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“Normally sebum is made in the sebaceous gland, and then it goes to the top of the skin by way of a duct; there’s a structure that’s like a pipe that lets the sebum go to the surface,” explains dermatologist Melanie Grossman, MD. When you have an overproduction of sebum, she says, it’s basically too much stuff trying to exit one tiny hole. “That p. acnes bacteria in the sebaceous gland likes the fat that the sebum is creating. When there’s an overproduction or a blockage and there’s a collection of the sebum, the bacteria multiplies and there’s this inflammatory reaction.”

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