Acne, the scourge of many an adolescent life, is getting harder to treat, but 80 percent of teenagers have some form of it.
Conventional
treatment includes topical and oral antibiotics. Studies are now
finding the bacteria that cause acne are increasingly resistant to antibiotic treatment. Alternatively, there are effective laser treatments. But these are costly and typically not covered by insurance.
Now, researchers are scrambling to come up with new treatments
for acne. One promising possibility involves harnessing a harmless
virus living on skin that naturally seeks out and kills the bacteria
that cause pimples.
UCLA dermatologist Dr. Jenny Kim
says many people don't realize it's bacteria that cause acne. "Some
people say your face is dirty, you need to clean it more, scrub more,
don't eat chocolate, things like that. But really, it's caused by
bacteria and the oil inside the pore allows the bacteria to
overpopulate," Kim says.
For most
teenagers with mild acne, over-the-counter products containing peroxide
or salicylic acid are enough to clear up the acne. But lots of teenagers
end up in the doctor's office and getting antibiotics. This was the
hardest thing for Bagrodia: No matter how much she followed doctors'
orders, diligently cleaning her face and using antibiotic cream, nothing
worked.
Antibiotic-Resistant Bacteria
Dermatologist Elizabeth Martin is in private practice in Birmingham, Ala., and is a fellow with the American Academy of Dermatology. She says these bacteria, like many others, are mutating quickly and becoming resistant to antibiotics.
"Over
the years, we have seen an increase in this antibiotic-resistant
bacterium, both in the U.S. and also worldwide," Martin says. She points
to studies that show a tripling of drug-resistant acne bacteria over the past few decades.
This
means doctors can no longer rely on antibiotics alone. Most doctors now
use a combination of low-dose antibiotics along with benzoyl peroxide,
which also kills acne-causing bacteria.
As
Martin says, benzoyl peroxide "works to decrease bacteria through a
different mechanism than antibiotics, and it helps to prevent
development of resistant bacteria. When we combine benzoyl peroxide
along with an antibiotic, patients tend to have better clearance of
their acne than when we use antibiotics alone."
Other Treatment Options
Retinoids,
vitamin A derivatives, can also be used early on to treat acne.
Typically creams, they work by unclogging pores before they become
large, inflamed bumps.
A stronger
form, called Accutane, is used for severe acne. It's a highly effective
pill, but it can cause serious side effects, including depression and
birth defects. So the government regulates its use.
Intensely
focused light and lasers can also help fight acne when other treatments
fail. Kim is also a researcher at UCLA. In the room dedicated to light
and laser therapy, Kim points out what appears to be a half-cylinder
with stacks of oblong light bulbs.
"Patients
with acne can go right under blue light, and they sit there for about
15, 20 minutes, and acne often improves after several treatments," Kim
says.
It's not known exactly how
light therapy works to fight acne, but Kim says studies indicate it
destroys the bacteria. "Probably physically without giving it time to
mutate; and the other thing — the light treatment can improve the
inflammation that the bacteria causes in acne," she says.
But
laser and light therapy doesn't work for everyone. It's expensive and
typically not covered by insurance. So Kim and colleagues at the
University of Pittsburgh are also looking into an entirely new way to fight acne: taking a harmless virus that lives on the skin and programming it to become a bacteria killer.
"The
virus is going to go and kill the bacteria that causes acne. It's just
going to break it apart and burst its membrane so there's no time for
the bacteria to mutate," she says. It's sort of a surprise attack.
The
approach is a promising way to get rid of acne without using
antibiotics. If further lab studies prove successful, researchers will
begin testing on people to see if viral therapy is both safe and
effective in fighting acne.
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