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As you probably know, acne goes hand in hand with a problem of sebum quantity, and mainly affects oily skin. There is no acne without hyperseborrhea, i.e. excessive sebum production.
While acne is obviously associated with excess sebum, it's not the only factor. Discovered only a few years ago by leading acne specialists, dysseborrhea is a change in the quality of sebum found specifically in acne sufferers.
An essential discovery that is changing the therapeutic approach to acne. What exactly is sebum, and what are the sebum composition problems that can explain acne?
A substance naturally secreted by the human body, sebum is essentially composed of lipids from the sebaceous glands: triglycerides, wax esters, squalene (12%), cholesterol esters and fatty acids.
Sebum is often blamed for blemishes and unwanted shine, yet it is essential to skin balance. Sebum is part of the skin's hydrolipidic film. It is responsible for maintaining skin hydration and protection, preserving the cutaneous microbiota and limiting the development of pathogenic agents.
So it's a good idea to keep it that way, even if it's sometimes necessary to control excesses...
A study* of 914 patients* showed :
On the other hand, sebum reduction and acne lesion reduction are correlated. A 30-50% reduction in sebum production is required to achieve a 50% reduction in acne lesions. So there's no acne without an increase in sebum.
Les peaux acnéiques se distinguent par un sébum de mauvaise qualité, avec notamment un déficit en vitamine E, la vitamine qui protège les lipides du sébum contre l’oxydation. A cause de ce manque de vitamine E, la composition du sébum des peaux acnéiques est altérée avec une oxydation du squalène. Le sébum est comédogène et très irritant. Mais ce n’est pas tout.
La vitamine E est l’anti-oxydant naturel du sébum. Or, des recherches récentes ont pu mettre en évidence une corrélation entre un taux bas de vitamine E dans le plasma sanguin et l’importance des imperfections.
Researchers discovered that fatty acids prevented the skin from playing its barrier role properly, leading to increased insensible water loss (IWL). As a result, acne-prone skin is naturally more dehydrated than healthy skin.
The weakened barrier function sustains an inflammatory state, making the skin more susceptible to redness and irritation. The sensitivity of acne-prone skin can be further aggravated by aggressive anti-acne treatments, particularly those with a keratolytic effect (Adapalene, PBO...).
