If pimples are caused by oily skin, why doesn’t a good wash prevent all pimples? A recent study offers an answer – and perhaps a new line of defense.

The buds contain small and individual bacterial infections. The most common bacteria involved are Cutibacterium acnes, which live harmlessly on skin cells, but can grow out of control when oily sebum in the skin increases and enhances bacterial food. What we think of as acne – pustules, redness and swelling – is a battle between our immune system and these fast-growing bacteria, said dermatologist Richard Gallo of the University of California, San Diego, who led the new study. “For most people, it’s not that you’re dirty or that you don’t wash your face enough,” Gallo explains. “It’s a problem with the way your body’s immune system handles bacteria that’s supposed to be there.”

If we imagine that the immune system and bacteria are in the opposing football teams, acne is the broken grass at the end of the game. The new study identifies a hitherto unknown and particularly grass-destroying immune system player. Gallo and his colleagues showed him in Science Translational Medicine that a structural cell type called a fibroblast (which is not normally considered an immune cell) contributes to the facial face. Working with mice and human skin samples, the researchers found this C. acne triggers fibroblasts to transform into fat cells that secrete antimicrobials – along with proteins that cause inflammation. Researchers have also found that retinoids, a powerful and commonly used class of anti-pimple drugs, work in part by blocking fibroblast transformation and the release of irritating proteins.

Janet Kerry, a clinical dermatologist at the University of Miami School of Medicine who did not participate in the study, called the discovery an “exciting” new way to think about acne. Because retinoids can have unwanted side effects, she says, pursuing a more targeted way to halt fibroblast transformation would be “fantastic” for clinical treatment.


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