New insights into acne pathogenesis: Exploring the role of acne-associated microbial populations

Acne vulgaris, a prevalent disorder of the skin, is found to increase the incidence of suicidal ideation in acne patients (∼7.1%). This creates a dilemma in the mind whether acne is a life threatening disease among humans. The main inducer for this multifactorial disease is microbial fluctuation of common resident microbes on the skin with each microbe possessing their own purpose and style in protecting the human body. For acne progression, the microbial population has to get around the defense barriers of the host skin and be able to also resist them in order to survive. These matters have been resolved by their pathogenic lifecycle and associated virulence factors coded within their pathogenic islands in the single circular chromosome. This review addresses the different microbial populations residing in acne lesions and promoting acne by emphasizing their pathogenic mechanisms and the genes associated with virulence factors involved in the development of acne. Model systems such as animal models and cell culture models in studying the pathogenic lifestyle of the microbes are also addressed.