Acne Treatments More Personalized and Effective; No More ‘Snap, Crackle, Pop’

Dr. Lance Barazani

Squeezing and popping acne-related skin nodules could lead to scarring, which would later require more extensive – and expensive – treatments.

Snap, crackle, pop. That may be the right approach for breakfast cereals, but it is not effective in ridding the skin of the pimples and blackheads associated with acne, according to dermatologist Lance Barazani, M.D., of Advanced Dermatology PC. Squeezing and popping acne-related skin nodules could lead to scarring, which would later require more extensive – and expensive – treatments, said Dr. Barazani, who is certified by the American Board of Dermatology.

But, for those plagued by acne, especially in its more severe forms, hope may be near.

At the Microbiology Society’s annual conference last month (April 2017) in Edinburgh, United Kingdom, researchers from the University of California-Los Angeles reported that acne and other skin disorders are likely the result of an imbalance of healthy and disease-causing bacteria in the skin. This finding, Dr. Barazani said, could lead to much more personalized, effective treatments for patients.

“Understanding more clearly the mechanisms that cause acne will enable us as physicians to apply treatments targeting specific strains of bacteria active in a patient’s skin,” Dr. Barazani explained. These treatments could include greater use of probiotics to repopulate the skin with healthy bacteria or phage therapies, which introduce viruses that target and kill disease-causing bacteria, he said.

In their study, also published in the journal, Scientific Reports, in December 2016, researchers used a DNA shotgun sequencing technique to examine the skin follicles of 72 young and older adults, 34 of whom had healthy skin and 38 had acne. Comparing the skin microorganisms present in each sample, the researchers found differences in strains of Propionibacterium acnes, or P. acnes, which is believed to play an important role in the development of acne. The P. acnes in those with healthy skin contained a far greater abundance of genetic elements thought to be protective against skin inflammation. Study participants with acne had P. acnes strains with higher levels of genes associated with the production of bacterial toxins that can cause skin disorders.

Acne is an inflammatory skin condition characterized by the appearance of blackheads, whiteheads, papules, cysts and other skin nodules on the face, back, shoulders, chest and upper arms. Eighty to 85 percent of Americans experience an outbreak of acne sometime in their lifetime. Although thought to be a disease primarily affecting teenagers and young adults, the disorder has been increasingly seen in middle-aged adults as well, Dr. Barazani said.

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