Preadolescent acne: the better we can identify cutaneous microbiota, the better the treatment will be
Identifying prepubescent children’s cutaneous microbiota may change how we treat their acne, an American study suggests.
Adolescents are not the only ones to suffer from acne; some adults and three-quarters of prepubescent children are also affected. Unlike adolescents and adults, for whom acne manifests by inflammatory lesions and comedones (pimples), acne appears more often in children before puberty as comedones. This difference may be attributable to the cutaneous microbiota, which changes with age. As a result, determining the microbial composition of acne-affected skin could help us evaluate the effect treatments have on the cutaneous flora, and could lead to alternative therapies targeting the microbiota itself.
Common anti-acne treatments (benzoyl peroxide, tretinoin) act on the proliferation of epidermal cells. However, they also have an indirect effect on the growth of one of the dominant bacteria in affected adults (the Propionibacterium genus). A study has now shown that preadolescents in general have a cutaneous bacterial population dominated by streptococcus, and those with acne are also largely dominated by staphylococcus. The researchers conclude that the prepubescent population may need a tailored therapeutic approach (probiotics, vitamin B12), which would target the composition of their cutaneous microbiota. Additional studies will help to better characterize the microbiota associated with the onset of acne and how it changes depending on the patient’s age, and to evaluate treatments adapted to those characteristics.
Coughlin C et al. The preadolescent acne microbiome: A prospective, randomized, pilot study investigating characterization and effects of acne therapy. Pediatric Dermatology. 2017;1–4.