How acne occurs has never been truly understood until now. Latest research has found that the harmless bacteria Propionibacterium acnes turn sebum into fatty acids. Sebum is secreted by the sebaceous gland which cover the entirety of the body, with exception to the soles of the feet and the palms of the hands. Sebum is made of triglycerides, wax esters and free fatty acids making it a very oily substance which means that it is ideal for keeping the skin waterproof but also protecting the skin from bacterial and fungal infections. Sebum makes its way to the skin through the hair follicles but when these hair follicles become blocked with dead skin cells and sebum the bacteria Propionibacterium acnes begin to thrive. When follicles below the skin become blocked, white heads appear and when the follicles on the skins surface become blocked black heads appear. Propionibacterium acnes lives on the skin but is only harmful when it gets trapped in the aerobic conditions of hair follicles and it causes inflammation and spots. When the bacterium is trapped it turns sebum into fatty acids that cause cells to become inflamed. It has been found that the fatty acids deactivate histone deacetylases - the enzymes which stop inflammation. Once deactivated, the skin cells produce more chemicals which further worsens the acne that forms. The image below shows Propionibacterium acnes.
Image from:SuperNaturalAcneTreatment
The research also shows that washing the face isn't as effective as previously thought as biofilms form, which are structures caused when the bacteria stick together and this helps to keep them attached to the skin. Researcher Gallo and his team who were in charge of the project have confidence that they can inhibit the fatty acids. However, further cures may be difficult to find because many of the bacteria the are beneficial.
The research also suggests that some people may be more likely to develop acne because their hair follicles are particularly lacking in oxygen and others may have genes that mean they're more likely to get inflamed skin from the fatty acids caused by the breakdown of sebum. Another possible reason is that they have a type of the bacterium that will produce more of the fatty acids. Teenagers are more likely to develop acne because of the hormones released during puberty which cause the production of sebum to increase meaning more of bacteria are able to survive causing more acne.
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