Microbiota Manipulation: A Literature Review of Oral and Topical Probiotic Efficacy in Acne Vulgaris

Radyat Fachreza; Jeniffer Handiokho; Indah Rosidha; Agnes Amalia

doi:10.37287/ijghr.v7i3.4958

Radyat Fachreza Universitas Sriwijaya
Jeniffer Handiokho Universitas Pelita Harapan
Indah Rosidha Universitas Hasanuddin
Agnes Amalia Universitas Airlangga

DOI: https://doi.org/10.37287/ijghr.v7i3.4958

Keywords: acne vulgaris, gut microbiome, probiotics, skin microbiome

Abstract

Acne Vulgaris (AV) is a chronic inflammatory skin condition affecting global population, especially adolescents and young adults. Recent study highlighted the potential role of probiotics in managing AV by controlling the gut-skin microbiome axis. Objective: This review aimed to examine the role of human microbiota in controlling AV and explore how probiotics can contribute to the prevention and treatment of AV. Methods: A literature search was conducted from multiple databases (Google Scholar, PubMed, Hindawi, Science Direct, Proquest, and Cochrane) from 2014 to 2024. The inclusion criteria is study written in English that focus on probiotics effects on AV, with a total of 1,435 articles early identified and 1,217 articles carefully screened. Results: Multiple studies showed the potential of both oral and topical probiotics in managing AV. Key findings include: Probiotics can inhibit bacteria that can cause acne like Cutibacterium acnes, some probiotic strains (e.g., Lactobacillus and Bifidobacterium) showed promising improvements in reducing inflammatory lesions, probiotics help controlling immune responses and reduce inflammation. Conclusion: Probiotics show promising potential as an alternative or additional treatment for AV by balancing gut and skin microbiomes. However, further research is needed to be explored to understand the molecular mechanisms and optimizing probiotic treatment strategies.

References

Assefa, G. (2023). Acne Necrotica in Its Entirety: When It Starts, and After It Evolves. International Medical Case Reports Journal, 16(August), 467–471. https://doi.org/10.2147/IMCRJ.S421796

Atefi, Najmolsadat, et al. “Evaluating the Effectiveness of Probiotic Supplementation in Combination with Doxycycline for the Treatment of Moderate Acne: A Randomized Double‐Blind Controlled Clinical Trial.” Journal of Cosmetic Dermatology, 16 Oct. 2024, https://doi.org/10.1111/jocd.16614.

Bae, I. H., Kwak, J. H., Na, C. H., Kim, M. S., Shin, B. S., & Choi, H. (2024). A Comprehensive Review of the Acne Grading Scale in 2023. Annals of Dermatology, 36(2), 65–73. https://doi.org/10.5021/ad.23.094

Bay, L., Barnes, C. J., Fritz, B. G., Thorsen, J., Restrup, M. E. M., Rasmussen, L., Sørensen, J. K., Hesselvig, A. B., Odgaard, A., Hansen, A. J., & Bjarnsholt, T. (2020). Universal Dermal Microbiome in Human Skin. MBio, 11(1). https://doi.org/10.1128/mBio.02945-19

Bull, M. J., & Plummer, N. T. (2014). Part 1: The Human Gut Microbiome in Health and Disease. Integrative Medicine (Encinitas, Calif.), 13(6), 17–22.

Cavallo, I., Sivori, F., Truglio, M., De Maio, F., Lucantoni, F., Cardinali, G., Pontone, M., Bernardi, T., Sanguinetti, M., Capitanio, B., Cristaudo, A., Ascenzioni, F., Morrone, A., Pimpinelli, F., & Di Domenico, E. G. (2022). Skin dysbiosis and Cutibacterium acnes biofilm in inflammatory acne lesions of adolescents. Scientific Reports, 12(1), 21104. https://doi.org/10.1038/s41598-022-25436-3

Chang, J., Duizendstra, A. A., Jansen, R., Jimena, A. O., Gutierrez, P., Zhao, T., Weijers, C. A. G. M., Lommen, W. J. M., Ultee, J., & Boog, M. C. (2014). The effect of probiotics on skin. https://api.semanticscholar.org/CorpusID:85919632

Christensen, G. J. M., Scholz, C. F. P., Enghild, J., Rohde, H., Kilian, M., Thürmer, A., Brzuszkiewicz, E., Lomholt, H. B., & Brüggemann, H. (2016). Antagonism between Staphylococcus epidermidis and Propionibacterium acnes and its genomic basis. BMC Genomics, 17, 152. https://doi.org/10.1186/s12864-016-2489-5

Cruz, S., Vecerek, N., & Elbuluk, N. (2023). Targeting Inflammation in Acne: Current Treatments and Future Prospects. American Journal of Clinical Dermatology, 24(5), 681–694. https://doi.org/10.1007/s40257-023-00789-1

Dapkevicius, I., Romualdo, V., Marques, A. C., Lopes, C. M., & Amaral, M. H. (2023). Acne Vulgaris Topical Therapies: Application of Probiotics as a New Prevention Strategy. Cosmetics, 10(3), 1–17. https://doi.org/10.3390/cosmetics10030077

De Almeida, C. V., Antiga, E., & Lulli, M. (2023). Oral and Topical Probiotics and Postbiotics in Skincare and Dermatological Therapy: A Concise Review. Microorganisms, 11(6). https://doi.org/10.3390/microorganisms11061420

Dessinioti, C., & Katsambas, A. (2022). Antibiotics and Antimicrobial Resistance in Acne: Epidemiological Trends and Clinical Practice Considerations. The Yale Journal of Biology and Medicine, 95(4), 429–443.

Dréno, B., Dagnelie, M. A., Khammari, A., & Corvec, S. (2020). The Skin Microbiome: A New Actor in Inflammatory Acne. American Journal of Clinical Dermatology, 21(Suppl 1), 18–24. https://doi.org/10.1007/s40257-020-00531-1

Eguren, C., Navarro-Blasco, A., Corral-Forteza, M., Reolid-Pérez, A., Setó-Torrent, N., García-Navarro, A., Prieto-Merino, D., Núñez-Delegido, E., Sánchez-Pellicer, P., & Navarro-López, V. (2024). A Randomized Clinical Trial to Evaluate the Efficacy of an Oral Probiotic in Acne Vulgaris. Acta Dermato-Venereologica, 104, adv33206. https://doi.org/10.2340/actadv.v104.33206

Espinoza-Monje, M., Campos, J., Alvarez Villamil, E., Jerez, A., Dentice Maidana, S., Elean, M., Salva, S., Kitazawa, H., Villena, J., & García-Cancino, A. (2021). Characterization of Weissella viridescens UCO-SMC3 as a Potential Probiotic for the Skin: Its Beneficial Role in the Pathogenesis of Acne Vulgaris. Microorganisms, 9(7). https://doi.org/10.3390/microorganisms9071486

Fabbrocini, G., Bertona, M., Picazo, Ó., Pareja-Galeano, H., Monfrecola, G., & Emanuele, E. (2016). Supplementation with Lactobacillus rhamnosus SP1 normalises skin expression of genes implicated in insulin signalling and improves adult acne. Beneficial Microbes, 7(5), 625–630. https://doi.org/10.3920/BM2016.0089

Gowda, V., Sarkar, R., Verma, D., & Das, A. (2024). Probiotics in Dermatology: An Evidence-based Approach. Indian Dermatology Online Journal, 15(4), 571–583. https://doi.org/10.4103/idoj.idoj_614_23

Grice, E. A., & Segre, J. A. (2011). The skin microbiome. Nature Reviews. Microbiology, 9(4), 244–253. https://doi.org/10.1038/nrmicro2537

Guzzo, F., Durán, A. G., Sanna, C., Marasco, R., Molfetta, N., Buommino, E., Fiorentino, A., & D’Abrosca, B. (2022). Gallomyrtucommulones G and H, New Phloroglucinol Glycosides, from Bioactive Fractions of Myrtus communis against Staphylococcus Species. Molecules (Basel, Switzerland), 27(20). https://doi.org/10.3390/molecules27207109

Habeebuddin, M., Karnati, R. K., Shiroorkar, P. N., Nagaraja, S., Asdaq, S. M. B., Khalid Anwer, M., & Fattepur, S. (2022). Topical Probiotics: More Than a Skin Deep. Pharmaceutics, 14(3). https://doi.org/10.3390/pharmaceutics14030557

Hall, J. B., Cong, Z., Imamura-Kawasawa, Y., Kidd, B. A., Dudley, J. T., Thiboutot, D. M., & Nelson, A. M. (2018). Isolation and Identification of the Follicular Microbiome: Implications for Acne Research. The Journal of Investigative Dermatology, 138(9), 2033–2040. https://doi.org/10.1016/j.jid.2018.02.038

Hay, R. J., Johns, N. E., Williams, H. C., Bolliger, I. W., Dellavalle, R. P., Margolis, D. J., Marks, R., Naldi, L., Weinstock, M. A., Wulf, S. K., Michaud, C., J L Murray, C., & Naghavi, M. (2014). The global burden of skin disease in 2010: an analysis of the prevalence and impact of skin conditions. The Journal of Investigative Dermatology, 134(6), 1527–1534. https://doi.org/10.1038/jid.2013.446

Heng, A. H. S., & Chew, F. T. (2020). Systematic review of the epidemiology of acne vulgaris. Scientific Reports, 10(1), 5754. https://doi.org/10.1038/s41598-020-62715-3

Heng, A. H. S., Say, Y.-H., Sio, Y. Y., Ng, Y. T., & Chew, F. T. (2021). Gene variants associated with acne vulgaris presentation and severity: a systematic review and meta-analysis. BMC Medical Genomics, 14(1), 103. https://doi.org/10.1186/s12920-021-00953-8

Henshaw, E. B., & Olasode, O. A. (2019). Prevalence of skin infections, infestations, and papular urticaria among adolescents in secondary schools in Calabar, Nigeria. Ghana Medical Journal, 53(4), 287–293. https://doi.org/10.4314/gmj.v53i4.6

Hill, C., Guarner, F., Reid, G., Gibson, G. R., Merenstein, D. J., Pot, B., Morelli, L., Canani, R. B., Flint, H. J., Salminen, S., Calder, P. C., & Sanders, M. E. (2014). Expert consensus document. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nature Reviews. Gastroenterology & Hepatology, 11(8), 506–514. https://doi.org/10.1038/nrgastro.2014.66

Jumiati, Nur Ramadhan, L. O. A., & Himaniarwati. (2022). Uji Aktivitas Ekstrak Etanol Daun Rumput Mutiara (Hedyotis corymbosa (L) Lamk.) Terhadap Bakteri Penyebab Jerawat Propionibacterium acnes dan Staphylococcus epidermidis. Jurnal Pharmacia Mandala Waluya, 1(4), 165–173. https://doi.org/10.54883/jpmw.v1i4.36

Kim, M.-J., Kim, K.-P., Choi, E., Yim, J.-H., Choi, C., Yun, H.-S., Ahn, H.-Y., Oh, J.-Y., & Cho, Y. (2021). Effects of Lactobacillus plantarum CJLP55 on Clinical Improvement, Skin Condition and Urine Bacterial Extracellular Vesicles in Patients with Acne Vulgaris: A Randomized, Double-Blind, Placebo-Controlled Study. Nutrients, 13(4). https://doi.org/10.3390/nu13041368

Kitkuakosol, S., & Khunngam, P. (n.d.). The Effectiveness of Probiotic in The Treatment of Inflamed Acne. 1–10.

Lebeer, S., Oerlemans, E. F. M., Claes, I., Henkens, T., Delanghe, L., Wuyts, S., Spacova, I., van den Broek, M. F. L., Tuyaerts, I., Wittouck, S., De Boeck, I., Allonsius, C. N., Kiekens, F., & Lambert, J. (2022). Selective targeting of skin pathobionts and inflammation with topically applied lactobacilli. Cell Reports. Medicine, 3(2), 100521. https://doi.org/10.1016/j.xcrm.2022.100521

Lee, Y. B., Byun, E. J., & Kim, H. S. (2019). Potential Role of the Microbiome in Acne: A Comprehensive Review. Journal of Clinical Medicine, 8(7). https://doi.org/10.3390/jcm8070987

Lynn, D. D., Umari, T., Dunnick, C. A., & Dellavalle, R. P. (2016). The epidemiology of acne vulgaris in late adolescence. Adolescent Health, Medicine and Therapeutics, 7, 13–25. https://doi.org/10.2147/AHMT.S55832

Marasca, C., Ruggiero, A., Cacciapuoti, S., Fabbrocini, G., & Annunziata, M. C. (2022). Probiotic supplement combined with topical therapy in the treatment of mild to moderate acne: results from an Italian single centre interventional study. Italian Journal of Dermatology and Venereology, 157(6), 510–514. https://doi.org/10.23736/S2784-8671.22.07361-3

Mills, J. G., Selway, C. A., Thomas, T., Weyrich, L. S., & Lowe, A. J. (2023). Schoolyard Biodiversity Determines Short-Term Recovery of Disturbed Skin Microbiota in Children. Microbial Ecology, 86(1), 658–669. https://doi.org/10.1007/s00248-022-02052-2

Nast, A., Dréno, B., Bettoli, V., Bukvic Mokos, Z., Degitz, K., Dressler, C., Finlay, A. Y., Haedersdal, M., Lambert, J., Layton, A., Lomholt, H. B., López-Estebaranz, J. L., Ochsendorf, F., Oprica, C., Rosumeck, S., Simonart, T., Werner, R. N., & Gollnick, H. (2016). European evidence-based (S3) guideline for the treatment of acne - update 2016 - short version. Journal of the European Academy of Dermatology and Venereology : JEADV, 30(8), 1261–1268. https://doi.org/10.1111/jdv.13776

Navarro-López, V., Núñez-Delegido, E., Ruzafa-Costas, B., Sánchez-Pellicer, P., Agüera-Santos, J., & Navarro-Moratalla, L. (2021). Probiotics in the Therapeutic Arsenal of Dermatologists. Microorganisms, 9(7). https://doi.org/10.3390/microorganisms9071513

Paetzold, B., Willis, J. R., Pereira de Lima, J., Knödlseder, N., Brüggemann, H., Quist, S. R., Gabaldón, T., & Güell, M. (2019). Skin microbiome modulation induced by probiotic solutions. Microbiome, 7(1), 95. https://doi.org/10.1186/s40168-019-0709-3

Podrini, Christine, et al. “Topical Administration of Lactiplantibacillus Plantarum (SkinDuoTM) Serum Improves Anti-Acne Properties.” Microorganisms, vol. 11, no. 2, 7 Feb. 2023, p. 417, https://doi.org/10.3390/microorganisms11020417. Accessed 11 Dec. 2024.

Polak, K., Jobbágy, A., Muszyński, T., Wojciechowska, K., Frątczak, A., Bánvölgyi, A., Bergler-Czop, B., & Kiss, N. (2021). Microbiome Modulation as a Therapeutic Approach in Chronic Skin Diseases. Biomedicines, 9(10). https://doi.org/10.3390/biomedicines9101436

Ramasamy, S., Barnard, E., Dawson, T. L. J., & Li, H. (2019). The role of the skin microbiota in acne pathophysiology. The British Journal of Dermatology, 181(4), 691–699. https://doi.org/10.1111/bjd.18230

Ramírez-Boscá, A., Navarro-López, V., Martínez-Andrés, A., Such, J., Francés, R., Horga de la Parte, J., & Asín-Llorca, M. (2015). Identification of Bacterial DNA in the Peripheral Blood of Patients With Active Psoriasis. JAMA Dermatology, 151(6), 670–671. https://doi.org/10.1001/jamadermatol.2014.5585

Rao, A., Douglas, S. C., & Hall, J. M. (2021). Endocrine Disrupting Chemicals, Hormone Receptors, and Acne Vulgaris: A Connecting Hypothesis. Cells, 10(6). https://doi.org/10.3390/cells10061439

Rinaldi, F., Marotta, L., Mascolo, A., Amoruso, A., Pane, M., Giuliani, G., & Pinto, D. (2022). Facial Acne: A Randomized, Double-Blind, Placebo-Controlled Study on the Clinical Efficacy of a Symbiotic Dietary Supplement. Dermatology and Therapy, 12(2), 577–589. https://doi.org/10.1007/s13555-021-00664-z

Rocha, M., Schalka, S., Bayan, F., Yoshizumi, T., & Blum, V. (2022). The efficacy of an oral probiotic associated with a fixed combination of benzoyl peroxide and adapalene in the treatment of acne: A randomized, double-blind, placebo-controlled clinical trial. https://doi.org/10.21203/rs.3.rs-2227654/v1

Salem, I., Ramser, A., Isham, N., & Ghannoum, M. A. (2018). The Gut Microbiome as a Major Regulator of the Gut-Skin Axis. Frontiers in Microbiology, 9, 1459. https://doi.org/10.3389/fmicb.2018.01459

Sánchez-Pellicer, P., Navarro-Moratalla, L., Núñez-Delegido, E., Ruzafa-Costas, B., Agüera-Santos, J., & Navarro-López, V. (2022). Acne, Microbiome, and Probiotics: The Gut-Skin Axis. Microorganisms, 10(7). https://doi.org/10.3390/microorganisms10071303

Shi, Z., Malfa, P., De Ponti, I., Yu, X., Lo Re, M., & Tursi, F. (2024). Investigating the impact of oral probiotic supplementation for acne management: A randomized controlled trial. Our Dermatology Online, 15(3), 210–219. https://doi.org/10.7241/ourd.20243.1

Yu, Y., Dunaway, S., Champer, J., Kim, J., & Alikhan, A. (2020). Changing our microbiome: probiotics in dermatology. The British Journal of Dermatology, 182(1), 39–46. https://doi.org/10.1111/bjd.18088