Can Acne be cured with a new gel?

Main Category: Infectious Diseases / Bacteria / Viruses
Article Date: 22 Apr 2004 - 0:00 PDT

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A British scientists believes he can develop a new gel which will eradicate acne and leave no undesirable side effects. He said the bacteria which commonly causes acne can be destroyed by a virus found on the skin.

Dermatologists are encouraged by Professor Keith Holland's research. Professor Holland is from the University of Leeds, UK. He is at the initial stages of his research into this.

The problems with available treatments is that they have side-effects. The most effective treatment today is antibiotics. If antibiotics are used for too long you get resistant strains of them. Contraceptive pills sometimes work as they alter the hormonal levels of the patient.

Professor Holland found that a bacteriophage, a virus common on human skin, kills the bacteria that creates acne. He said "We are thinking of the future. We think a possible answer is the use of bacteriophage. We want to make a gel which contains the bacteriophage which we can put in a higher concentration on the skin."

The reason he believes the gel will have no side-effects is that the virus is already present on the skin.

WHAT IS ACNE?

Acne is an inflammatory skin disease which affects the tiny pores which cover the face, arms, back and chest and the oil glands attached to them.

It is an abnormal response in the skin to normal levels of the male hormone, testosterone, in the blood. Both men and women have testosterone circulating in the blood, but in the acne sufferer, this hormone has a profound effect on the skin. This abnormal response is self limiting and eventually acne does get better without treatment, but there is no way of predicting how long this can take, and it may take years or even decades! Acne can also leave scars which are permanent and are easier to prevent than to treat.

In the skin, the disease attacks two structures:

1 The pore through which the hairs emerge from the skin - here dead skin cells become more "sticky" and partially block the pore.

2 The oil or sebaceous gland - more oil is produced, which gives rise to a generally oily complexion.

The partial blockage in the pore restricts the flow of oil onto the skin surface. This results in solidification of the oil which fills the hair channel forming a blackhead. The black of the blackhead is not due to dirt, but a change in pigment in the blockage in the pore. If the partial blockage becomes complete, the oil builds up around the hair and hair root and becomes infected with bacteria normally present on the skin. The bacteria break down the oil to very inflammatory chemicals which cause redness, pus formation and pain - the "zit".

If the inflammation is deep and severe, or if the spot is manipulated or squeezed, the pus can burst deep into the skin rather than onto the surface. This deep-rooted inflammation and infection results in scarring and cyst formation.

When does acne start?

Acne is commonest in adolescents with a peak in the late teens. Acne may however, appear for the first time in the mid-twenties or even later and persists in a significant number of people into their 40s or even their 50s.

Does diet affect acne?

The simplest answer is no. The myth persists that chocolate and fatty foods make acne worse. In a very small percentage of people, these foods do make their acne worse, but in most people, diet is not important. A good balanced diet is, however, important for general well-being.

What about periods and the pill?

The female hormone oestrogen, at high levels, can help alleviate acne. Many women notice a worsening of acne premenstrually, which is due to changes in hormone levels at this time. Pills that contain oestrogen can help acne, and progesterone-only pills (the mini pill) can make acne worse.

How should I wash my skin?

Acne is not caused by dirt or poor cleanliness. Normal soap and water is the best way of washing the skin, twice daily. If you have a combination skin, use non-greasy moisturisers on the dry areas.

To squeeze or not to squeeze?

If you squeeze blackheads or pustules, you may force the contents deep into the skin rather than onto the surface. If this happens you may be left with much worse scarring or cyst formation. For blackheads, invest in a comedone spoon (available from most chemists and the Body Shop) which gets rid of blackheads with minimal trauma to the skin. Never squeeze a spot unless you can see pus. When squeezing, wash your hands beforehand and puncture the surface of the pustule with a sterilized needle before gently squeezing out the pus. If you squeeze until you see blood you may be left with a scar!

What treatments are available?

Please note, the availability of treatments will vary in different countries. The following are available in the UK.

Benzoyl peroxide: this is available over the counter and can be effective in mild acne; however it can irritate the skin and may dry it.

Antibiotic lotions: these are available on prescription only. They are very effective in mild-to-moderate acne and dry up pustules quickly. Clindamycin lotion has been shown to be as effective as taking antibiotics by mouth in acne.

Topical vitamin A derivatives: these are supplied as creams, gels or lotions. They are very good for blackheads but often dry and irritate the skin. They should be used with lots of moisturisers.

Antibiotic tablets: these are the usual treatment for moderate-to-severe acne. Many different antibiotics can be used, but the tetracyclines are the most popular. Treatment should last for at least 6 months and, depending on the response, may last for 2 to 3 years. Never stop antibiotics suddenly as the acne may flare up badly if this is done. The tablets should always be slowly reduced.

Hormone treatments: high oestrogen pills do help acne, but are not without their side-effects. A form of the pill is made with low-dose oestrogens and an anti-testosterone drug which may be useful in bad acne.

Oral vitamin A derivatives: these drugs are only available from hospitals. They are very powerful anti-acne drugs and with them we can control and even cure the most severe forms of acne. They do have side-effects and we tend to restrict their use to the more severe cases of acne.

Scarring

Acne can and does scar the skin and this can be very severe. Prevention of the scarring is achievable as long as the treatment is started at an early stage. Once the scars have formed, they are permanent and though plastic surgery and chemical peeling can help, the skin will never be the same again. What should I do about my acne?

Acne is a very treatable disease, but in many patients treatment needs to be started early and be aggressive to prevent the scarring.

If your acne fails to respond quickly to products bought at the chemist, consult your doctor. He or she can advise you about the different treatment options and can prescribe most of these. In severe or difficult cases, your doctor can refer you to a dermatologist for further specialist treatment.