The Joplin Globe, Joplin, MO

October 11, 2012

Acne attack: Though study shows future therapies, plenty of options already available

By Joe Hadsall
Globe Features Editor

JOPLIN, Mo. — News about more treatments for acne sounds OK to Dr. Mark Matlock. But the Joplin dermatologist said his treatment toolbox offers plenty of tools to help acne already.

“Some of the things we look for are what age the patient is and how deep the acne is,” said Matlock, of M&T Dermatology. “We have a lot of diversity in treatments.”

A study published in the current issue of mBio, a publication of the American Society for Microbiology, discussed new strategies for treating acne beyond using antibiotics.

Acne in pubescent teens is usually caused by an imbalance between acne-causing bacteria and viruses called P. acne phages, which kill the bacteria. Puberty usually increases normal bacterial activity in the skin, so much so that the phages can’t keep up.

“The fact that acne continues to be quite a significant problem is a good illustration of how poorly effective our arsenal is in dealing with it,” said Graham Hatfull, professor of biological sciences at the University of Pittsburgh and an author of the study. “Resistance to antibiotics is one of the key problems, and from a clinical perspective, there are few alternative solutions.”

The study provides a variety of directions to take, he said, but doesn’t promise any new therapies.

Treatments of acne can include anything from over-the-counter remedies to strong antibiotics, Matlock said. Other forms include topical compounds, vitamins and lasers.

“We have a tendency to look at other forms instead of antibiotics,” Matlock said. “We know about Vitamin A drugs or various forms of light. But that doesn’t mean it’s automatically our first approach. It’s just another tool in the box.”

What to watch

Matlock said based off of his experience working with patients, girls are usually more motivated to see a dermatologist, whereas boys are brought in by their parents.

But when acne first makes its appearance, parents can help their kids deal with it before seeing a doctor. Matlock recommended over-the-counter medicines such as benzoyl peroxide and salicylic acid.

If lesions aren’t too numerous or too deep, he recommended trying one of those solutions for two or three months.

He also said that kids who want to take the situation in their own hands by squeezing out blackheads or whiteheads should be extremely careful.

“The major thing is don’t get too aggressive that you’re damaging the skin,” Matlock said. “Whether you use an extractor or do some mild treatment to open up pores, you don’t want to be picking to where it causes scarring.”

Matlock said scarring usually happens after someone has gotten most out of a pimple or zit, and they are checking to see if they got it all.

The most important thing parents can do is make sure their kids wash their faces more often, especially after using makeup or participating in sports.

“Part of the problem is sweat,” Matlock said. “When you sweat a lot, you need to wash well and remove all that debris from the surface.”

Future treatments

Perhaps in the distant future, phages will be able to cure acne more thoroughly.

Potential therapies could include high concentrations of phage to kill off the proliferation of acne-causing bacteria during puberty or enzymes that the viruses produce that kill the bacteria by breaking down cell membranes.

Hatfull said the acne-causing bacterium serves no beneficial function, with its inflammatory response leading to acne.

The study reveals the potential of phage as a treatment, said Elizabeth Kutter, professor emeritus at Evergreen State College in Olympia, Wash. It also could prove profitable, once it is developed.

The bacteria neither develop resistance to phage nor destroy good bacteria, said Kutter, who also holds a doctoral degree. The study reflects the advantages, not available five to 10 years ago, of using genome sequencing to understand all the properties of phages.

Scripps Howard News Service contributed to this report.