A Honey Trap for the Treatment of Acne: Manipulating the Follicular Microenvironment to ControlPropionibacterium acnes

Abstract

Today, as 40 years ago, we still rely on a limited number of antibiotics and benzoyl peroxide to treat inflammatory acne. An alternative way of suppressing the growth of Propionibacterium acnes is to target the environment in which it thrives. We conjecture that P. acnes colonises a relatively “extreme” habitat especially in relation to the availability of water and possibly related factors such as ionic strength and osmolarity. We hypothesise that the limiting “nutrient” within pilosebaceous follicles is water since native sebum as secreted by the sebaceous gland contains none. An aqueous component must be available within colonised follicles, and water may be a major factor determining which follicles can sustain microbial populations. One way of preventing microbial growth is to reduce the water activity (a w) of this component with a biocompatible solute of very high water solubility. For the method to work effectively, the solute must be small, easily diffusible, and minimally soluble in sebaceous lipids. Xylose and sucrose, which fulfil these criteria, are nonfermentable by P. acnes and have been used to reduce water activity and hence bacterial colonisation of wounds. A new follicularly targeted topical treatment for acne based on this approach should be well tolerated and highly effective.

Skin microbiome and acne vulgaris: Staphylococcus, a new actor in acne

“…To date, the role of S. epidermidis in acne remains to be elucidated, while the role of Propionibacteria in the development of acne lesions is considered as predominant with a great majority of acne treatments continuing to target this bacterial genus exclusively, using their antibacterial effects as a main argument …”

A Precision Microbiome Approach Using Sucrose for Selective Augmentation of Staphylococcus epidermidis Fermentation against Propionibacterium acnes

“…Unlike glucose and glycerol, which are endogenous metabolites in human skin, sucrose (C 12 H 22 O 11 )—a disaccharide combination of glucose and fructose sugars—is found naturally in many fruits and vegetables. It has been documented that sucrose is nonfermentable by P. acnes , and it has been used to reduce water activity and hence bacterial colonization of wounds [9]. …”

Honey, a Gift from Nature to Health and Beauty: A Review

“…They are used to prevent and treat dry skin, and, on top of that, they can also keep the skin supple and enhance the natural barrier function of the skin (Eady et al 2013). Several different formulations of moisturizers include barrier cream, emollients, lotions and ointment.…”

“…Past research found out that honey can be used as a moisturizer for the skin. The ability of honey to act as a moisturizer comes from its natural humectant properties (Eady et al 2013). Though, the exact mechanism is unknown, it is believed that the humectant property is contributed by the high content of glucose and fructose in honey.…”