have failed to show an increase in FFA concentration in skin surface lipids (SSL) from acne patients. It has been suggested that a marked increase in FFA concentration in a single sebaceous follicle may lead to the inflammatory lesion in acne, and because SSL samples are usually taken from a large area, this localized increase would be swamped by the lipid from the surrounding normal follicles. We therefore used a micro-cylinder method to obtain SSL from early acne papules and we compared this with SSL from nearby ‘normal’ skin in 19 patients. The samples were analysed by quantitative thin layer chromatography. We found no significant difference in the mean FFA concentration in SSL obtained from acne papules and normal skin. Our findings do not support the idea that the inflammation of acne is due to an increase in FFA concentration in skin lipids.