Electronmicroscopy showed also that in subjects with acne the corneocyte lamellae are thicker, denser and  less regular than in control subjects.6 In acne patients the appearances are much more bizarre and the follicular cast material is arranged in a complex manner . Electronmicroscopy of the pilosebaceous duct Knutson has demonstrated ultrastructural changes in the pilosebaceous ducts of patients with and without acne.

He examined unaffected  skin of patients with acne and compared his observations with the normal skin of healthy individuals. He noted that the pilosebaceous  duct contents were  more  densely packed. Knutson also showed  that the abnormal corneocytes contained lipid droplets not seen in controls and probably of ductal rather  than  sebaceous origin  (Figure localization of acne to the face may simply be the greater number of glands and the smaller sizes of their ducts. This hypothesis is supported by the comparative rarity of acne in wide-mouthed sebaceous follicles such as are present on the nose.