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What You Need to Know About Acne

8 min read

Essential Takeaways

  • A study conducted in November 2012 of almost 3,000 women at Boston’s Massachusetts General Hospital discovered that 45% of 21-30-year-old women had acne
  • Acne vulgaris refers to a dermatological condition depicted by too much production of sebum, prolonged inflammation of the pilosebaceous unit and follicular hyperkeratinization
  • A different study found that there was 80-100% improvement in 79% of the people given an antioxidant supplement

Acne vulgaris is a popular disease in developed nations such as the USA. A study conducted in November 2012 of almost 3,000 women at Boston’s Massachusetts General Hospital discovered that 45% of 21-30-year-old women had acne. 26% of 31-40-year-old women and 12% of 41-50-year-old women had acne.

Acne is not life threatening in itself, but it may be associated with significant psychological impairment.  This is because it can be embarrassing which causes depression and anxiety. Fortunately, most cases of adult acne can be effectively treated if not prevented. This works best when both periodic and chronic breakouts are addressed as acne may result in scarring and dark spots over time.

In the past acne was mostly associated with environmental factors, microbes, and genetic susceptibilities. Recent research has however shown that acne patients experience heightened oxidative stress. Studies and research show that this oxidative stress, and particularly lipid peroxidation, may be what stimulates the development of acne.

According to Dr. Whitney Bowe, adult acne varies from teenage acne. A study published in the Journal of Drugs in Dermatology in 2012 found that oxidative stress, and hence inflammation, could be a key causal factor in the pathogenesis of acne. In addition, very low antioxidant levels are usually present in adults experiencing acne. Also, other studies have found that people that have acne suffer a greater oxidative stress burden and this is shown by certain indicators in their blood.

What is acne?

Acne vulgaris refers to a dermatological condition depicted by too much production of sebum, prolonged inflammation of the pilosebaceous unit and follicular hyperkeratinization. It commonly occurs in late childhood and adolescence. Acne may result from sebaceous hyperplasia, bacterial hyper colonization, inflammations, follicular hyperkeratinization and immune reactions. The condition is characterized by prolonged inflammation of oil glands and the hair follicles. Acne patients may have pimples and comedones (whiteheads and blackheads), cysts, nodules, and papules. Although acne often appears on the face, it may appear on the back, shoulders, chest, buttocks, neck and upper arms.

The role of oxidative stress in the development of acne

A number of recent studies have shown that acne patients experience heightened oxidative stress. One such study discovered that acne patients produced 43% higher hydrogen peroxide compared to people who had clear skin. Another study showed notable differences in inflammation indicators between patients with mild and chronic acne. People with chronic acne were found to have a greater degree of inflammation and fewer antioxidants in comparison to those with mild acne.Oxygen, when reduced to water, can produce reactive species referred to as free radicals. The formation of these radicals is usually slow, and they are cleared by the antioxidant enzymes present within the cell such as glutathione synthetase. However, this is not always the case.

Propionibacterium involved in acne pathogenesis stimulate the production of some chemotactic factors resulting in neutrophils accumulation. Consequently, the process of phagocytosis is initiated whereby inflammatory substances such as lysosome enzymes are released. These inflammatory enzymes then damage follicular epithelia. The active neutrophils in the inflammatory tissue release free radicals which attack DNA and membrane lipids and damage them, together with the healthy tissue. Squalene, a substance found specifically in human sebum, is responsible for protecting the skin surface from the products of peroxidized lipids. These lipid peroxidation products of Squalene cause comedogenic effects. Also, they have been found to be present in high concentrations in open and closed comedones.

Since inflammation causes, acne is it possible to treat it with antioxidants?

There exists sufficient scientific research to prove that both internal and external inflammation have a significant part to play in acne development. Internal inflammation emanates from factors like diet, stress, and lack of sleep, while Ultra Violet rays from the sun, pollution, and chemical exposure may lead to external inflammation of the skin. This inflammation causes damage to sebum. This is why an increasing number of researchers are now convinced that this inflammatory damage to sebum is the real cause behind the pathogenesis of acne vulgaris. This emerging theory is further given credence by the fact that treatment of acne vulgaris with antioxidants has demonstrated good results. Both oral and topical antibiotics used to treat this dermatological condition have shown reliable results in preliminary studies.

Studies on treatment of acne with topical and systemic antibiotics have demonstrated excellent results. For instance, studies that used sodium ascorbyl phosphate (SAP), which is a precursor of vitamin C, have shown that it is more successful than creams containing clindamycin and benzoyl peroxide. Studies on the topical use of zinc have also shown promising results. Another possible treatment is vitamin B3. One study found that 4% vitamin B3 cream was slightly more effective than creams containing only antibiotics. Over 80% of the patients who used the B3 cream improved as opposed to the 68% improvement noted with the use of the antibiotic cream.

Researchers have also studied the impact of antioxidant supplements on acne treatment. For instance in one such study inflammatory acne reduced by 57% after using 30mg of zinc gluconate in just two months. Another study compared the effectiveness of zinc supplements to that of oral antibiotics. Even though the antibiotics demonstrated better results, zinc was clinically effective in about 31% of the patients. This implies over 2/3 reduction in the amount of inflammatory acne. A different study found that there was 80-100% improvement in 79% of the people given an antioxidant supplement. This improvement was registered after 12 weeks of using the supplement. 

The over production of sebum by acne-prone skin means that such people require more antioxidants. This is because their skin becomes sensitive if it doesn’t get the sufficient amount of antioxidants. The excessive oxidative stress experienced by these individuals means that they do not have enough natural antioxidants in their system hence the need to supplement their natural production. This means that an increased use of glutathione supplements is probably the best way to deal with acne as it the role of glutathione in reducing oxidative stress cannot be over-emphasized.

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