Acne is one of the most common skin diseases with an estimated 80 percent of all people between the ages of 11 and 30 having acne outbreaks at some point. The actual reason behind these breakouts are still not clear though genetics, hormonal changes and bacteria play a major role. The current paradigm of treatment for severe acne involves antibiotics, hormone regulators, or isoretinoin which have side-effects and do not always ensure relief; in some cases it doesn’t work too.
The ever-intriguing relationship between excessive oil production, skin bacteria and acne has now encountered a new twist with researchers telling us how exactly these “breakouts” unfold.
Originally believed to have been a collaborative action of the harmless skin bacteria and excessive oil production, researchers were not able to put a finger on the exact reason that triggered acne-related inflammation.
However, Richard Gallo of the University of California, San Diego, and his colleagues have now discovered that an oxygen-depleted or airless environment such as hair follicles could act as a trigger which makes the otherwise harmless Propionibacterium acne turn nasty and cause havoc to the skin.
This could explain why some people are more prone to acne than others, because not everyone’s hair follicles are created equal – some people might simply have hair follicles that are more dense than others.
In airless environments, Propionibacterium acnes converts sebum into fatty acids that activate inflammation in nearby skin cells. These fatty acids deactivate enzymes called histone deacetylases, that normally help in curbing the inflammation. As a result, cascades of chemicals are produced by skin cells causing inflammation resulting in acne.
“For the first time, it shows how fatty acids derived from P. acnes act on skin cells to induce inflammation,” says Holger Brüggemann of Aarhus University in Denmark, who in 2004 unravelled the entire genome of the skin bacterium.
This discovery also dispels the effects of face scrubbing for combating acne. The team also showed that the bacteria involved here, form an adherent film (biofilms) on the skin that are difficult to dislodge just by scrubbing. Potential therapies are further complicated by the fact that certain strains of P. acnes are actually beneficial to skin health.
However, the team believes that this discovery may open up new avenues for acne treatment.
“We can either inhibit these fatty acids, or block their impact on the skin,” says Gallo. “We’re working on how to do this.”
Gallo explains that this discovery could lead to more insights on why some people are more susceptible to acne outbreaks.
“If we get lucky, it could lead to new medications in two to five years,” he says.
The research was published in Science Inflammation.