Acne is a common skin disease with a high prevalence among young people, including infants. The causes are often attributed to bacterial infections, inflammatory reactions, changes in hormone levels, and lipid composition on the skin surface. 1 Studies have found that sebum lipid fractions with proinflammatory properties and inflammatory tissue cascades are associated in the process of the development of acne lesions. The proportion of oxidant/antioxidant and alterations of lipid composition on the skin surface lipid (SSL) are the main factors inducing acne inflammation. 2 Therefore, the research of SSL in acne patients can help to clarify the role of sebum in the occurrence of acne and provide an important theoretical basis for the study of the pathogenesis and treatment of acne.SSL is produced by sebocytes, keratinocytes, and the skin microbiome, has many important cellular functions (signal transduction, transmembrane transport, enzyme activation, etc). Among them, the proportion of lipids secreted by sebum cells was 75%-90% of the total, and the major components include triglyceride (TG) (41%), wax ester (26%), fatty acid (FA) (17%), squalene (12%), and others (4%). 3,4 Importantly, studies a few years ago found that increased sebum secretion was a key factor in acne. However, with the development of lipidomics technology, recent studies have shown that sebum composition changes may be more important than sebum total secretion in the development of acne lesions. 5,6 For example, changes in saturated/unsaturated fatty acid ratios in sebum are currently thought to be initiators of follicular inflammation and innate immune responses and play a crucial role in the early development of acne inflammation. 7