Skin Barrier Parameters in Acne Vulgaris versus Normal Controls: A Cross-Sectional Analytic Study

Data of objective skin barrier parameters in acne patients with and without therapy compared with normal controls are limited. This information could provide more insight into the pathogenesis of acne vulgaris and optimal acne treatment.

To measure and compare skin barrier parameters in a large cohort of acne patients with and without therapy compared with normal controls.

This cross-sectional analytic study was conducted on healthy Thai volunteers. After completing a questionnaire on their general information and skincare routine, volunteers received a full skin examination and were divided into subjects with and without acne. Skin barrier parameters, including the transepidermal water loss (TEWL), skin hydration and sebum production were measured and compared between the two groups. Factors that may affect each parameter were analysed and adjusted for in a multivariate regression analysis. In addition, data from acne patients with and without treatment were evaluated.

The study included 316 volunteers (164 acne patients, 152 controls), mostly female (79% acne, 78% controls). The mean age of the acne group was considerably lower than that of the control group (34 vs 48.6 years (p < 0.001)). Acne patients showed significantly higher TEWL (13.16 vs 10.63 g/m²/day, p < 0.001), sebum production (median 3 vs 0 A.U, p = 0.002), and skin hydration (244.60 vs 222.60 uS, p = 0.001). These differences remained significant after adjusting for confounding factors. Additionally, significant differences were observed between controls, acne. Patients receiving and not receiving acne medications. The highest TEWL was observed in acne patients receiving treatment, followed by untreated acne patients and normal controls (p = 0.0003). Skin hydration exhibited a comparable pattern (p = 0.03).

There were significantly higher TEWL, sebum production and hydration in acne patients. Acne treatment further impaired the skin barrier. These findings support the possible benefits of moisturisers with barrier-enhancing properties in patients receiving acne medications.