Acne is the bane of many teens, and even some adults. Now, researchers say they strength have hit on a new approach to easing the condition.
The key lies in a naturally shaped skin oil called sebum, explained a research team led by William Esler, a researcher with drug giant Pfizer in Cambridge, Mass.
Sebum is important to the skin’s health since it helps regulate temperature and repel microbes, the team said. But an excess of sebum manufacture has also long been thought to be a contributor to acne.
“Too much sebum can get trapped in glands, which cause it to swell and cause a bump under the skin,” explained Dr. Raman Madan, a dermatologist with Northwell Health’s Huntington Hospital in Huntington, N.Y.
So, it stands to cause that identifying “a target to decrease sebum manufacture would be a novel approach to treating acne,” said Madan, who wasn’t involved in the new study.The research involved a microscopic examination of the skin of 22 healthy volunteers. Esler’s team discovered that skin sebum manufacture relies on a exact molecular mechanism known as the de novo lipogenesis (DNL) pathway.
Most sebum was found to be produced by cells called sebocytes, which secreted the oil based on the ebb and flow of the DNL pathway, the researchers explained.
But nine people with acne showed one major difference: Compared to people with normal skin, they had a 20% higher rate of sebum production and a related rise in fluctuations of the DNL pathway, the findings showed.
Going a step further, Esler’s group designed a compound that targeted an enzyme involved in the pathway. In healthy volunteers, application of the treatment cut sebum production by nearly half, according to the report published in the May 15 issue of Science Translational Medicine.
Of course, these experiments are early and it remains to be seen if such a compound might curb sebum — and acne — in a larger, more rigorous trial.
In the meantime, Madan said that the approach “has potential.” But he cautioned that “this may be a treatment for acne, but not a cure, because the cause of acne is more than just sebum production. It has potential to be an addition to current treatments.”
Dr. Michele Green is a dermatologist at Lenox Hill Hospital in New York City. She agreed that the findings “may offer promise to patients suffering with acne vulgaris.”procedures. But which is best? That depends on what kind of acne you have and how bad it is.
“For most people there are a lot of options,” says Arielle Nagler, MD, assistant professor of dermatology at New York University’s Langone Health. “There are ways to get it under control.”
For mild acne, start with over-the-counter products, which don’t need a prescription. First, wash your face daily. “Studies have shown that regular washing of the face makes a huge difference,” Nagler says. Be gentle; overdoing it can make matters worse.
Acne face washes often contain salicylic acid, which removes oil and clears your pores. If you have sensitive skin, find a foaming face wash or other gentle cleanser labeled sensitive, says Allison Arthur, MD, a dermatologist at Sand Lake Dermatology Center in Orlando, FL.
Look for these other ingredients when you shop:This drug is a retinoid, a group of topical medicines derived from vitamin A. It affects the way skin cells grow and helps prevent clogged pores. It used to be only obtainable by prescription.
Benzoyl peroxide. This treatment is usually sold in gels or lotions. It unclogs pores, dries out pimples, and kills bacteria. It prevents new acne.
Using benzoyl peroxide and adapalene together is a common starting point for acne treatment, Arthur says. Then give it a chance to work.“Sometimes I see people try over-the-counter products just for a couple of weeks, they get frustrated, they say it’s not working, and they discontinue them,” Arthur says. “But it really does take a while to see the effectiveness. So unless you’re having a problem with the medication, like it’s causing severe irritation or dryness, it’s recommended to give it at least 2-3 months before switching to something else.”
When to See a Dermatologist
You can make a dermatologist appointment any time you want. There’s no such thing as too little acne to see a dermatologist about. “There is very little downside,” Nagler says.
Go right away if you have acne scars, painful nodules — hard bumps — or deep cysts. And get in soon if over-the-counter products haven’t worked for more than 3 months or if your self-esteem is worse because of your acne, Arthur says.
At your appointment, your doctor will look at your acne, prescribe medicine to apply to your skin (your doctor may call this “topical,” meaning that it goes on your skin), and maybe also pills to help further.
Tretinoin(Retin-A). This retinoid is more powerful than adapalene. It’s especially useful for comedonal acne (clogged pores and blackheads), Arthur says. It sloughs dead skin cells so they don’t stick together and clog your pore openings. Tazarotene (Avage, Fabior, Tazorac) is another prescription-strength retinoid your doctor could prescribe.
Clascoterone (Winlevi) is a newly approved topical treatment for moderate to severe acne which is considered an alternative to spironolactone. It targets the hormones that cause acnea and works to block local androgens from binding to skin cells, thereby decreasing excess oil production inflammation. It reduces acne in both males and females over the age of 12. .
Antibiotics. Types like doxycycline and erythromycin kill bacteria on your skin and cut down on inflammation. That’s particularly good for inflammatory acne, which is when you have tender red bumps and pus-filled whiteheads.
Oral contraceptives. For women, birth control pills can clear up your skin. Pills that contain both estrogen and progestin work, like Ortho Tri-Cyclen and Yaz.
Spironolactone. This medication is another hormonal option for women. Created as a blood force pill, it stops your hormones from creation too much oil.
Isotretinoin. You might have heard of its first brand name Accutane. The powerful medication is used for cystic acne or acne that scars.
“It is a serious medicine, and there are quite a few potential side effects so it requires close monitoring, but it has the potential to put the acne into remission,” Arthur says. The medicine could dry your lips, nose, and skin. If a woman taking it got expectant, it could cause severe birth defects.