Acne is a common skin condition that affects millions of people globally. Inflammatory acne is a type of acne that involves red, swollen, sore bumps that contain pus, dead skin cells, and excess oil (sebum). It’s caused by bacteria growing in and infecting clogged pores, triggering the body’s immune system to spring into action and fight off the infection. [1]

Inflammatory acne is closely linked to inflammation and the health of the skin barrier. One of the key contributors to inflammatory acne is what’s known as the “acne inflammasome”, a complex biological system within our skin. In this blog, we will explore the connection between acne, inflammation, and the skin barrier, providing valuable insights into effective treatment approaches for managing an activated acne inflammasome and some practical tips on how to reduce its likelihood of being activated in the first place.

What is the acne inflammasome?

The acne inflammasome plays a significant role in the development of acne lesions (pimples and pustules) due to its activation of an inflammatory response within the skin. When the acne inflammasome is “activated”, it releases pro-inflammatory molecules that promote inflammation, stimulate excess oil (sebum) production in the skin, and disrupt the normal shedding of skin cells. This biological perfect storm leads to clogged pores, excessive growth of acne-causing bacteria within the clogged pores, and the formation of painful, unsightly, puss-filled pimples. [2]

Think of the acne inflammasome as a fire alarm system in your skin, and the pro-inflammatory molecules as fire fighters. Once the fire alarm system is activated, the fire fighters send signals via the body’s immune system to recruit infection-fighting immune cells and increase blood flow to the affected area. This results in inflammation, redness, swelling, pimples, and PAIN!

The acne inflammasome is “activated” in response to various triggers such as excess oil production by the skin, uncontrolled growth of acne-causing bacteria, and disruption of the normal skin cell shedding process. The excess oil and dead skin cells lead to clogged pores being formed at the base of one’s hair follicles which become filled with bacteria and puss resulting in the formation of red, swollen, and painful pimples and pustules. As though the mere presence of unsightly red blemishes and bumps on your face is not bad enough, the acne inflammasome makes the situation worse by making them painful to boot!

Does the acne inflammasome effect the skin barrier?

The acne inflammasome can also negatively affect the skin barrier by compromising its health, function, and integrity. The skin barrier serves as a protective barrier that keeps external irritants (bacteria and viruses) out, and water in.

When the acne inflammasome (fire alarm) is activated, the constant inflammation and immune cell activity caused by the body’s pro-inflammatory molecules (fire fighters) can compromise the skin barrier and negatively affect its ability to do its job in protecting your body.

What’s more, when people try to get rid of the oiliness and pimples on their skin by using harsh cleansers, acne medication, and acids, they end up doing even more damage to their skin barrier which further intensifies the inflammation they experience. This damage can take the form of red, irritated bumps that people often confuse with acne/pimples (which they are not), causing them to apply more skin-drying products that further compromise their skin barrier – a truly vicious cycle.

To further bring this point home, a compromised skin barrier can manifest in several ways including:

1. Increased Transepidermal Water Loss (TEWL): A compromised skin barrier can cause water/moisture to evaporate from the skin more easily, leading to dryness and dehydration.
2. Impaired Barrier Function: The inflammation associated with activation of the acne inflammasome can also weaken the skin barrier to the point of making it more permeable (porous). This increased permeability allows external irritants, allergens, and bacteria to penetrate the skin more easily, leading to further inflammation and potential skin damage.
3. Delayed Healing: A compromised skin barrier can hinder skin’s natural healing process. Acne lesions may take longer to heal and may be more prone to infection and scarring.

By repairing and supporting your skin barrier with effective, clinically proven, microbiome-friendly products like ANTU® REFRESHING GEL CLEANSER, a daily use cleanser with moisture-locking ingredients that protect your skin from prematurely drying out, together with the award winning ANTU® SKIN BARRIER SERUM for repairing a compromised skin barrier, and ANTU® SKIN BARRIER MOISTURIZER, a daily use skin barrier strengthening moisturizer, both of which contain a potent combination of plant-derived antioxidants and actives (our patented AntuComplex®) plus powerful hydrating ingredients like hyaluronic acid, your skin barrier will be “repaired and prepared” to deal with acne, and its kissing cousin, inflammation.

Can an activated acne inflammasome be treated?

The short answer is yes and involves following certain tried-and-true strategies including:

1. Gentle Cleansing: Start by using a gentle cleanser twice a day to gently remove excess oil, dirt, and bacteria. Cleansers specifically formulated for oily, sensitive skin like the oil-free, micellar water-based SHAANT® BALANCING FOAMING CLEANSER and SHAANT® BALANCING REFINING TONER with poly-hydroxy acids to help reduce the appearance of redness and enlarged pores are excellent choices. Be sure to avoid harsh scrubbing or using abrasive products as these can further irritate the skin and worsen inflammation.
2. Topical Treatments: Consider using topical treatments that target inflammation and acne. Ingredients such as benzoyl peroxide, salicylic acid, and retinoids can help reduce inflammation, unclog pores, and calm an activated acne inflammasome. For example, the SHAANT® SPOT HERO with 5% colloidal sulfur, fruit acids, and green tea extract can be used to gently, but effectively, shrink pimples and reduce redness within 24 hours after use.
3. Moisturization: Maintaining a well-hydrated skin barrier is essential, in general, but especially when it comes to managing the acne inflammasome since inflammation is notorious for drying out skin. Look for moisturizers that contain ingredients that help draw moisture into the skin like hyaluronic acid to restore and reinforce the skin barrier like the SHAANT® BALANCING OIL CONTROL CREAM with Bakuchiol (Mother Nature’s retinol) to hydrate and calm skin that’s been irritated by the acne inflammasome.
4. Professional Intervention: In severe cases, consult a dermatologist who can provide further guidance and prescribe appropriate medications or procedures to manage acne and inflammation effectively. This might involve the use of oral antibiotics, topical corticosteroids, or in-office treatments like chemical peels or laser therapy.

Can activation of the acne inflammasome be avoided?

Consistency and discipline are important if you want to steer clear of the acne inflammasome. Strategies to be used include:

1. Maintain a Consistent Skincare Routine: Develop a skincare routine tailored to your specific skin type and concerns. Cleanse your face twice a day, exfoliate gently to remove dead skin, and moisturize regularly to keep your skin balanced and prevent excess oil production. The SHAANT® OILY, ACNE-PRONE SKIN SET might just be the “consistent” skincare routine your skin’s been needing to combat acne and inflammation. With its revolutionary, patented, ShaantComplex® technology, which was specifically designed to help those with oily, acne-prone skin avoid activation of the acne inflammasome, the set will help reduce oiliness, purify pores, shed dead skin cells, and reduce redness. How can we be so sure? Because we have the clinical data to prove it!
2. Choose Suitable Skincare Products: By “suitable” we mean those that are non-comedogenic and non-acnegenic, i.e., oil-free and won’t clog your pores. As an FYI, the entire SHAANT® COLLECTION clearly (pun intended) qualifies as non-comedogenic/non-acnegenic.
3. Avoid Harsh Ingredients: Steer clear of harsh ingredients including alcohol, perfumes, and sulfates as they can strip the skin of moisture and disrupt its natural balance. These ingredients can trigger inflammation and activate the acne inflammasome. Yet another “harsh ingredient” that needs to be called out is benzoyl peroxide. While this ingredient’s ability to eliminate acne-causing bacteria and shrink pimples is well documented, because benzoyl peroxide is an oxidant (a highly reactive molecule) it also kills skin cells when topically applied, thereby degrading the skin barrier. This phenomenon can lead to formation of a skin rash that may include itchy, red, swollen, blistered or peeling skin. And, in addition to damaging the skin barrier, benzoyl peroxide also results in a reduction in microbial diversity which negatively impacts the skin microbiome based on recent findings from a study published in Dermatologic Therapy. [3] A gentler alternative to benzoyl peroxide-based acne products is the above-mentioned SHAANT® SPOT HERO with 5% colloidal sulfur, fruit acids, and green tea extract which gently, but effectively, shrinks pimples and reduces redness within 24 hours after use.
4. Hands Off Approach: Avoid picking, popping, or squeezing acne lesions (pimples/pustules) as this can introduce more bacteria into the already affected area and further worsen inflammation. In addition, frequently touching your face can transfer dirt and bacteria from your fingers onto your skin, thereby further increasing the likelihood of acne formation and inflammasome activation.
5. Healthy Lifestyle Habits: Maintain a healthy lifestyle by adopting habits that promote overall skin health. This includes eating a balanced diet rich in fruits and vegetables, staying hydrated, getting sufficient sleep, managing stress, and avoiding excessive sun exposure. And, to help get you on the path to clearer, de-stressed skin you may also want to incorporate the use of daily supplements specifically formulated to achieve that goal into your healthy lifestyle routine like SHAANT® SKIN DE-STRESS DIETARY SUPPLEMENT and in SHAANT® CLEAR SKIN DIETARY SUPPLEMENT that introduce good bacteria into your skin’s microbiome.

Conclusion.

Understanding the connection between acne, inflammation, and the skin barrier is crucial for effectively managing and preventing acne breakouts. By adopting a comprehensive approach that includes gentle cleansing, targeted treatments, soothing ingredients, and a goal-oriented skincare routine, it’s possible to alleviate acne and inflammation with a healthy skin barrier. Additionally, implementing preventive measures such as choosing suitable products that are oil-reducing, inflammation-calming, and microbiome-friendly like those in our SHAANT® COLLECTION and maintaining a healthy lifestyle can help reduce the occurrence of acne inflammasome-related breakouts. Remember, consistency and patience are key when dealing with acne, and seeking professional advice can provide further guidance for even more personalized treatment.

And, to help you monitor the progress your chosen products/solutions are making in addressing your acne inflammasome-related issues (painful, red pimples), you may want to take advantage of Codex’s newest acne-fighting tool, DERMSCORE™, an AI-powered, mobile phone operated skin analyzer that will help you keep track of the progress being made on your pimples/pustules. And because it’s FREE to use you literally have nothing to lose, and only valuable insight and information to gain!

References:

1. https://my.clevelandclinic.org/health/diseases/22765-inflammatory-acne
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9263782/
3. https://www.dermatologyadvisor.com/home/topics/acne/bpo-can-damage-epidermal-barrier-and-microbial-diversity-while-treating-acne/#:~:text=Benzoyl%20Peroxide%20Can%20Damage%20Epidermal%20Barrier%20and%20Microbial%20Diversity%20While%20Treating%20Acne,-Dermatology%20Advisor%20Contributing&text=Although%20benzoyl%20peroxide%20(BPO)%20can,study%20published%20in%20Dermatologic%20Therapy