Acne is a worldwide problem that affects 80% of the population during adolescence. And, unfortunately, for many of us (like me), this struggle does not end up with adolescence but extends into our adulthood, persisting as a daily challenge that affects our lives, and if you have dark skin, then that struggle doubles up because then you will suffer from hyperpigmentation and dark spots that can last for over a whole year!
So, when the conventional treatments for acne fail, the need calls for more innovative approaches and new treatments that might prove to be effective, such as lactoferrin. Phages too might be an effective way to fight acne, and this is what we will look into in this article.
What Are Phages?
Phages, or bacteriophages, are viruses that infect bacteria. The term bacteriophage, if we take it literally, then we find that it means a bacteria eater, and that is because bacteriophages destroy their host, which is the bacteria.
Bacteriophages have been used for many purposes, such as the detection and removal of pathogenic bacteria from wastewater. One of those uses, the one that concerns us most, actually, is its use for the treatment of bacterial infection.
General Uses of Phages
Phage therapy has a wide range of applications aside from the prospect of using them for treating bacterial infections. For example, phage therapy is used in the food industry to fight the bacteria that infect and ruin food and sometimes even cause food poisoning, such as:
E. Coli
Salmonella
Mycobacterium tuberculosis
Listeria
Pseudomonas
Campylobacter
They are also added to processed food, sometimes with the goal of preventing bacterial growth.
The applications of phage therapy do not stop here; it is used to kill the bacteria in sewage water and also as part of disinfectant and surface cleaning products that are aimed at killing bacteria.
Do Phages Help With Acne?
To answer this question, we must take a look at the nature of acne. The causes of acne are many, and usually it is a combination of more than just one factor. Excessive production of sebum and clogged pores, hormones, and abnormal production of keratin. Bacteria are among the main causes of acne.
Bacteria increase the severity of the inflammatory lesions in acne and contribute to it. With puberty, the number of bacteria on your skin increases, and those are represented by:
Cutibacterium acnes
Corynebacterium granulosum
Staphylococcus epidermidis
That is why, among the most common treatments of acne, we find a persistent presence of antimicrobial agents, both oral and topical, such as clindamycin, doxycycline, minocycline, erythromycin, and azithromycin.
Why Phages?
So you might be asking, why would we consider something like phages when we have antibiotics? The answer is simple: antimicrobial resistance.
Antibiotic resistance in acne is an old thing; it was noted and observed since 1970. And nowadays it represents a major concern for dermatologists around the world.
So, there is a call for novel treatments that target the bacteria involved in acne efficiently. Bacteriophages are among those novel treatments alongside other approaches such as probiotics, natural or synthetic peptides, and antibacterial agents that work around the bacterial resistance to conventional treatments.
In that sense, bacteriophages offer a good approach for reducing the bacteria related to acne. Studies already show positive and promising results, but using bacteriophages for acne is still a new path (as of now) that requires more investigation and studying before we get to the point where it is prescribed and used for this specific purpose.
Pros and Cons of Using Phages for Acne Treatment
Like any other treatment out there, phage therapy too has its pros and cons.
Pros of Using Phage Therapy for Acne
An alternative option for when there is antimicrobial resistance.
Absence of cross-resistance between different antimicrobial agents, a problem that we encounter when bacteria become resistant to one drug.
Phages have little chance of causing resistance themselves.
Automatic dosing, phage concentration tends to increase in the regions where there is a higher concentration of bacteria.
Selectivity.
Relatively cheap.
Cons of Phage Therapy
The antibacterial spectrum might be narrow.
There is a low chance of triggering the immune system and causing an allergic reaction.
We need more research on the subject.
Introducing this into the field poses the biggest challenge.
While phages offer a way to circumvent the effect of antimicrobial resistance, they have a small chance of causing it themselves.
Is Phage Therapy Approved In The US?
So far, phage therapy is not approved for use in the US or Europe, although there have been some experiments. That is because we need more research into this matter.
However, there is a case of an old man in California who was infected with a resistant bacterium called Acinetobacter baumannii and was being treated with antibiotics for a whole three months with no outcome whatsoever. After which his doctors decided to give him phages, which cured the infection.
The Takeaway
One of the most important causes of acne is the accumulation of harmful bacteria within the skin pores. Treatment with antimicrobial agents is one of the standard treatments for acne, but one that happens to fail sometimes due to antimicrobial resistance. Phage therapy is a novel treatment that uses bacteriophages in treating bacterial infections and which so far has shown promising results for use in acne treatment.
References and Citations
Aslan Kayiran, M., Karadag, A. S., Al-Khuzaei, S., Chen, W., & Parish, L. C. (2020). Antibiotic Resistance in Acne: Mechanisms, Complications and Management. American journal of clinical dermatology, 21(6), 813–819. https://doi.org/10.1007/s40257-020-00556-6
Loc-Carrillo, C., & Abedon, S. T. (2011). Pros and cons of phage therapy. Bacteriophage, 1(2), 111–114. https://doi.org/10.4161/bact.1.2.14590
https://my.clevelandclinic.org/health/diseases/22468-pimples#symptoms-and-causes
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