A Honey Trap for the Treatment of Acne: Manipulating the Follicular Microenvironment to Control Propionibacterium Acnes

The document discusses the limitations of current acne treatments, which primarily rely on antibiotics and benzoyl peroxide, and proposes an alternative method to suppress the growth of Propionibacterium acnes by manipulating the follicular microenvironment. The authors suggest that the key limiting factor for P. acnes colonization in pilosebaceous follicles is the availability of water, as sebum does not contain water. They hypothesize that reducing the water activity in the follicles with a biocompatible solute that is highly water-soluble, small, easily diffusible, and minimally soluble in sebaceous lipids could prevent microbial growth. Xylose and sucrose are identified as potential solutes that meet these criteria and have been used to reduce bacterial colonization in wounds. The document proposes a new topical treatment for acne that targets the follicular environment, which is expected to be well tolerated and highly effective.