O acne corresponds to a condition of the skin of high frequency, in which the balance of the microbiota of the skin is altered, manifesting in rashes of variable intensity.
According to statistics, 8 out of 10 pre-teens suffer from it. O common acne It usually appears between 8 and 12 years as an early manifestation of puberty. According to the sexes, it is more common in girls of 14 to 17 years and in children of 16 to 19 years. It is normal to disappear at age 25, although 12% of women and 3% of men have acne until age 44.
This condition may
occur at any age, as demonstrated by women who develop it
in their 30s, 40s, 50s and more. Even newborns are not exempt
Acne also affects all ethnic groups and is often related to family history because if a parent had it, it is more likely that the child will also present it.
The negative impact of acne on the self-esteem of children and adults is well known. It can lead to the development of anxiety, loss of confidence, social isolation, absenteeism at school and at work. Classifications can be affected, in addition to the derision of colleagues, which can further complicate an isolation situation.
In cases of severe acne,
can lead to teen depression and suicidal thoughts.
in addition to the typical skin rashes, comedones and discomfort
the skin, include dark spots, which can take months or years
In cases of more severe cases involving cysts and nodules, they may
important permanent scars remain.
All these effects can be avoided or
attenuated by appropriate and timely treatment.
Most widespread drug: isotretinoin
25% of patients with acne vulgaris are prescribed oral antibiotics that should be ingested for a period of more than 6 months, which can cause a significant side effect, as is the case dysbiosis or resistance to antibiotics.
These anti-acne drugs are directed against the Cutibacterium acnes, also known as Propionibacterium acnes, a bacterium associated with acne that can cause opportunistic infections.
O isotretinoin or 13-cis-retinoic acid is a synthetic retinoid (a derivative of vitamin A) – which is marketed under the Brand Accutane– It is one of the drugs most used in the treatment of moderate to severe acne, although it is not known exactly how it exerts its mechanism and the consequent improvement of acne.
But isotretinoin has associated a number of possible side effects, including depression and liver damage. It also causes serious birth defects, depending on the dose, when the women ingest during the gestation period.
Isotretinoin and its changes in the microbiome
A group of researchers at the University of Washington School of Medicine in St. Louis conducted a study that was published in the Journal of Investigative Dermatology, Where they reveal how isotretinoin alters the microbiome of the skin, findings that serve to focus acne treatment differently.
The study's lead author, Dr. William H. McCoy, explains that "There are areas of the skin that support the growth of certain
communities of bacteria, and we know that some of them seem to be
associated with acne"
The researchers set out to find out if treatment with isotretinoin would reduce the amount of bacteria, especially Cutibacterium acnes, the main microorganism associated with acne.
The study included 17 people with acne who were treated with isotretinoin. The control group consisted of eight individuals: four with acne and four without, without treatment.
The team collected facial skin samples from each participant four times – over a 10-month period – in which they were studied. the microbiome (set of genes of microorganisms that are part of the body) through sophisticated laboratory techniques.
As a result of this study, it was found that treatment with isotretinoin effectively reduced the number of C. acnes, as McCoy explains: "The medicine seems to make the skin less hospitable to the bacteria that cause acne"
The staff also found out that
the bacterial diversity on the skin surface was increased, for
show that the presence of other types of bacteria increased in number after
treatment with isotretinoin, a finding that had not been previously related
with the improvement of acne.
These results indicate that isotretinoin alters the physical-chemical conditions of the skin, giving rise to growth in favor of more diverse bacterial populations, instead of directly modifying the amount of bacteria present. It was also observed that this effect continued even after treatment had been discontinued and sebum production returned to normal as indicated Makedonka Miterva, associate professor of medicine and lead author of the study:After treatment, microbial communities shift to a mix of populations that appears to be healthier, and this change persists for months after treatment."
How to improve bacterial "quality"
Understanding how isotretinoin works to improve acne is only the first step, as the team is now focusing on a larger study to improve anti-acne therapy, in McCoy's words:Our study suggests that there may be a way to provide some kind of & # 39; fertilizer & # 39; or & quot; herbicide & quot; microbial growth in the skin to help promote the growth of healthy microbes."
Finding a type of substance that improves the quality of the microbiota (population of microorganisms) would be an excellent way to reduce the possible side effects associated with isotretinoin, in addition to offering advantages to those taking this medicine and offering a risk-free option for pregnant women with severe acne, as McCoy explains: "Women often get untreated acne during pregnancy because there simply are no good therapies that are totally safe to use during that period."