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  • Bacteria and Breakouts: A Deeper Look into P. acnes

    We’ve all experienced some form of breakout and sometimes it seems to have appeared overnight. How did this happen?! As skin therapists we immediately do a mental checklist of possible triggers—was it stress, hormones, diet, product? We know that on a basic level, acne occurs within the sebaceous follicle by excessive skin cells, sebum, inflammation and presence of bacteria known as Propionibacterium acnes (P. acnes). However, we also know the process of acne is anything but basic. Let’s take a deeper look at the one element of this process that is always with us: bacteria.

    P. acnes is part of the natural skin flora and accounts for about 87% of the bacteria. It grows deep inside follicles, lives anaerobically and feeds on the sebum produced by the sebaceous glands. For the most part, this bacteria can be relatively harmless; however, if follicles become plugged, the low oxygen levels and accumulating sebum create a prime environment for the growth of P. acnes.

    Using sebum as an energy source, the bacteria produces lipase that converts triglycerides into glycerol and fatty acids, causing inflammation and irritation. The inflammation then triggers the innate immune response and white blood cells are activated. Next they release destructive enzymes and free radicals that causes extensive damage to the surrounding tissue. This damage often stimulates the production of more pro-inflammatory mediators, making it easier for the bacteria to multiply and continuing its vicious cycle. By understanding the behavior of P. acnes, we can get a better handle on how it can be managed for acneic clients.

    Porphyrins as seen through VISIA

    Porphyrins as seen through VISIA

     

    The Other P Word

    P. acnes produce porphyrins, which are groups of organic compounds that play major roles in processes like oxygen transportation and photosynthesis. When observing skin under a Wood’s lamp, you may even see them as fluorescent spots or dots. P. acnes synthesize and store large amounts of porphyrins that ultimately pays favor to LED treatments, such as using a Blue light to treat acne. The Blue light excites the Porphyrins that causes them to release free radicals into the bacteria therefore killing them from the inside out.

    A Sticky Situation

    The bacteria also produces a natural self-protection mechanism called biofilms. These are clusters of bacteria that are attached to a surface and are embedded in a sticky slime layer. The biofilm surrounds the microbes and helps it adhere to the follicle and can further promote hyperkeratinization. This same biological glue that allows the cohesion of the biofilm could also cause keratinocytes to stick together creating comedones.

    Research has also shown that the formation of biofilms seems to be a natural behavior for bacteria, but this formation has a consequence—it appears to be resistant to antibiotics, a common therapy for the treatment of acne including topical and oral medications. It is suspected that the antibiotics are not able to penetrate into the biofilm because the bacteria are tightly packed into a cluster.

    What’s in a Strain?

    P. acnes reside in the pilosebaceous unit, but its presence doesn’t necessarily mean that an individual is going to have acne. Several studies have indicated that specific strains of P. acnes bacteria are more commonly associated with acne prone skin versus normal skin, which may point to why some individuals are more predisposed to breakout while others are not.

    A UCLA study discovered that acne bacteria contain “bad” strains associated with pimples and “good” strains that may protect the skin. Through metagenomics, or the study of collection and analysis of bacteria in our environment, research has uncovered three specific strains of P. acnes in the skin’s microbiome; two that are found to be dominant in acneic skin and one strain in healthy skin.

    As scientists continue examining the relationship between our microbiome and acne, we can at least steer our clients to specific key ingredients to help contain acne formation and keep P. acnes at bay.

    Ingredients to target bacteria:

    Colloidal Silver

    Lactobacillus Ferment

    Benzoyl Peroxide

    Tea Tree Oil

    Cinnamon Bark

    Spirea Ulmaria

    Polygonum Cuspidatum (Japanese Knotweed) Root Extract

  • Shining the Light on LED

    Derm_Headshot28775BB-e1422475470394-150x150For some, using Light Emitting Diodes (LED) to treat certain skin issues like acne and aging may sound too good to be true. How is it that shining a light on your client’s face will clear up those pesky breakouts and plump up their skin? Well, the science is in the stars. About 40 years ago, scientists at NASA discovered through plant growth experiments that light therapy was a beneficial way to repair damaged cells and speed up the healing process.

    Through the years the basis for this technology has been accepted as a non-invasive popular application to treat a variety of common skin conditions. LED photomodulation works similar to the way photosynthesis works in plants as it triggers the body to convert the light energy into cell energy. The light encourages natural cellular activity and “re-energizes” the cells in the skin.

    While the visible spectrum of light can be represented in many LED devices, we are focusing on the most researched and effective light waves: Red and Blue.

    Red LEDRed for Wrinkles

    Red light therapy, is a technology that uses visible red light wavelengths from 630-660 nanometers and infrared light wavelengths at around 880nm to penetrate deep into the layers of the skin. Red and Infrared light increases energy inside cells and jump-starts the production of collagen and elastin to help make skin firm and supple. Because the layers of the skin have a high content of blood and water, it makes it easy for the skin to absorb light. Most researchers agree that light therapy increases production of Adenosine Triphosphate (ATP)—the energy or battery life of cells—and it may also work by targeting water layers on elastin, gradually restoring its elastic function reducing the appearance of facial wrinkles. In addition, Red Infrared light therapy also assists with blood circulation, which effectively transports oxygen and nutrients to the skin. Along with fighting wrinkles, red light therapy has been used in skin healing for rosacea and even eczema.

    Blue LEDBlue for Blemishes

    Blue light has a wavelength of 400–490 nm and has special effects on the skin especially when it comes to treating acne. When blue light reaches the sebaceous glands in the skin, it can help excite porphyrins, which are compounds inside acne bacteria (Propionibacterium acnes). When porphyrins are activated, they release reactive oxygen molecules that damage the bacteria internally, basically killing the bacteria from the inside out. Since red light helps accelerate wound repair, it’s often used in combination with blue light to treat acne, encourage healing, and lessen acne scarring and under the skin lesions.

    These two light wavelengths can effectively and gently make significant changes in the skin at a deep level by repairing cells, stimulating collagen and elastin and helping to treat acne. By incorporating these light therapies you can add another level of expertise to your skin treatments and energize your services.

    Keep in mind before shining that light—manufacturers of LED devices must gain FDA clearance in order to make certain claims about their devices. It’s always good to check on the company’s status and proven results before purchasing so you can ensure your client’s treatment is on track for optimal skin health.

    To see LED in action, watch the IDI webisode Using Machines to Power up Your Treatments-Part 2.