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What is actually effective in acne formation?

Research seems to lead to changes in acne treatments.

Acne is one of the most common chronic skin diseases, affecting more than 85 percent of teenagers and adults.

There is some controversy about how acne occurs. But the common view is the fact that it is a problem that does not depend on a single factor. The most blamed mechanisms in acne formation are;

– Excessive oil (sebum) production from the sebaceous glands

– Inflammatory reaction in the hair root

– Excessive cellular production in the hair canal

– Mechanisms such as the abnormal growth of Propionobacterium acnes bacteria living around the hair were valid.

For years, we determined our acne treatment approach according to whether the acne was inflamed or not. Black and white dots (called open and closed comedones) were considered non-inflammatory acne, and those with red, raised skin and pus were considered inflamed acne. However, recent studies have shown that all forms of acne have inflammatory properties. When the inflammatory structures, which we cannot see with the naked eye, are examined under a microscope, invasion of immune cells is observed around the hair root and hair.

Studies on the immune system have shown that the natural immune system (the system that recognizes pathogenic microorganisms attacking our skin, gives the first response and triggers the first immune signal) does not work properly against P. acnese bacteria and an immune problem occurs. Treatment regimens that suppress the elements of the immune system that manage this function (called inflammasome and tool like receptors) are effective because they prevent the acne formation process.

The sebaceous glands produce too much sebum, but how?

A question may come to mind, such as what is the role of the sebaceous glands in this problem. In fact, it is in the middle of the acne formation mechanism. Acne bacteria, called P. acnes, cannot withstand the appetite of sebum, the original oil of the skin, and breaks it down into fatty acids. Fatty acids -even though they are in the fatty structure- start the inflammatory process in the skin.

So, is the whole mechanism of acne formation that simple? Of course not. In recent studies, the sebaceous gland cells that produce sebum not only produce oil, but also work as a pioneering force of the immune system. It produces more sebum with the warning of decreasing fatty acids that cause skin irritation. The sebum secreted from the sebaceous glands highlights an inflammasome, and this pro-immune agent triggers and increases the inflammatory reaction. In other words, sebum oil in the form of inflammasome, which is produced to protect the skin against bacteria, cannot do its main job and causes a bad result in acne, although it is produced for good purposes. If this vicious circle cannot be broken, the acne problem continues to increase from mild to severe.

The data obtained from this research is very important. First of all, it clearly reveals the role of sebaceous glands in acne formation. Besides, the most exciting feature is understanding the role of activation of sebaceous glands with immune system function in acne formation mechanism. This will help us develop new methods of acne treatment and prevention in the future.

In other words, adequate cleaning of the skin, not more or less, leaving a certain amount of protective sebum on the skin, reducing the number of bacteria that cause acne on the skin with regular washing – unfortunately, it does not end, it is the permanent natural host of the skin – is the first step treatment of acne treatment. In addition, anti-inflammatory treatments that suppress the inflammatory process in the skin will come to the fore as the main treatment products.