Acne vulgaris is the most common skin disease in the United States, affecting approximately 50 million Americans. Acne sufferers may experience both physical and psychological effects, including permanent scarring, anxiety, depression and poor self-esteem. The disease is a result of four major pathogenic factors, but the overproduction of the oily/waxy secretions of skin (sebum) may be the most important.
Recent studies support sebum’s critical role in acne and, in particular, its downstream effects on bacterial colonization, inflammation and plugging of the follicle. Based on a review of historical data, regimens that decrease oil production in the skin by 50 percent are predicted to lead to significant reductions in the number of acne lesions following three to four months of treatment. This literature suggests that non-comedogenic skin care products that manage oil and the resulting appearance of shine/sheen are an integral component of the daily skin care regime. Despite the link between sebum and acne severity, none of the current topical prescription products approved by the FDA reduce the production of these excess oils.
One treatment on the horizon for the overproduction of sebum is topical nitric oxide. Produced naturally by the human body, nitric oxide plays an important role in many biological processes in the skin including wound healing and host defense against foreign microorganisms. Recent laboratory findings reveal that nitric oxide-releasing compounds can also reduce sebum production in cultured cells. Approximately 20 percent of oil production was eliminated as early as 24 hours after a single treatment. These results indicate that topical nitric oxide-based drugs hold tremendous promise not only in the treatment of acne, but also in other skin conditions associated with overproduction of oils.
References
Zouboulis, C.C. “Propionibacterium acnes and Sebaceous Lipogenesis: A Love–Hate Relationship?” J. Invest. Dermatol. 2009. 129, 2093–2096. Janiczek-Dolphin, N.; Cook, J.; Thiboutot, D.; Harness, J.; Clucas, A. “Can sebum reduction predict acne outcome?” Br. J. Dermatol. 2010. 163, 683-688.