Acne: Fresh ideas about its causes are bringing new skincare treatments

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“HAVE you been bitten?”, an older woman asks me, gesturing to my spotty temple. It isn’t the first time this has happened. Normally, I go along with it to save enquirers the embarrassment, but today I have had enough. “It’s acne,” I tell her. Clearly uncomfortable, she reassures me it makes me look younger, presumably based on the notion that only teenagers have acne. Perhaps a passer-by in the street sees my pimples and pegs me at a youthful 17, rather than my actual 32 years. There’s a silver lining.

Acne affects more than 640 million people worldwide to some degree, often arising during puberty. As a teenager with blemish-free skin, I assumed I had escaped the danger zone relatively unscathed – since I didn’t have acne during my adolescence, surely my adult years were safe? My breakouts, however, took hold in my mid-20s, and I am not alone. It turns out acne can strike at any age.

Hormones undoubtedly play a part, but they are far from the only culprit: diet, lifestyle and genetics have been implicated too. There is one offender, however, whose contribution to acne has long been suspected, but has proved difficult to pin down. I am talking about our microbiome – microbes that reside in our gut, on our skin and in our hair follicles.

Now, a flurry of new evidence and a leap in the technology that lets us study this microscopic community have led to a shift in our understanding of acne. For the first time, we can actually see what is happening on our skin during a breakout, and these insights are offering up …

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