ACNE: A SCIENTIFIC DESCRIPTION

The Skin Society Natural Skin Care and Psoriasis treatments

Oily skin, usually accompanied by mild to moderate acne, is a widespread problem for

nearly all teenagers and for many adults. Studies report that 90% of teenage boys and

80% of teenage girls and 40-50% of adults aged 20-40 are affected. Excessive

skin surface oil is cosmetically unappealing, but can also trigger acne by clogging pores

and by providing a growth medium for inflammation-causing bacteria.

Sebum, which contains more than 50% triglycerides, as well as free fatty acids, wax

esters, squalene, cholesterol esters and cholesterol, is produced by sebaceous glands

located within the pilosebaceous unit (sebaceous gland(s), hair and follicle). It normally

takes 14-21 days for sebum producing cells to generate their lipids, release them and

then for these lipids to reach the skin’s surface. Normal amounts of sebum, upon

reaching the skin’s surface and mixing with skin surface lipids, may play an important

role of lubricating skin and hair and providing a protective layer on the skin’s surface.

Sebum production is stimulated by androgens, stress hormones and, as more recently

discovered, peroxisome proliferators-activated receptor (PPAR) ligands. Which

appear to play a crucial role in lipid metabolism.

While the exact mechanism of acne formation is still unknown, traditional theory centers

on excess sebum, which mixes with hyperproliferated keratinocytes to block follicles to

form microcomedones (blackheads and whiteheads). P. acnes and other bacteria

lipases break down sebum triglycerides into irritating free fatty acids, which, combined

with other sources of inflammation, can lead to more severe types of acne, including

pustules and cysts.

There are many pharmaceutical approaches to acne, many of which reduce sebum.

These include topical and oral retinoids, topical and oral antimicrobials and keratolitic

agents such as salicylic acid. However, they are commonly associated with irritation and

other negative side effects that are especially significant to the growing numbers of

adults seeking treatment. Most cosmetic approaches to sebum control rely upon

absorption of surface oils with materials such as talc and microsponges. A few cosmetic

ingredients help to inhibit the underlying causes of oily skin and acne. They include 5-

alpha reductase inhibitors, which block the conversion of testosterone into DHT and

thus block a primary trigger of sebum production, and anti-inflammatory and

antibacterial agents. In most cases of oily skin and/or acne, a multi-pronged approach to

treatment is advised.

Recent studies have linked oily skin and acne to abnormalities in lipid metabolism within

the pilosebaceous unit. In individuals with oily skin, hyperkeratosis of the follicular

epithelium is often linked to abnormalities in lipid composition in the follicle cell

membrane. These abnormalities lead to barrier dysfunction of the follicle membrane

with consequent release of digested lipids, which eventually increases the amount of

superficial lipids. A dysfunctional lipid metabolism in the sebaceous gland is responsible

for the lack of correct intra membrane lipid production, with accumulation of free fatty

acids and breakdown products.

THE SKIN SOCIETY APPROACH

It is possible that a local deficiency of certain lipid precursors is associated with this

abnormal lipid metabolism in the sebaceous glands of oily skin individuals, with a

decreased catabolism of free fatty acids and a slower anabolism and increased

breakdown of lipids important for the integrity and functionality of the follicle membrane

such as phospholipids, isoprenoids, cholesterol, ceramides, etc. Recent studies have

shown in fact that the lack of cholesterol, certain fatty acids and ceramides were

responsible for the membrane barrier disruption of the follicle cell. This abnormal lipid

metabolism in the pilosebaceous unit would lead to free fatty acid accumulation and to a

non functional follicle membrane, resulting in membrane rupture, release of free fatty

acids and overall superficial sebum increase.

One study links oily skin and acne to a deficiency of Coenzyme A (CoA), which the

body uses in two very important metabolic pathways: the synthesis of sex hormones and

in fatty acid metabolism. CoA carries acyl groups used to lengthen and degrade long

chain fatty acids along the metabolic pathway. When forced by shortage to choose

between the two uses of CoA, the body will choose the most important process,

production of sex hormones. Without enough CoA to properly metabolize fatty acids,

lipids accumulate in the sebaceous glands, sebum increases and acne forms. Oily skin,

acne and pore size were significantly improved by internal and external administration of

pantothenic acid, the only precursor of CoA not produced within the body.

Based on these studies associating deficient lipid metabolism with excess sebum and

acne, The Skin Society development made possible to treat oily skin with a cosmetic blend of lipid precursors (inparticular of the isoprenoids and sterols synthesis) which act as bioactivators on the skin, helping to normalize lipid metabolism.

Michel A. Hegi Ph.D.

http://www.theskinsociety.com/Acne/Acne.html

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