June 2022, ScientificAmerican.com 23B I O L O G YPimple Patrol
New dermatology research gets
to the root of acneIf pimples are caused by oily skin, why
doesn’t a good washing prevent all break-
outs? A recent study offers an answer—
and maybe a new line of defense.
Pimples contain tiny and discrete bac-
terial infections. The most commonly
involved bacteria are Cutibacterium acnes,
which live innocuously on skin cells but can
grow out of control when the skin’s oily
sebum increases and boosts bacterial food
supply. What we think of as acne—the
pustules, redness and swelling—is a battle
between our immune system and these
rapidly multiplying bacteria, says derma-
tologist Richard Gallo of the University
of California, San Diego, who led the new
study. “For most people, it’s not that you’re
dirty, or you’re not washing your face
enough,” Gallo explains. “This is a problem
with the way your body’s immune systemis dealing with
the bacteria that
are supposed
to be there.”
If one imag-
ines the immune
system and bacte-
ria as being on oppos-
ing soccer teams, acne is
the beat-up turf at the end of
the game. The new study identifies a
previously unknown, and particularly turf-
mangling, immune system player. Gallo
and his colleagues showed in Science
Translational Medicine that a structural cell
type called a fibroblast (which is not typi-
cally considered an immune cell) contrib-
utes to the facial face-off. Working with
mice and with human skin samples, the
scientists found that C. acnes triggers fibro-blasts to transform into
fat cells that secrete an
antimicrobial sub-
stance—along with
inflammation-caus-
ing proteins. The
re search ers also
discovered that
retinoids, a power-
ful and commonly
used class of pim-
ple-fighting drug,
work partially by
blocking fibroblasts’
transformation and release
of irritating proteins.
Jonette Keri, a clinical dermatologist
at the University of Miami Miller School
of Medicine, who was not involved in the
research, calls the finding an “exciting”
new way to think about acne. Because ret-
inoids can have undesirable side effects,
she says, pursuing a more targeted way to
stop the fibroblasts’ transformation would
be “fantastic” for clinical treatment.
— Maddie BenderADVANCES
B I O L O G YPimple Patrol
New dermatology research gets
to the root of acneIf pimples are caused by oily skin, why
doesn’t a good washing prevent all break-
outs? A recent study offers an answer—
and maybe a new line of defense.
Pimples contain tiny and discrete bac-
terial infections. The most commonly
involved bacteria are Cutibacterium acnes,
which live innocuously on skin cells but can
grow out of control when the skin’s oily
sebum increases and boosts bacterial food
supply. What we think of as acne—the
pustules, redness and swelling—is a battle
between our immune system and these
rapidly multiplying bacteria, says derma-
tologist Richard Gallo of the University
of California, San Diego, who led the new
study. “For most people, it’s not that you’re
dirty, or you’re not washing your face
enough,” Gallo explains. “This is a problem
with the way your body’s immune systemis dealing with
the bacteria that
are supposed
to be there.”
If one imag-
ines the immune
system and bacte-
ria as being on oppos-
ing soccer teams, acne is
the beat-up turf at the end of
the game. The new study identifies a
previously unknown, and particularly turf-
mangling, immune system player. Gallo
and his colleagues showed in Science
Translational Medicine that a structural cell
type called a fibroblast (which is not typi-
cally considered an immune cell) contrib-
utes to the facial face-off. Working with
mice and with human skin samples, the
scientists found that C. acnes triggers fibro-blasts to transform into
fat cells that secrete an
antimicrobial sub-
stance—along with
inflammation-caus-
ing proteins. The
re search ers also
discovered that
retinoids, a power-
ful and commonly
used class of pim-
ple-fighting drug,
work partially by
blocking fibroblasts’
transformation and release
of irritating proteins.
Jonette Keri, a clinical dermatologist
at the University of Miami Miller School
of Medicine, who was not involved in the
research, calls the finding an “exciting”
new way to think about acne. Because ret-
inoids can have undesirable side effects,
she says, pursuing a more targeted way to
stop the fibroblasts’ transformation would
be “fantastic” for clinical treatment.
— Maddie BenderADVANCES
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