• Josep Orellana, science journalist

    Damned acne!

    23 Jul

    Acne is not dangerous, but it affects three quarters of the population worldwide, most especially individuals between 11 and 30 years of age, for whom it is a serious aesthetic problem. Current treatments are of limited effectiveness. But soon we may have more effective solutions.


    Acne is an inflammatory disorder which originates in the overproduction of sebum (oil) by the sebaceous glands of the skin. The sebum blocks the hair follicles, which eventually become infected.  The cause of this infection is the bacterium Propionibacterium acnes.

    Acne manifests as pimples, blackheads, whiteheads, papules, cysts and redness. The most affected areas of the body are the face, neck, shoulders, chest and back. Acne causes itchiness and discomfort and may leave scars. It also affects the confidence and self-esteem of the teenagers who are most frequently affected by the problem.

    Although there is a strong hereditary and hormonal component in acne, the associated risk factors are not yet well known. For example, stress can worsen acne and increase inflammation. And although acne affects both men and women, it has been shown that men often suffer from acne for longer due to testosterone.


    Two false myths

    A widespread belief is that blackheads are the result of dirty skin. False: it has not been demonstrated that acne is affected by more or less clean skin. Another false myth regarding acne is that there is a direct link to diet and the intake of fats: no scientific evidence supports this claim.


    How to care for skin with acne

    The general rules of hygiene for the body and the face apply to skin with acne. Note, however, some advice issued by the American Academy of Dermatology.

    Wash skin thoroughly with hot water and mild soap whose pH is close to 5. Do not wash your face more than twice a day because too much washing may further damage lesions or dry out the skin. Do not touch your face or squeeze blackheads and pimples as this causes redness and worsens inflammation. Wash your hands before applying creams, lotions or makeup. Remove makeup before going to sleep. Try using makeup that does not obstruct the skin’s pores. And finally, sunbathe in moderation.


    The most widely used treatments

    Most people have mild or moderate acne. This can be treated with topical medications, which normally contain the following ingredients:


    -    benzoyl peroxide, which kills bacteria and reduces sebum production;

    -    tretinoin, which unclogs pores and prevents pimples;

    -    azelaic acid, which enhances the cells lining the follicles and reduces bacteria proliferation;

    -    salicylic acid, which breaks down blackheads and whiteheads and is effective in treating inflammation and swelling;

    -    topical antibiotics such as erythromycin or clindamycin, which eliminate the P. acnes bacterium.


    Treatment for severe cases should be prescribed by a physician. Oral medications that contain some of the ingredients listed above are sometimes prescribed but they often produce side effects and skin irritation.


    Are there any alternative therapies?

    According to the European Dermatology Forum acne treatment in the future will continue to be based on a combination of therapies. Being piloted experimentally is blue laser. According to a study by the University of Alberta, this treatment can reduce sebum production and eradicate the P. acnes bacterium. Other studies question its effectiveness, however. Another therapy involves injecting steroids locally, although complications are possible.

    Cosmetics based on prebiotics and probiotics have also been successfully tested as acne treatments. Does an alternative treatment exist in the market for natural products? Recent research at the University of Leeds demonstrated the effectiveness of thyme against the P. acnes bacterium. Finally, a vaccine developed at the University of California could be ready in a couple of years.



    The Lancet

    Journal of the European Academy of Dermatology and Venereology

    Medical News