It is the bane of teens and adults alike, but although acne is the most common skin disease in the world, why it causes scars and how to prevent it remain a mystery.
Researchers have uncovered some clues though - through an extremely rare skin disease called Winchester syndrome and a tiny fish. They hope their discovery will pave the way for better acne treatments.
Key to their findings is a protein called MMP14. It is an enzyme that can break down collagen, and a protein that not only makes up most of the connective tissue under the skin, but also ensures bones are strong.
The MMP14, which is under study by the research team comprising scientists from Singapore, Europe and Australia, is known to be associated with Winchester syndrome. The scientists found that in afflicted patients, the gene which programmes the body to create the MMP14 enzyme goes awry, so it is unable to break down collagen like it normally would, resulting in severe acne, scarring and osteoporosis.
Because acne as well as the associated scarring can also result from connective tissue problems, they made a zebrafish model of Winchester syndrome to develop and test new drugs that may help people with acne, scars, or osteoporosis, said A*Star in a statement. The researchers hope to improve the zebrafish model for drug testing and development.
Said Mr Ivo de Vos, an author of the study and research fellow at the Skin Research Institute of Singapore: "This fish will now be used to study scarring, and will furthermore be used to develop new drugs that may help against scarring, one of the residual effects of acne."
The study, published in the journal Human Molecular Genetics, is part of the Acne and Sebaceous Gland Programme funded by the institute.