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Akne – når hudens mikrobiom er inflammatorisk og dysbiotisk

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Akne - topbillede til artikel om akne feb 24

 

Af Eva Lydeking, ernæringsterapeut

Forekomst

Akne er et meget hyppigt problem, som rammer 80-85 pct. af unge og yngre voksne, de fleste i let grad, mens i alt ca. ni pct. af verdens befolkning har akne. Akne starter typisk i før-puberteten og er jævnt fordelt i verden hos alle de befolkninger, der spiser ”vestlig kosttype” med forarbejdet og raffineret mad. Akne kan også forekomme med hormonforandringer som graviditet, amning, menopause, ligesom miljøfaktorer, medicin og kemikalier, kan være involveret.

Akne ses som hudorme, papler, pustler, cyster eller knuder i huden, typisk de steder, hvor der er flest talgkirtler: ansigt, opadtil på ryg og bryst.
Akne er multifaktorel og involverer en kombination af genetisk disposition, stress, kostvaner og hormonelle forandringer med rigelig talgproduktion, tilstoppede hårsække, eventuelt pusdannelse og inflammation med rødme og irritation. Der er overvækst af hudbakterien

Cutibacterium Acnes

Mild akne er ikke inflammatorisk og har begrænset udbredelse, mens moderat til svær akne er inflammatorisk og involverer den omliggende hud med rødme og irritation, dannelse af bumser, cyster og knuder i et større område, hvilket kan føre til pigmentforandringer og ardannelse.


Konventionel behandling

Lokalbehandling med benzoylperoxid, retinoider, azelainsyre eller antibiotika har været hovedvinklen på aknebehandling i 50 år. Tabletbehandling med antibiotika eller A- vitaminforbindelser bruges ved svær akne. Langvarig antibiotikabehandling kan bidrage til tarmfloraforstyrrelser, der tager år at rette op på og til resistensudvikling over for antibiotika.

Hvorfor akne? Hudens sammenhæng med bakteriefloraen, kosten og næringsstofferne

 

Cutibacterium aknes (tidligere Propionibacterium aknes, P. aknes) er en normal hudbakterie, der kan blive dominerende, fordi den lever af forøget talgproduktion, og derved opstår inflammation, ophobning af døde hudceller, skader på de raske hudceller, inflammation og irritation, eventuelt pusdannelse.
Den normale bakterieflora på huden bliver dysbiotisk, ligesom det kan ske i tarmen. Der kan dannes biofilm, som hæmmer behandlingseffektivitet.
Der er ofte hormonelle forbindelser til opblussen, fx vækstspurt i puberteten, øget eller svingende mængde af kønshormoner ved menstruation, graviditet (også testosteron hos piger/kvinder) og stress. 

Man ved nu, at akne ikke kun er et lokalt problem i huden, men huden er kroppens største organ, der afspejler mange indre processer, som er relateret til inflammationsstyring, ernæring, stress, tarmflora og livsstil (for meget alkohol, søvnmangel, tobak).


Udviklingen af akne handler om fire faktorer, der skal styres for at bedre hudens tilstand:

 

  1. Øget talgproduktion pga. hormonelle udsving og øget niveau af IGF-1 vækstfaktoren, der provokeres af sukker, stivelse og hvide kulhydrater, samt mælkeprodukter, især valleprotein. Kosten bør styres og tillægges mindst tre gram omega-3, der dæmper IGF1 og inflammation

    2. Overvækst af den normale hudbakterie Cutibacterium acnes på bekostning af andre normale hudbakterier. Probiotika kan hjælpe.

    3. Øget afstødning af hudceller, der tilstopper porerne. Denne del kan påvirkes med omega-3-fedtsyrer, A-D-E-vitaminer og god hudpleje.

    4. Inflammationsstyring. A-D-E-vitaminer, zink, selen, omega-3-fedtsyrer og sund kost af rigtige råvarer og stærk begrænsning af sukker og forarbejdet mad samt tilskud af probiotika og collagen.

Probiotika
Probiotika har brede biologiske virkninger, som i forhold til akne er relevante på følgende områder:

  • Producerer stofskifteprodukter (bacteriociner), der hæmmer overvæksten af C. acnes og af andre biofilmproducerende bakterier, der kan bidrage til resistens hos C. acnes.
  • Forbedrer barrierefunktionerne, både i tarmen og huden.
  • Dæmper inflammation.
  • Modificerer hormonbalancen, dæmper talgproduktionen og øger insulinfølsomheden.

Adskillige probiotikastammer er fundet effektive, både Bifido-og Lactobacillusstammer kan hjælpe i samme størrelsesorden som antibiotika- og endda hjælpe antibiotika til at virke bedre. Effekten har i studier været i størrelsesordenen 30-67 pct. forbedring i løbet af tre måneder.


Collagentilskud fra Engholm NDS

 

Collagen SkinActive og NDS Probiotic SkinAcniX* er begge:

  • Generelt antiinflammatoriske.
  • Bidrager til opheling af læsioner med minimal ardannelse.
  • Forbedrer hudens barrierefunktion.
  • Kan måske mindske bivirkninger af konventionel behandling (antibiotika og retinoider).
  • Har hver deres profil

NDS Probiotic SkinAcniX* med både effektive probiotika-stammer og ekstra af akne-relevante vitaminer-mineraler, hvor SkinActive kan kombineres med probiotika efter behov i de situationer, hvor der er flere samtidige hensyn.

 

Kost og livsstil, der dæmper inflammation og blodsukkerstress

 

Eftersom IGF-1-vækstfaktoren følger insulinniveauet pga. blodsukkerudsving, bør kosten sammensættes, så blodsukkeret holdes jævnt og moderat. Mælkeprodukter er associeret til øget forekomst af akne, da de øger IGF-1-niveauet med valleprotein som den værste komponent.

Hudpleje med probiotika direke på huden
Hudpleje er vigtig. Probiotika kan bruges som ansigtsmaske.  Prøv at opløse probiotika i en smule vand og røre lidt aloe vera-gel i sammen med pulveret fra en kapsel olivenbladsekstrakt.

 

EngholmNDS-produkter til akne

 

Adskillige NDS-probiotika er egnet til at mildne akne og hjælpe med at genoprette både tarmens og hudens mikroflora; de kan kombineres med Collagen Skin Active, multivitamin-mineral og krom ved stor sukkertrang, så det bliver nemmere at ændre kosten.

Nyt produkt, NDS Probiotic SkinAcniX*, er sammensat til at være mere potent, da der også er tilsat de vitaminer og mineraler, som ofte er i underskud ved akne. Kombineres med NDS Olivenbladsekstrakt ved bumser med pusdannelse. Kan understøtte konventionel behandling med antibiotika.

NDS Probiotic SkinAcniX* forventes klar i marts 2024

Referencer:

 

Barnard, Neal D. 2022. nutritionguide.pcrm.org/nutritionguide/view/Nutrition_Guide_for_Clinicians/1342093/all/Akne_Vulgaris.
Baldwin H. Am J Clin Dermatol. 2021 Jan;22(1):55-65

https://www.everand.com/book/544708545/Probiotics-in-The-Prevention-and-Management-of-Human-Diseases-A-Scientific-Perspective

 

Cavallo I. Sci Rep 12, 21104 (2022).

 

Irshad M. JCPSP , 2023, 33 (5), 515-520 

 

Bowe, WP. Gut pathogens, 2011, 3 (1), 1.

 

Knaggs, HE. Int J of cosmetic sci, 2004, 26 (3), 129–138

 

Sánchez-Pellicer, P. Microorganisms ,  2014, 10 (7), 1303

 

Ozuguz P. Cutan Ocul Toxicol. 2014 Jun;33(2):99-102

 

Ohishi T. Med Chem. 2016;15(2):74-90

 

Khayef G.  Lipids Health Dis. 2012 Dec 3;11:165

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