Acne, so in the future we will address “blackheads”

A new acne cure aims to target the cells surrounding the hair follicle: how it works

It is not always the same. Comedones, pustules and other lesions must be addressed on a case-by-case basis, based on the characteristics of the skin, the age of the person and their distribution. But there is no doubt that acne is one of the great challenges of dermatology, even for the large number of people who suffer from it. Research conducted at the University of San Diego now opens a window for future approaches to this condition, in different ways.

In fact, there would be a new target to act on: the cells surrounding the hair follicle. They could be the target of future targeted treatments, since they would affect compounds that in some way act on skin bacteria and the possible future development of the disease. The study by the Californian university, published in Science Translational Medicine, testifies to the possible importance of this new opportunity.

Beware of fibroblasts

The innovative research key starts from fibroblasts, or cells that make up collagen. The study has shown that these cells can transform themselves into “productive” units of a particular substance, called cathelicidin, which plays a role in the development of skin infections thanks to the transformation of these fibroblasts into fat cells capable of producing the anti-infective compound. Cathelicidin would therefore be important in the response to specific bacteria, which play a role in the genesis of acne.

As a further demonstration of this situation, it has been seen that working on skin tissues of people with acne and administering derivatives from vitamin A (used in specific cases) it has been seen that cathelicidin improves the responses in terms of treatment of skin pathology. Precisely from this observation could therefore start a new opportunity for the development of treatments that have this substance as a possible objective. In any case, only the future will reveal whether this avenue of research will prove useful for acne sufferers.

Certainly, at the moment, there is that against comedones and the like, we need to face the situation in the right world. If simple blackheads don’t have to worry too much, the situation changes when real inflamed pustules form. There are in fact several forms of the disease.

The simplest is the comedonic one, without inflammation, characterized by the presence of the so-called “black points” and “white points”, very typical in the initial stages. It can then arrive at the papular-pustular form, with inflammation, in which there are small red skin reliefs, sometimes accompanied by pus. The most serious, the one that can also leave scars on the skin, is the nodular one. For this reason, acne treatment must be personalized and modulated over time both to put the disease under control and, above all, to maintain the results obtained.

What happens in acne

Acne needs to be studied. And the dermatologist’s care must be followed constantly, even if among the very young it can be more difficult while in adults adherence to the treatment is simpler. And we must not forget that the causes of the problem can also be different at the outset.

When acne appears in adults, it is generally easier for hormonal causes to come into play, particularly in women. In general terms, however, several factors influence the genesis of the disease. For example, the qualitative and quantitative composition of the sebum is important, which has the task of keeping the skin hydrated and protecting, together with the action of a bacterium, called propionibacterium acne, which does not directly have an infectious action but rather tends to favor the skin. ‘inflammation. The black point arises from a kind of “plug” that is created on the follicle of the skin, preventing the elimination of sebum, which therefore “irritates” from the inside.

Then the hormones come into play: the hyperkeratinization, that is the occlusion of the duct, would be linked to a greater sensitivity of the cells to androgens. Let me be clear: the vast majority of people who suffer from acne do not have changes in the hormonal values ​​in the blood, but rather a different sensitivity to them of the pilo-sebaceous follicles, the tubes that should carry the sebum outside. The sebum itself, however, is under the magnifying glass of science.

This fatty substance is produced by specialized cells which eventually break and release different types of lipids, mostly triglycerides and fatty acids, into the hair follicle. These are normally extremely useful for defending the skin: they moisturize the surface layer, help protect itself from the sun’s rays, especially from ultraviolet B, and bring antioxidant substances to the surface that preserve cells.

Unfortunately, acne sufferers tend to produce a greater amount of sebum, without forgetting that the composition of the sebum itself also has significance. This is why we are faced with a mosaic of elements that it is up to the doctor to put in order to understand the situation well. And deal with it accordingly.

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