Virulent Acne Biofilms Offer Insight into Novel Therapeutic Options

Asha Gowda1, *, Craig G. Burkhart2, 3
1 Medical Student, University of Toledo College of Medicine, Toledo, Ohio 43560, USA
2 Clinical Professor, University of Toledo College of Medicine, Toledo, Ohio 43560, USA
3 Clinical Assistant Professor, Ohio University College of Osteopathic Medicine, Athens, Ohio 43560, USA

© 2018 Gowda and Burkhart.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: ( This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Medical Student, University of Toledo College of Medicine, Toledo, 5600 Monroe Street, Suite 106B, Sylvania, OH 43560, USA; Fax: 2489321909; E-mail:


Acne vulgaris is a disease of the pilosebaceous unit that may manifest as either noninflammatory or inflammatory skin lesions. The microcomedone theory suggests that the first step in the pathogenesis of acne vulgaris is the noninflammatory comedone. The comedone is a collection of keratin and sebum that is trapped within the pilosebaceous unit due to hyperproliferation of keratinocytes in the follicular lining. The biofilm produced by P. acnes bacteria promotes the formation of a comedone by acting as a biological glue that prevents expulsion of the hyperkeratotic plug. In addition to its adhesive properties, the biofilm has virulence factors contributing to the pathogenicity of P. acnes in acne vulgaris. With further investigation and a better understanding of the P. acnes biofilm, new therapeutic options for acne vulgaris can be made available. By targeting the P. acnes biofilm, treatment can be made more effective and precise, without the concern of side effects seen in currently available acne medications.

Keywords: Acne, Comedonal acne, Comedone, P. acnes biofilm, Biological glue, Virulence factors.