Study Could Explain Why Some People Get Acne And Others Don’t

Megan Charles - Author

Aug. 23 2017, Updated 1:27 a.m. ET

Are you a sufferer of the occasional pimple or worse, chronic cystic acne? Do you look upon the seemingly flawless pulchritudinous of someone else’s skin in mystified envy, curious as to the genetic lottery they were bestowed or what beauty regime they use? Are you annoyed when those same pimple-less people say they never hassle with their skin?

In contrast, you have tried every pill, lotion, wash, scrub, and mask sold over-the-counter or prescribed – spending a fortune with little relief. You’ve experimented, out of sheer desperation, with bizarre concoctions other sufferers have sworn by. Yet there you are, still plagued with painful, unappealing acne.

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Acne vulgaris (acne) is a common condition of the skin, particularly effecting the areas with the densest population of sebaceous (oil) follicles. This includes the face, upper chest, and back. Sebaceous secretions are intended to condition and maintain a hydration balance.

The bane of most adolescents, acne is characterized by areas of skin with seborrhea (scaly red skin), comedones (blackheads/whiteheads), pustules (pimples), nodules (large inflamed papules) – which can result in post-inflammatory hyperpigmentation (slow healing discoloration), giving the illusion of acne long since gone, and scarring (dimpling/pocking/permanent discoloration).

Acne affects 90 percent of Americans at some point in their lives and is most common among teenagers. Regardless of what some people say about “growing out of it,” the frustrating affliction can continue well into adulthood.

In adolescence, acne is usually caused by an increase in testosterone, which accrues during puberty, regardless of sex – yes, women have testosterone too.

In fact, higher levels of testosterone (or what is commonly referred to as androgens) is typically the cause of cystic acne – massive, inflamed red nodules along the chin line – in women. And ok, yes, for most people, once their hormones have balanced out, the acne does diminish or lessen over time. But there are people who suffer with it into their 40s and beyond.

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It is difficult to accept and a wee bit unfair, but some people are just predisposed to have acne over others. Along with hormones, skin-surface bacteria plays a role. Acne develops as a result of blockages in the follicles.

Dead cells are meant to desquamate (slough off). When they don’t properly shed they can accumulate within the pores and around hair follicles (hyperkeratinization), forming a commingled plug of keratin (natural protein), sebum (natural oil), and the dead cells. The cohesion of the protein, oil, and cells can block or cap the follicle or clog up the sebaceous duct.

In these conditions, the naturally occurring bacterium Propionibacterium acnes that thrives in the depths of our pores become inflamed. This leads to a variety of infected, inflammatory lesions in the dermis. When the bacteria provokes the immune system it results in swollen, red bumps.

Researchers wanted to delve further into the influence of naturally occurring bacteria on acne. Dermatological and molecular researchers – at UCLA, the Los Angeles Biomedical Research Institute, and Washington University in St. Louis – probed into why some people are afflicted with acne while others seem immune.

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In the study, principle investigator Huiying Li and her colleagues used over-the-counter pore-cleansing strips to collect Propionibacterium acnes from the noses of 101 volunteers, roughly half of whom were pimply (49) and the others clear-skinned (52).

Microbial DNA was extracted and genetic markers were identified in nearly 1,000 bacterial strains – uncovering 66 never before isolated. Scientists sequenced the genomes in order to zero in on the unique attributes of each one.

Two distinctive stains of the bacteria were discovered in one of five participants with acne, but rarely in those with clear skin. A third strain was uncovered, which in turn was found more commonly among those without acne. Scientists assume this third strain could potentially contain a defense mechanism that enables the bacteria the increased ability of defending itself from infection, thus not resulting acne.

Both “bad” bacterial strains, which contribute to acne, and “good” bacterial strains, which protect the skin were found. “Not all acne bacteria trigger pimples,” according to Huiying Li, an assistant professor of molecular and medical pharmacology at the David Geffen School of Medicine at UCLA.

The findings, published in the Journal of Investigative Dermatology, may lead to new, personalized therapies that will either prevent or treat the embarrassing, painful, and disfiguring skin condition with more success. The team posed the potential for topical probiotic ointments, targeted at killing off the distinctive strains of bad bacteria, or oral drugs that stimulate and preserve the good strains. But that will be determined in future research.

[Image via Shutterstock]


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