The Skin Microbiome May Play A Larger Role In Acne Than We Thought
The skin microbiome continues to be at the forefront of conversation regarding skin care. Research has been developing over the last few years about its incredibly important role in our skin barrier health—and recently, more and more research has emerged about its intimate connection with acne, specifically.
Well, researchers have introduced a new way of thinking about adolescent acne and the microbiome: Acne, especially during the teen and young adult years, should be thought of less as a pathological condition and more as a natural, transitory state in the skin as it gets used to new microbes. In an article published in the journal Trends in Immunology, the researchers present this new framework of thinking as an argument to alter how we treat acne.
"The main take-home message is that, instead of considering acne as an accidentally occurring disease accompanied by pathological processes, we propose that acne is unavoidable inflammation precipitated by physiological changes of sebaceous skin during adolescence," says first author Andrea Szegedi, M.D. "This challenges convention thinking." As acne is an inflammatory response, the researchers argue that the breakouts develop as a reaction to new microflora on the skin—as our skin microbiome naturally changes during this developmental period. Then, as more sebum is produced during these years, it creates an environment for acne-causing bacteria to thrive.
To highlight their point, they compare it to other inflammatory skin diseases such as psoriasis and rosacea, which tend to be more chronic in nature with recurring flare-ups. And while we know adult acne is a real concern for many, acne isn't experienced as a lifelong condition in the same way: Spontaneous remission of acne vulgaris occurs in up to 50% of affected patients, they note. Essentially, their argument is that since acne is unique in its very specific time frame, we must look at the changing microorganisms as more of an important player than previously considered.
Given this new framework, the authors argue that treatments for acne during these years should be less about "fighting" a skin disorder and more about promoting balance (or homeostasis, in their words) between facial skin and its microbial and chemical environment.
Of course, given the relative newness of the microbiome-acne connection as a whole, the development of treatment plans is still lacking. However, from past research, we do know that allowing the skin's microflora to flourish largely has to do with keeping the pH balanced and not stripping the skin barrier. So going forward, dermatologists and skin care brands may be encouraged to address these needs in a larger way. Certainly, this area of research is far from complete—but this article does call for an interesting, and new, journey for young people dealing with acne.
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