What Is Acne?
Acne is one of the most common dermatological conditions worldwide. It primarily affects adolescents and young adults, but it may persist into later life or appear for the first time in adulthood.
It develops within the pilosebaceous unit. Excess sebum production, follicular hyperkeratinisation and overgrowth of Cutibacterium acnes create a biological environment that sustains chronic inflammation.
Clinically, acne ranges from mild non-inflammatory lesions, such as comedones, to severe inflammatory lesions, including pustules, cysts and nodules, which may leave post-acne scarring and discolouration.
The psychological impact of acne can be disproportionately severe, affecting self-esteem, social relationships and quality of life. Persistent or severe forms require an individualized dermatological approach combining topical and systemic treatments.
Clinical Characteristics
One of the less widely recognized but clinically important characteristics of acne is the hypoxic microenvironment within the follicle. C. acnes thrives under anaerobic conditions, meaning in the absence of oxygen.
Hypoxia within an obstructed follicle is a key factor that allows pathological bacterial overgrowth and initiates the inflammatory response.
In addition, the chronic inflammation associated with acne causes local tissue destruction which, if not repaired properly, may result in post-acne scars characterized by excessive fibrotic tissue deposition.
The quality of healing following acne lesions, which depends to a considerable extent on adequate local oxygenation, influences whether scarring develops or the skin recovers without permanent marks.
Scientific Studies
Studies have documented the bactericidal effects of high oxygen concentrations against C. acnes. As an anaerobic bacterium, it is particularly sensitive to hyperoxygenation.
Clinical reports have described reductions in inflammatory acne lesions and improvements in overall skin condition in patients with treatment-resistant acne who received hyperbaric oxygen therapy as an adjunct to their dermatological treatment.
In addition, its anti-inflammatory effects, mediated through the suppression of IL-1β and TNF-α, may reduce the persistent inflammatory response that sustains and extends acne lesions. Fibroblast activation may also support more effective healing with a lower tendency towards scarring.
The Role of Hyperbaric Oxygen Therapy
In acne, hyperbaric oxygen therapy may be used as an adjunctive option, primarily in cases of resistant or recurrent inflammatory acne or in patients seeking additional support for the healing of post-acne scars.
It does not replace dermatological treatment. Instead, it provides a biological effect in areas where conventional treatment may have limited reach.
Increasing oxygen tension within the follicular microenvironment creates unfavourable conditions for C. acnes and may complement the effects of antibiotic treatment. At the same time, reducing inflammation may accelerate the healing of active lesions and improve the quality of tissue repair, thereby lowering the risk of permanent scarring.
A typical treatment course consists of 10 to 20 sessions, planned in collaboration with the dermatologist.