is not suitable for the growth of anaerobic bacteria, especially Propionibacterium acnes.5 Exposure of pilosebaceous keratinocyte cells to surface protein of Propionibacterium acnes induces formation of free radicals superoxide O2 leading to lipid peroxidation of sebum. Neutrophils kill propionibacterium by producing hydrogen peroxide (H2O2) resulted in inflammation and further tissue damage.6 Polyunsaturated fatty acid, the component of membrane cells damaged by oxidative stress, will form malondialdehyde (MDA) which has been recognized as an important lipid peroxidation indicator