As if our teenage years weren’t painful enough already, acne was a not-so-welcome addition to the party for about 80% of us over this period. Magazines and school friends provided a continual source of tips and tricks to get rid of those pesky pimples: whether it’s drinking more water or using a blemish-busting face cream, there seems to be an ever-growing list of miracle cures for acne, but one remedy certainly does not fit all. While acne is by no means a life-threatening condition, it can wreak havoc on an individual’s self-esteem, and has been associated with the development of anxiety, and even depression.
While the build-up of bacteria often bears the brunt of the blame for acne, a new study from UCLA reveals that not all the bacteria on our faces are the bad guys; in fact, some may actually help to improve our skin, while others could make it worse. Having the wrong type of bacteria on our skin is something I’m sure we never even thought about. Before we discuss this further, let’s go back to basics…
How do we get spots?
Acne vulgaris, to give acne its full name, is officially the most common skin condition encountered by doctors, and there are four changes to think about when we’re trying to understand how acne develops:
Normal and clogged hair follicles, courtesy of youngwomenshealth.org
1. Sebum production. Sebum is the natural oil produced by our own skin and hair. Before puberty begins, the glands that produce sebum (the sebaceous glands) get much bigger, so we end up producing a lot more of it (and not just on our face: our chest and back produce a lot more too). Seemingly, the more sebum our skin produces, the worse our acne gets.
2. Follicular hyperkeratinisation. While this sounds horrendously complicated, it’s just a process that clogs up our pores, or the follicle opening, when we couple it with the production of high levels of sebum.
3. Colonisation of the sebaceous gland by Propionibacterium acnes (P. acnes). Our sebaceous glands are one of the favourite hiding places of a bacterial species called P. acnes: living in the sebum-rich follicles mean that the bacteria have a constant supply of nutrition, as it can break these lipids into a food source with ease.
4. Bacteria behaving badly. Unfortunately, these bacteria aren’t always well-behaved: they release substances called proinflammatory mediators and free fatty acids into the surrounding area of the skin that irritate it and cause it to become inflamed.
How could bacteria help me?
Now, back to the bacteria. Before this paper was published, we didn’t really know anything about specific strains of P.acnes found on the face. A different strain of bacteria is the same species, but has slightly different characteristics due to the development of mutations in its genes. So while some of these bacterial strains contribute to acne, not all are to blame for it; some seem to be associated with having clear skin. A sheep in wolf’s clothing, if you will.
The study of 101 people (52 with clear skin, 49 with acne) wanted to investigate if there were any differences between the bacterial hitch-hikers on a clear-skinned person compared to one with acne. The bacteria were collected using pore strips, and a quick analysis of the DNA revealed 66 new strains of P. acnes which were previously unknown. Three strains were of particular interest: RT4 and RT5 seemed to be associated with acne, while RT6 was found to be “enriched” in people with clear skin. It was found that RT6 lacked some of the genetic elements that make some other strains more problematic.
What the group haven’t worked out yet is why there are differences in the bacteria we carry, and we can’t exactly prove that these bacterial strains are making acne worse. This doesn’t detract from the fact that these are some very strong associations, and hopefully future research can tell us a bit more.
So what do you think? I do wonder what we can actually do these results; while finding a way to administer these bacteria may seem like a bit of an oddity, if snake venom is good enough for anti-ageing, then I’m sure some face-friendly bacteria may be finding their way into the shops sooner than you might think…