Acne and Cutibacterium Acnes: Are they always bad?

Cutibacterium acnes – perhaps you’ve heard of it, or you may know it by its old name, Propionibacterium acnes. This bacteria plays a leading role in one of the most common skin problems in the world: acne. Yes, those annoying pimples, blackheads and inflammations that almost everyone experiences, are often associated with this tiny inhabitant of your skin. But before you think that C. acnes is only bad news, it’s good to know that the story is a bit more complex.

This bacteria can actually be both a friend and an enemy, depending on your skin’s balance. Therefore, let’s take a look at Cutibacterium acnes and exactly what this bacterium does – and how you can deal with it for healthier skin. But is this bacterium actually a friend or an enemy to your skin? What exactly is the role of this bacteria, the different subspecies, and how do they affect your skin health?

What is Cutibacterium Acnes?

Cutibacterium acnes (C. acnes) is a bacterium that naturally occurs in the sebaceous glands of your skin. It is part of the skin microbiome, the collection of microorganisms that live on and in your skin. This bacterium feeds on sebum (skin oil) and grows mainly in a low-oxygen environment, such as deep within your pores. But is this bacterium a friend or foe to your skin, or is it better to fight it as much as possible? The answer lies somewhere in the middle. C. acnes can be both a friend and an enemy, depending on the circumstances and the balance in your skin microbiome.

The Two Faces of Cutibacterium Acnes

C. Acnes as a Friend

C. acnes is not necessarily bad. In fact, it plays a crucial role in keeping your skin healthy:

• Protection against harmful bacteria: C. acnes helps in maintaining the acidity level of your skin, which keeps harmful bacteria at bay.
• Support of the skin barrier: The skin microbiome, which C. acnes is a part of, contributes to a healthy skin barrier.

C. Acnes as Enemy

When the balance is disturbed, however, C. acnes can cause problems:

• Inflammation and acne: An overgrowth of C. acnes, often due to an excess of sebum production, can lead to inflammation and acne. The bacteria produce enzymes that irritate the skin and clog pores.
• Formation of blackheads and pimples: C. acnes can combine with dead skin cells and sebum to create clogged pores, resulting in blackheads and pimples.

The Different Subspecies of Cutibacterium Acnes

C. acnes is not just one type of bacteria; it is a collection of different “subspecies” – think variants of the same bacteria that have minor differences amongst themselves. These subspecies each play their own role in your skin’s health. Some can help protect your skin, while others can cause inflammation and acne. The main subspecies are:

1. Cutibacterium acnes subsp. acnes (Type I)

This subspecies is most associated with acne and inflammation. It has the following characteristics:

Causes inflammation: Type I, one of the variants of C. acnes, produces enzymes such as lipases and proteases. These enzymes are actually little “scissors” that break down certain substances in your skin. For example, lipases break down sebum (skin fat), while proteases break down proteins in the skin barrier. Unfortunately, this process can damage your skin barrier and cause inflammation, leading to redness, swelling, and pimples. It’s as if this bacterium is a kind of demolition team that throws everything off balance, and that’s exactly why type I is often seen as the “culprit” in acne.

Thrives in numerous environments: This subspecies flourishes in pores that are clogged with sebum and dead skin cells.

Genetic Diversity: Within type I of Cutibacterium acnes there is a genetic diversity, which means that there isn’t one sort of type I, but multiple “strains” – small variations of the same bacteria, such as type 1A1, 1A2, 1B, and 1C. These strains can differ amongst each other in how they behave and how they affect the skin. For example, some strains are more aggressive and cause more inflammation, while other strains are milder and cause less damage.

Type IA1: The “Culprit”

• Behavior: IA1 is the most aggressive strain within type I. It is often found in people with severe acne and strongly promotes inflammation.
• Why?: This strain produces enzymes such as lipases and proteases that damage the skin barrier and cause inflammation. It thrives well in oily, clogged pores, which gives it an ideal environment to grow.
• Example: IA1 is often associated with cystic acne or deep, painful pimples.

Type IA2: The “Milder Variant”

• Behavior: IA2 is a milder version of IA1. It can still contribute to acne, but less often causes severe inflammation.
• Why?: Although it promotes inflammation, IA2 produces fewer harmful substances than IA1. It’s like a quieter family member who occasionally causes problems, but not as extreme as IA1.
• Example: This strain is often found in mild to moderate acne, such as blackheads and small pimples.

Type IB: The “Intermediate Form”

• Behavior: IB seems to play an intermediary role. It is sometimes found with acne, but it is not as strong an inflammation promoter as IA1.
• Why?: IB has less aggressive properties and appears to be less involved in causing severe inflammation. It’s like a family member who participates occasionally, but does not play the main role.
• Example: This strain is often found in people with a mixed skin type, where acne alternates with calm periods.

Type IC: The “neutral player”

• Behavior: IC is less well-studied, but seems to be associated with acne less frequently than IA1 and IA2.
• Why?: IC may have a neutral role and less frequently causes inflammation. It seems less involved in causing pimples.
• Example: This strain is often found in people with healthy skin or mild skin problems.

2. Cutibacterium acnes subsp. defendens (Type II)

Type II is often seen as the “good” variant of Cutibacterium acnes, and not without reason. This subspecies has a number of properties that could actually help your skin rather than harm it. Let’s take a look at what makes Type II so special:

Protective function: Type II acts like a sort of bodyguard for your skin. It produces substances that combat harmful bacteria, such as Staphylococcus aureus. This helps to prevent infections and inflammations, keeping your skin healthy. It’s as if type II has a natural defense system that protects your skin from intruders.

Less inflammation promoting: Contrary to type I, which is often associated with acne and inflammation, type II is much milder. It produces fewer of the enzymes and substances that irritate the skin, thus causing less pimples and redness. This makes type II a key player in maintaining a calm, healthy skin.

Supports the skin microbiome: Type II contributes to a balanced skin microbiome, the community of microorganisms that live on and in your skin. It helps to keep the pH of the skin at a healthy level and supports the skin barrier, thereby better retaining moisture and warding off external irritants. It’s like a team player ensuring everything runs smoothly.

3. Cutibacterium acnes subsp. elongatum (Type III)

Type III is still a bit of a mystery compared to type I and II, but what we do know is that it occupies a sort of intermediate position. It does not seem to be as involved in acne as type I, but it also does not have the same protective properties as type II.

What is known about this type III:

Less associated with acne: Type III is less often found in areas where acne frequently occurs, such as the face, chest, and back. This suggests that it is less involved in causing pimples and inflammation. Therefore, it seems to not play a major role in acne, which in itself is good news.

Possible neutral role: At the moment, type III seems to play mainly a neutral role. It does not have strong inflammation-promoting properties like type I, but it also does not seem to have the same protective functions as type II. It’s a bit like an extra in a movie – it’s there, but it does not play the leading role. However, more research is needed to understand exactly what type III does and how it contributes to the skin microbiome.

How does C. Acnes affect Acne?

Acne is a complex skin problem that usually arises from a combination of different factors. It is not just one thing that is the culprit, but an interplay of processes that reinforce each other. Let’s take a closer look at these factors:

Excessive Sebum Production

One of the main causes of acne is an overactive sebum production. Hormonal fluctuations – for example during puberty, menstrual cycle or pregnancy – can stimulate the sebaceous glands to produce more sebum (skin fat). This excess sebum creates an ideal environment for Cutibacterium acnes (C. acnes) to grow. It’s as if the bacteria is being offered a party in a fatty, nutrient-rich environment.

Clogging of pores

In addition to excess sebum, dead skin cells play a major role. Normally, your skin regenerates itself by shedding old cells, but sometimes these cells stick and mix with sebum. This mixture accumulates in the pores, causing them to become clogged. These blockages, also known as comedones, are the perfect breeding ground for C. acnes. The bacteria thrives well in this oxygen-poor environment and starts to multiply quickly.

Inflammatory Response

When C. acnes multiplies, it activates the immune system. The bacterium produces substances that irritate the skin, causing the immune system to respond. This leads to an inflammatory response, which manifests as redness, swelling, and painful pimples. It’s as if your skin is sounding an alarm and trying to combat the intruder, but in doing so, it inflicts damage on itself.

How do these factors work together?

It often starts with an overproduction of sebum, followed by clogged pores. This gives C. acnes the chance to multiply, which then provokes an inflammatory response. The result? Acne in all its forms: from blackheads and pimples to cystic acne. It’s a chain reaction where each step reinforces the next.

New Research on C. Acnes 

In the background, scientists are collecting new insights and research data on Cutibacterium acnes and its subspecies. Here are some interesting developments:

1. Stem-specific Treatments

Strain-specific treatments are a new and promising approach in the fight against acne. Instead of targeting all bacteria on the skin, these treatments specifically target the most inflammation-promoting strains of Cutibacterium acnes (C. acnes), such as type IA1. This strain is known for its aggressive behavior: it causes inflammation, damages the skin barrier, and contributes to severe acne. By only targeting these “culprits”, researchers hope to treat acne more effectively, without disturbing the “good” bacteria on the skin.

Why is this important?

Traditional acne treatments, such as antibiotics or benzoyl peroxide, often work broadly: they tackle all bacteria on the skin, both the bad and the good. Although this is sometimes effective, it can also lead to unpleasant side effects. Think of a disrupted microbiome of the skin or intestines when you take it or even resistance to antibiotics. Strain-specific treatments are much more targeted: they only focus on the strains that cause acne, such as IA1, and leave the good bacteria alone. This maintains the balance on the skin and minimizes side effects.

2. The use of bacteriophages

Bacteriophages, often shortened to phages, are a special type of viruses. But don’t worry – these viruses are not harmful to humans. On the contrary, they can be very useful! Bacteriophages have one specific task: they attack bacteria. And not just any bacteria, but very specific types. This makes them a promising weapon in the fight against acne, especially when it comes to combating the most inflammation-promoting strains of Cutibacterium acnes (C. acnes), such as type IA1.

How do bacteriophages work?

Bacteriophages are like small “hitmen” that only go after their specific target. In this case, that would be the harmful strains of C. acnes, such as type IA1. This is how it works:

1. Recognition: A bacteriophage recognizes a specific bacterium (for example, C. acnes type IA1) and attaches to it.
2. Infection: The phage penetrates the bacterium and uses it as a kind of factory to multiply itself.
3. Destruction: Eventually, the bacterium bursts open, releasing new phages that seek out more bacteria to attack.

The beautiful thing is that bacteriophages only attack the bacteria for which they are programmed. This means that they leave the “good” bacteria on your skin, such as the beneficial subspecies of C. acnes (for example, type II), alone.

Why is this important?

The use of bacteriophages can revolutionize the treatment of acne, and this is why:

1. Approach Towards Dishes

Traditional acne treatments, such as antibiotics, often tackle all bacteria on the skin – both bad and good. This can lead to a disrupted skin microbiome, which can cause new skin problems. Bacteriophages are much more targeted: they only attack harmful strains of C. acnes, such as type IA1, and leave the good bacteria alone. This helps to maintain the natural balance of your skin.

2. Fewer side effects

Because bacteriophages only attack specific bacteria, they are much gentler on your skin than, for example, antibiotics. This means less risk of side effects such as dryness, irritation or resistance to antibiotics.

3. New Hope for Severe Acne

For people with severe acne, such as cystic acne, bacteriophages can provide an effective solution. They specifically target the most inflammatory strains, which can lead to faster and more effective treatment.

4. A possible permanent solution

Bacteriophages can multiply as long as harmful bacteria are present. This means they can work for a long time without you constantly needing new treatments.

FAQ: About C. Acnes

Can I determine which subspecies are present on my skin?

Without professional tests, it’s hard to know which subspecies of C. acnes are present on your skin. If you have severe acne, a dermatologist can help you to investigate this.

Can I completely eradicate C. acnes?

No, and that is not desirable either. C. acnes is a natural part of the skin microbiome. The goal is to restore the balance, not to completely eliminate the bacteria.

Why does C. acnes cause acne in one person and not in another?

This has to do with the balance of your skin microbiome and the specific strains of C. acnes present on your skin. Some strains, such as type IA1, promote inflammation and cause acne, while other strains, such as type II, are actually protective. Factors such as sebum production, hormones, and lifestyle also play a role.

How can I promote the growth of “good” C. acnes strains?

You can support the growth of beneficial strains, such as type II, by:

• Use pH-balanced products that respect the natural acidity of your skin. A pH of 5 is the ideal value for your skin – it helps to keep the skin barrier strong, keep harmful bacteria at bay, and support the growth of good bacteria. At Iconic Elements all our products are tuned to this perfect pH value, so your skin remains healthy, balanced, and radiant. 
• Probiotic skincare to try, which supports good bacteria.
• Anti-inflammatory ingredients such as niacinamide or green tea extract to use.
• Maintain a healthy lifestyle with a balanced diet and adequate hydration.

Can stress worsen acne?

Yes, stress can exacerbate acne. It increases the production of cortisol, a hormone that can stimulate the sebaceous glands and exacerbate inflammation. This can promote the growth of harmful strains such as IA1 and disrupt the balance in the skin microbiome.

Are there other microorganisms that cause acne?

Yes, bacteria such as Staphylococcus Aureus, Staphylococcus epidermidis, Streptococcus agalactiae, Klebsiella Pneumoniae and Malassezia folliculitis is a yeast, cause inflammation that can resemble acne. Also known as fungal-acne.

In other words

Cutibacterium acnes is a fascinating bacterium with several subspecies, each playing a unique role in skin health. By maintaining a balanced skincare routine, a healthy lifestyle, and possibly professional advice, you can ensure that the “good” subspecies prevail. Stay curious and continue learning about your skin – after all, it’s your largest organ!

Now that you’re here

We have a special page full of useful information and tips! Here you will find everything you need to know, such as:

• What exactly is acne?
• What are the causes of acne?
• How do you recognize acne?
• How do you treat skin with acne?
• Helpful tips if you have acne
• The best products to take care of your skin with acne

Whether you’re looking for answers, advice, or the right products, we’re happy to guide you towards healthier, radiant skin. Click here to go to our acne page and discover everything you need to know! 

Want to know even more about acne? Check out all our blogs about acne!

Are you looking for comprehensive information, practical tips, and the latest insights about acne? We have collected all our acne-related blogs for you in one place.

Click here and discover everything you need to know about acne: from causes and treatments to skincare and lifestyle tips.