Scientists have given hope to millions of acne sufferers as a new study suggests the condition may be genetic.
In the first trial of its kind, researchers analysed the DNA of more than 26,700 people, of which over 5,600 were battling severe acne.
Results suggest there are significant genetic variations between people with the crippling condition and those with clear skin.
Genes that control hair follicles are thought to play a particularly critical role in acne’s onset.
The researchers have called the study a ‘significant leap forward’ and hope it will lead to more effective treatments that prevent permanent scarring.
World first study reveals acne may be genetic and related to a sufferer’s hair follicles (stock)
The study was carried out by the National Institute for Health Research Biomedical Research Centre at Guy’s and St Thomas’ NHS Foundation Trust in London and led by consultant dermatologist Professor Jonathan Barker.
Acne is a very common condition in teenagers and young adults, with around 80 per cent of those aged 11-to-30 in the UK being affected, according to NHS statistics.
It is defined as spots and oily skin that can be red or painful. Although not fully understood, acne is thought to be caused by a combination of sebum, inflammation and the bacteria Propionibacterium acnes entering hair follicles.
People are most likely to suffer in their teens, with symptoms generally disappearing by the time they reach their mid-20s. However, around five per cent of women and one per cent of men in the UK continue to suffer over 25.
Acne is also very common in the US, with up to 50million Americans being affected every year, according to the American Academy of Dermatology. Around 85 per cent of 12-to-24 years old suffer to some extent.
After analysing the DNA of 26,772 people, of which 5,602 had acne, the scientists found many of the genetic variants related to the skin condition affect the formation of hair follicles.
Impaired hair follicle function is thought to encourage the colonisation of acne-causing bacteria that lead to inflammation.
‘Applying these genetic approaches to acne has never been done before, and it’s a significant leap forward,’ Professor Barker said.
The researchers found variants related to acne at 15 genetic locations, of which 12 had not previously been identified. They believe these genes control 22 per cent of the differences in appearance between acne patients.
Professor Barker hopes understanding the role of genetics in acne will lead to more effective treatments that focus on reducing inflammation and suppressing bacterial colonisation.
‘When you have insight into the genetic basis of a condition, you can develop much more effective treatments,’ he said. ‘For people with acne, it’s so important to have more treatments available.
‘We need to treat people earlier and more effectively, so that they don’t get scars, which last even after the condition has come and gone.’ Scars affects up to 20 per cent of patients.
Writing in the journal Nature Communications, the authors added: ‘Acne can have severe emotional and psychological consequences and has been associated with depression, unemployment, suicidal ideation and suicide itself.
‘The treatment regimes are often ineffective and poorly tolerated, and there remains a substantial unmet medical need.’
The study was a collaboration between Professor Barker’s team and Professor Michael Simpson’s Genomic Medicine Group at King’s College London.
Professor Simpson added: ‘A number of the genetic variants point to interesting mechanisms that could be really good targets for new drugs or treatments that would really help patients.’
The researchers stress there are additional genetic variants related to acne that have not been discovered.
Acne treatment varies depending on how severe the condition is. The NHS advises that if a person has just a few blackheads, whiteheads or spots, that they try over-the-counter creams containing benzoyl peroxide.
Benzoyl peroxide is an antiseptic that reduces the amount of bacteria on the skin, which should lower the number of black and whiteheads.
In more severe cases, topical retinoids may be prescribed, however, these can cause birth defects and should not be taken during pregnancy. Antibiotics may be given alongside creams and gels.
Hormonal therapies have been shown to be effective in women, particularly if their acne relates to their hormones. An example is the controversial drug isotretinoin, which reduces the production of sebum and prevents follicles clogging.
Isotretinoin damages unborn babies, and women are required to sign a form confirming they understand the risk and will use contraception, even if they are not sexually active.
There have also been reports of people experiencing extreme aggression or suicidal thoughts while taking isotretinoin. The NHS stresses, however, there is no evidence these mood changes are the result of the medication.