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The Practical Use of Topical Oxygen

By: Peter T. Pugliese, MD
Posted: August 22, 2008, from the September 2008 issue of Skin Inc. magazine.

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Briefly, cytokines are special signaling proteins and proteins linked with sugars called glycoproteins. They are very much like hormones that are able to provide signals to other cells by cellular communication. Cytokines are a diverse class of compounds arising from many origins and having multiple functions. Both blood cells and nonblood cells can produce them, and their effects can be felt by cells nearby and throughout the body. Mainly, they are a response to trouble, but they often produce more trouble. The body could not exist without them.

In summary, inflammation in acne is mainly the result of P. acnes and the cytokines they evoke from white blood cells. Along with the other factors, the acne follicle is a roaring source of inflammation.

Oxygen in acne treatment

Every effective therapy treats the causes of the disease. When looking at the causes of acute acne, the presence of P. acnes stands out as a major factor in the formation of pimples or cysts. It is important for the esthetician to understand just what is happening when oxygen is being delivered to the skin. See Figure 1.

Diffusion of atmospheric oxygen. The excellent work of Strucker, et al1 shows that the needs of the epidermis can be supplied with oxygen from the atmosphere through a diffusion process. The epidermis, however, needs additional oxygen, which is supplied by the capillaries. The skin uses oxygen to kill bacteria, to supply energy to the cells, to reduce swelling, to stimulate fibroblast activity, to inhibit lipid peroxidation and to initiate new blood vessel production. It is unknown how these actions occur, but it has been identified through experience with medical hyperbaric oxygen that they do occur.a By using wet oxygen—either mist-laden or in a solution—you are able to get effective levels of oxygen into the hair follicle, deep enough to reach the sebaceous gland. This is the No. 1 reason for using topical oxygen for acne.

Bacterial kill mechanism. It is most likely that a free radical reaction occurs at the cell surface of the bacteria. Oxygen can form very reactive by-products, such as hydrogen peroxide and superoxide, when they enter a cell. The targets of the reactive oxygen species (ROS) are protein and DNA, which denatures both these compounds. It is not fully known what the antimicrobial mechanisms of oxygen are, but some of these processes are understood. For example, the cell envelopes of bacteria consist of polysaccharides (complex sugars) and proteins. Some bacteria have a lot of complex lipids in their membranes, including glycolipids and lipopolysaccharides.