The relationship between your acne and bacteria
Acne is recognised as a chronic skin condition, affecting millions of people.
Acne appears when skin pores become blocked from the excess sebum produced by sebaceous glands, giving your skin an ‘oily’ appearance.
Dead skin cells and sebum accumulate in your pores and form a plug.
Once the pore is blocked, the build-up causes irritation, and the right conditions for bacteria that normally lives on the skin to thrive.
The body’s immune system then attacks the bacteria, causing the pain and swelling of a pimple.
However, new research suggests the bacterium found in your stomach, Helicobacter Pylori (H. Pylori) is related to acne.
What are H. Pylori?
H. Pylori is a type of bacterium that can live in the lining of the stomach.
The bacterium can cause stomach inflammation (gastritis) and more serious conditions like stomach ulcers and stomach cancer.
More than half of the world’s population is infected with this bacterium.
An estimated 3 in every 10 Australian adults are expected to carry H. Pylori in their stomach bacteria.
Types of Gut Bacteria
There is a specific bacterium in your gut that can create an imbalance in the microbiome of your stomach. This includes:
- Increased Bacteroides: Patients with severe acne show an increased level of Bacteroides in the intestinal tract. This suggests Bacteroides promote inflammation such as redness, clogged pores and excess oils.
- Decreased Firmicutes: A decreased level of Firmicutes in the gut can promote inflammation of the skin.
This specific combination of gut bacteria has been shown to directly contribute to acne development.
New Research
Previous research into the effect of H. Pylori suggested that the bacterium was a key factor in dermatological disorders, such as:
- Chronic hives: Raised, itchy welts on the skin triggered by a reaction to food, medicine or other irritants that last for six weeks or longer.
- Psoriasis: A chronic inflammatory skin condition characterised by red, scaly patches called plaques, often appearing on the elbows, knees and scalp.
- Rosacea: A chronic condition causing sensitive skin, redness, inflammation and sometimes papules (red bumps) or pustules (pus-filled spots), often appearing like acne.
New research published in the Archives of Dermatological Research has shed light on the connection between an H. Pylori infection and acne, particularly severe acne.
This study is supportive of previous studies suggesting that removing H. Pylori could improve acne.
The Method
The study reviewed the presence of H. Pylori in a group of 45 participants with acne, and 45 without acne.
The participants were tested for H. Pylori through a stool antigen test and a blood antigen test. This indicated whether H. Pylori bacterium was present in stools or the blood.
The 45 participants with acne were ranked against the Global Acne Grading System (GAGS) and were classified as either:
- Mild (few pimples and blackheads)
- Moderate (more widespread acne, with some inflamed pimples)
- Severe (large, painful pimples, nodules and scaring)
Key Findings
Participants with acne had a higher likelihood of having an H. Pylori infection with the bacterium present in stool and blood samples.
58% of acne participants tested positive for infection in their stool samples, compared to 20% of participants without acne.
60% of acne participants had H. Pylori antibodies in their blood samples, compared to 31% of participants without acne.
There was a strong link identified between H. Pylori bacterium and acne.
A Closer Investigation
Among the group of 45 participants with acne, those with severe acne had the highest rate of H. Pylori infection.
92% of severe acne participants tested positive for the bacterium in their stool and blood samples.
However, mild acne participants had lower H. Pylori bacterium presence.
25% of mild acne participants tested positive for the bacterium in their stool samples, and 31% in their blood samples.
This suggests that participants with H. Pylori present experience severe acne, and that the bacterium contributes to acne severity.
The Role of H. Pylori in Acne Development
This study supports that H. Pylori has a role in acne.
The bacterium contributes to acne development by causing inflammation and influencing sebum production.
H. Pylori also produces toxins and enzymes, such as lipase, that can further clog skin pores and trigger acne flares.
Further Contributions of H. Pylori in Acne Development
H Pylori can contribute to acne development by affecting other areas of your physical and emotional health.
The most notable impact is its ability to induce system inflammation.
When H. Pylori infects the stomach lining, it triggers an immune response designed to fight off the bacteria; however, this isn’t always localised and can circulate throughout the entire body.
The bacterium is also disruptive to the entire gut microbiome.
This imbalance, called dysbiosis, can compromise the protective nature of your gut and allow toxins to ‘leak’ into your bloodstream.
This is known as ‘leaky gut’ and can play a role in immune dysregulation and chronic inflammation.
The emotional effects of H. Pylori can indirectly contribute to acne development and exacerbation.
Hormones are a major player, particularly androgens, with emerging research suggesting gut health can influence hormone levels.
Living with H. Pylori-induced symptoms can also be stressful, and stress is a well-known acne trigger.
The gut-brain-skin axis highlights how the gut influences mental health, and in turn, skin health.
Treating H. Pylori
H. Pylori is typically treated with a combination of antibiotics and medications to suppress the stomach acid.
Common antibiotics that are used to treat acne, such as Doxycline, Tetracycline and Metronidazole, are also effective in treating H. Pylori.
These antibiotics are a type of tetracyclines (antibiotics), which are prescribed to manage and treat various bacterial infections.
They work by preventing the growth and spread of bacteria.
Talking to Your Dermatologist
There is growing interest among dermatologists in the study of a patient’s gut microbiome and its relationship with acne and other dermatological skin conditions, such as rosacea.
If you are experiencing persistent, severe, and treatment-resistant acne, it is recommended that you talk to your dermatologist to consider testing for and treating H. Pylori bacterium.
Digestive issues, such as stomach ulcers, gastritis or bloating, are also traits indicating the presence of H. Pylori bacterium.
Remember to discuss all potential factors for acne and treatment with your dermatologist.
Conclusion
Treating H. Pylori may be the next ground-breaking approach to treating severe acne.
Patients could see their inflammation reduce, and overall acne symptoms lessen.
While definitive proof that H. Pylori causes acne is yet to be confirmed, this study suggests a strong relationship between digestive and skin health.
Reference: Grada A, Ghannoum MA, Bunick CG. Sarecycline demonstrates clinical effectiveness against staphylococcal infections in inflammatory dermatoses: Evidece for improving antibiotic stewardship in dermatology. Antibiotics (Basel)). 2022; 11(6):722. Doi:10.3390/ antibiotics 1160722 cited in Vidal, S, Menta, N, Friedman, A, To Acne and Beyond: A Review of Sarecycline’s Off-Label Uses. Journal of Drugs in Dermatology. 2024 September; doi:10.36849/JDD/2024.NVRN0924.
