Pimple popping secret revealed: Discovery in the skin may treat acne for good

SAN DIEGO, Calif. — “Dr. Pimple Popper” may need to find a new line of work, thanks to a discovery which may help doctors treat acne for good. Researchers from the University of California-San Diego have found a specific chemical in skin cells which fights off the bacteria that causes pimples to break out.

Study authors note that around 50 million Americans deal with acne every single year. Unfortunately, there are few studies into what actually triggers it or if doctors can cure it. One thing scientists know is hair follicles play a role in pimples popping up on your face and body. However, the new study finds the skin cells around these hairs appear to be even more important in causing or stopping acne.

“These findings may transform the way we treat acne,” says Richard Gallo, MD, PhD, Ima Gigli Distinguished Professor of Dermatology and chair of the Department of Dermatology at UC San Diego School of Medicine, in a university release.

“Previously, it was thought that hair follicles were most important for acne to develop. In this study, we looked at the cells outside of the hair follicle and found they had a major effect on controlling bacteria and the development of acne.”

Scientists call these cells fibroblasts. They are common in the connective tissues which run throughout a person’s body. In the skin, fibroblasts produce an antimicrobial peptide called cathelicidin, which is key in fighting off acne.

How do fibroblasts stop pimples?

Specifically, fibroblasts transform into fat cells when your skin is trying to stop an infection in a hair follicle. It’s a process scientists call reactive adipogenesis. At the same time, the cells produce more cathelicidin to suppress bacteria which causes acne to break out. The UC San Diego team notes this discovery came as a complete surprise to them.

“We began our research wanting to understand the biology of acne and specifically looked at the role of fibroblasts, which typically provide structural support in the deeper layers of the skin,” explains first author Alan O’Neill, PhD, project scientist at UC San Diego School of Medicine. “What we uncovered instead was that these cells were activated to produce large amounts of an important antimicrobial, cathelicidin, in response to acne-causing bacteria called Cutibacterium acnes.”

acne
Microscopic image of an inflamed pimple with cathelicidin stained red, fat cells stained green and the nuclei of every cell stained blue. Because cathelicidin is produced from fat cells, their staining merges together.
(CREDIT: UC San Diego Health Sciences)

To study this process, the team performed skin biopsies from acne patients using retinoids for several months. Retinoids are a class of chemicals extracted from vitamin A which help keep skin healthy. The study found that using retinoids enhanced the skin’s ability to create cathelicidin — revealing a previously unknown reason why retinoids are so effective at treating acne.

Researchers also examined mice they injected with acne-causing bacteria to see if the same treatments worked on them as well. Those experiments produced similar results.

“Cathelicidin being so highly expressed in acne biopsy tissue was a very interesting finding to us,” Gallo says. “Knowing this will be helpful in developing a more targeted therapy to treat acne.”

A new acne treatment without side-effects?

Study authors note that current retinoid treatments focus on controlling the development of lipids (fats) in skin cells. However, a potential side-effect of using these drugs could be fetal abnormalities among pregnant women. Researchers are hopeful their findings will help scientists create a safer acne drug that directly targets the problem.

“This research could assist in identifying new treatment options that specifically target the fibroblast’s ability to produce cathelicidin,” O’Neill concludes. “Thus creating a therapeutic for acne that would be more selective with potentially less harmful side effects.”

The study is published in the journal Science Translational Medicine.

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