Acne is caused by overactive sebaceous glands in your skin. When excess oil builds up faster than it can exit your pores, it hardens and fosters overgrowth of normally harmless bacteria. Dermatologists at DermNet NZ.org identify the acne bacillus Proprionibacterium acnes, P. acnes, which is most common, Proprionibacterium granulosum and Staphylococcus and yeasts. Mayo Clinic physicians advise use of antibiotics and reduction of oil production to starve and kill the acne bacilli.
Proprionibacterium Acnes
P. acnes is the most common acne bacillus. This strain of bacteria secretes enzymes and inflammatory mediators into the oil trapped in glands behind your clogged pores. Among the enzymes are lipases, which digest the triglyceride portion of skin oils into free fatty acids. The free fatty acids cause irritation and induce the bacteria to clump together and colonize the oil gland duct, promoting further plugging. Other chemicals secreted by P. acnes promote inflammation by penetrating surrounding skin, attracting white blood cells which, together with bacteria and debris of dead cells, constitute pus, and cause swelling, redness and pain.
Propionibacterium Granulosum
Acne is usually a skin condition, but the bacilli in an infected acne pustule can enter your blood stream on rare occasions. Research published by Dr. Catherine Branger, conducted in the Department of Microbiology at Beaujon Hospital of the University of Paris in 1987, described a case of life-threatening septicemia, a blood-borne infection, by the acne bacillus, P. granulosum. Along with P. acnes, these are among the most common skin organisms and are usually non-pathogenic. However, strains of P. granulosum, isolated from acne pustules, were found to cause endocarditis, an infection in the heart, meningitis, an infection of the membranes around the brain, and arthritis.
Staphylococcus
A dangerous, though uncommon, complication of acne is the bacillus know as methycillin resistant Staphylococcus aureus, or MRSA. Many Staphylococcus bacilli live on normal skin, including S. aureus and S. epidermidis. They are usually well-tolerated and harmless unless your skin is damaged or your immune system is weakened by disease or certain drug, when infections with the MRSA bacillus can severely aggravate acne. Many public health specialists, inluding experts at the California Department of Public Health, prescribe topical, oral or intravenous antibiotics, in addition to careful washing and use of antiseptic, anti-bacterial cleansers, to prevent and treat acne infected with these bacilli.
Yeasts
Growth of excess yeasts, specifically Malassezia, was also cited by DermNet NZ.org in describing the progression of acne infections. Though yeasts are technically not bacteria, they are part of the complex picture of acne infections. Research conducted by Dr. H. Ruth Ashbee in the Division of Microbiology, University of Leeds in the United Kingdom, and reported in the "Clinical Microbiology Reviews," in 2002, indicates that this yeast increases in acne and stimulates the immune system, which may protect against other acne organisms in some cases. Therefore it is unclear whether Malassezia protects against or aggravates infections by acne bacilli.
Disclaimer
Although acne is common and usually more annoying than dangerous, it can lead to serious, sometimes disfiguring, complications. Consult your doctor if your acne frequently produces infections. Mayo Clinic physicians describe safe home care options and specific signs that you need medical care for more troublesome cases.
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