Ancient Egyptians were vexed by it, using sulfur to dry it out. Shakespeare wrote of its 'bubukles, and whelks, and knobs, and flames o' fire. '
Acne plagues us still. Doctors can cure some cancers and transplant vital organs such as hearts, but they still have trouble getting rid of the pimples and splotches that plague 85 percent of us at some time in our lives - usually, when we're teenagers and particularly sensitive about the way we look.
But new research hints that there's hope for zapping zits in the future, thanks to advances in genetic research.
Using state-of-the-art DNA sequencing techniques to evaluate the bacteria lurking in the pores of 101 study volunteers' noses, scientists discovered a particular strain of Propionibacterium acnes bacteria that might be able to defend against other versions of P. acnes that pack a bigger breakout-causing punch.
As best as dermatologists can tell, zits occur when bacteria that reside in human skin, including P. acnes, feed on oils in the pores and prompt an immune response that results in red, sometimes pus-filled bumps. But the study subjects who had the newly discovered bacterial strain weren't suffering from whiteheads or blackheads, according to a report in the Journal of Investigative Dermatology.
Someday, the realization that 'not all P. acnes are created equal ' might help dermatologists devise treatments that more precisely target bad strains while allowing beneficial ones to thrive, said Dr. Noah Craft, a dermatologist at the Los Angeles Biomedical Research Institute who conducted the study with colleagues from the University of California at Los Angeles and Washington University in St. Louis.
Doctors might prescribe probiotic creams that deliver 'good ' P. acnes to the face the same way a daily serving of yogurt helps restore healthy bacteria in the digestive tract.
'There are healthy strains that we need on our skin, ' Craft said. 'The idea that you'd use a nuclear bomb to kill everything - what we're currently doing with antibiotics and other treatments - just doesn't make sense. '
The research team recruited 101 patients in their teens and 20s from dermatology clinics in Southern California. Among them, 49 had acne and 52 had 'normal skin ' and were not experiencing breakouts but had come to the clinics for other problems.
Doctors used adhesive pore strips to remove skin bacteria from patients' noses. The researchers then collected the waxy plugs - a combination of bacteria, oils, dead skin cells and other stuff - and used DNA to figure out which bacteria were present.
They found that the P. acnes species accounted for about 90 percent of the bacteria in pores, in both healthy patients and acne sufferers. Digging a little deeper into the DNA, they found that two particular strains appeared in about 20 percent of acne sufferers, while a third strain was found only in acne-free patients.
The two notable bad strains had genes, probably picked up from other bacteria or viruses, that are thought to change the shape of a microbe to make it more virulent. The researchers hypothesized that the foreign DNA, perhaps by sticking more effectively to human host tissues, might help trigger an inflammatory response in the skin: acne.
The good strain, on the other hand, contained an element known to work like an immune system in bacteria, Li said.
Li said the researchers did not know why some people had the bad P. acnes strains and others did not, and whether genetics or environment played a bigger role.