The Microbiome and Acne: Perspectives for Treatment.

Area of Science:

• Dermatology
• Microbiology
• Immunology

Background:

• The skin microbiome, comprising diverse microorganisms, plays a crucial role in skin health.
• Cutibacterium acnes (C. acnes) is implicated in acne pathogenesis, influencing inflammatory and immune responses.
• Microbial dysbiosis, an imbalance in skin homeostasis, is increasingly recognized as a factor in acne development.

Purpose of the Study:

• To review the current understanding of the skin microbiome in acne.
• To discuss the impact of conventional acne treatments on skin microbiome homeostasis.
• To explore emerging non-antibiotic therapeutic strategies for acne.

Main Methods:

• Literature review of studies on the skin microbiome and acne.
• Analysis of the effects of benzoyl peroxide, isotretinoin, and antibiotics on skin microbiota.
• Evaluation of novel therapeutic approaches including spironolactone, PPARγ modulators, probiotics, bacteriotherapy, and phage therapy.

Main Results:

• Conventional acne treatments, particularly antibiotics, can disrupt skin microbiome balance and promote antimicrobial resistance.
• Short-term antibiotic courses can lead to dysregulation of the skin microbiome equilibrium.
• The review highlights the need for treatments that preserve or restore microbiome homeostasis.

Conclusions:

• Acne treatments significantly impact the skin microbiome, necessitating a shift towards therapies with minimal collateral damage.
• Emerging treatments like spironolactone, PPARγ modulation, probiotics, bacteriotherapy, and phage therapy show promise for acne management.
• Future research should focus on harnessing the skin microbiome for effective and sustainable acne therapies.