Is retention hyperkeratosis the only true cause of acne?

Retention hyperkeratosis is indeed a significant factor in the development of acne, but it is not the only cause. The statement that it is the only true cause of acne is misleading because several other factors contribute to the formation of acne lesions.

Acne is a multifactorial condition involving various contributors such as excess sebum production, bacterial proliferation (especially Propionibacterium acnes), and inflammatory responses. Hormonal fluctuations, particularly those related to puberty, menstrual cycles, and certain endocrine disorders, can exacerbate acne by increasing sebum production and altering the overall skin environment.

Furthermore, environmental factors, lifestyle choices, and the use of certain products can also influence the severity and occurrence of acne. The interplay between these elements creates a complex condition that cannot be attributed solely to retention hyperkeratosis. Understanding this complexity is essential for effective treatment strategies, which address the various underlying causes rather than focusing on a single factor.