Next Article in Journal
Metabolic Bone Disorders in Children with Inflammatory Bowel Diseases
Next Article in Special Issue
Cotton and Flax Textiles Leachables Impact Differently Cutaneous Staphylococcus aureus and Staphylococcus epidermidis Biofilm Formation and Cytotoxicity
Previous Article in Journal
Effects of Glucocorticoid Therapy on Sepsis Depend Both on the Dose of Steroids and on the Severity and Phase of the Animal Sepsis Model
 
 
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:
Background:
Review

Microbiome and Probiotics in Acne Vulgaris—A Narrative Review

1
Department of Health Sciences, University of Opole, 45-040 Opole, Poland
2
Medical College Yordanka Filaretova, Medical University of Sofia, 1606 Sofia, Bulgaria
3
Department of Dermatology, Venereology and Allergology, Wrocław Medical University, 50-368 Wrocław, Poland
*
Author to whom correspondence should be addressed.
Life 2022, 12(3), 422; https://doi.org/10.3390/life12030422
Submission received: 14 February 2022 / Revised: 8 March 2022 / Accepted: 14 March 2022 / Published: 15 March 2022
(This article belongs to the Special Issue The Microbiome in Dermatology and Cosmetology)

Abstract

:
Acne vulgaris is a chronic disease characterised by the appearance of eruptions such as whiteheads, blackheads, pustules, papules, and cysts. Among factors that cause acne vulgaris are the abnormal keratinisation of the sebaceous canal, bacterial colonisation (Cutibacterium acnes), increased sebum production, genotypic factors, and hormonal disorders. Treatment is often long and tedious, and can lead to a reduction in quality of life and social isolation. The intestinal microbiota is greatly important in the formation of acne lesions. It is also responsible for the proper immunity of the organism. Acne is a disease that can be related to the condition of the digestive tract and its microbiome. Research shows that the use of probiotics may reduce skin eruptions. The probiotic supplementation and cosmetics markets are very dynamically developing. The use of internal supplementation and probiotic-containing cosmetics gives hope for the improvement of the skin condition of people with acne.

1. Introduction

Acne vulgaris is a disease characterised by skin eruptions such as whiteheads, blackheads, pustules, papules, and cysts. Acne vulgaris can have either noninflammatory or inflammatory lesions, or a mixture of both. Factors that cause this disease can be bacterial colonisation, increased sebum production, and the abnormal keratinisation of the sebaceous canals. Acne vulgaris affects 95% of boys and 83% of girls at the age of 16. In females, acne is more persistent and commonly located on the face, while males experience more severe forms with eruptions located mostly on the chest and back. Acne occurs also in the adult population, not only in teenagers [1].
Standard acne therapy is the most appropriate first-line therapy for noninflammatory comedones or mild inflammatory disease. Topical agents are most frequently used. This group includes keratolytics, alpha-hydroxy acids, benzoyl peroxide, retinoid analogues, azelaic acid, and topical antibiotics. For patients with refractory lesions to topical therapy or those with more severe or extensive disease, oral antibiotics are useful. Tetracyclines, erythromycin, trimethoprim, and trimethoprim/sulfamethoxazole have all been used to inhibit Cutibacterium acnes. Tetracycline and erythromycin also have an anti-inflammatory effect in vitro by decreasing neutrophil chemotaxis and chemotactic factors. Patients with severe acne are frequently treated with oral isotretinoin (13-cis-retinoic acid), often with dramatic results. Isotretinoin is an ideal medication based on its mechanisms of action, which include a reduction in sebum production, the inhibition of comedone formation, and the modulation of the inflammatory response; a course of therapy may lead to prolonged remission even in the most severe cases. Unfortunately, isotretinoin is associated with a wide array of adverse effects, and only practitioners who are experienced with its use should prescribe it. It may cause arthralgias, stiffness, tendonitis, serum lipid abnormalities, alopecia, photosensitivity, mucosal and skin dryness, liver function test abnormalities, pancreatitis, depression, anaemia, and leukopenia. Laboratory tests, including serum cholesterol, triglycerides, high-density lipoprotein, liver function tests, and a complete blood count, should be performed before the initiation of isotretinoin therapy and periodically during treatment, generally every 4–6 weeks. Of particular concern is the risk to pregnant women, as isotretinoin is associated with spontaneous abortion and congenital malformations. Its teratogenicity mandates that appropriate screening and counselling be conducted before initiating therapy in women of childbearing age. Urine or serum pregnancy tests should be performed in the week before starting therapy and should monthly throughout treatment. The use of two methods of birth control is recommended; contraception should be practised from 1 month before starting therapy until 1 month after it is discontinued.
As a result of long-term treatment and severe forms of acne, scars can remain on patient skin and reduce quality of their life. Symptoms caused by acne contribute to the development of depression, especially in adolescents. Post inflammatory hyperpigmentation can cause fears that lead to deterioration of quality of life. It is very important to contact a dermatologist who could professionally assess the causes of acne and select the appropriate treatment that prevents complications such as discoloration or acne scars [2].
Androgen hormones and testosterone control sebum production. Patients with severe acne, both men and women, have increased levels of dehydroepiandrosterone sulphate, sex hormone-binding globulin, and androstenedione. Excessive sebum production plays a key role in the pathophysiology of acne and generates the inflammatory process [3].
Researchers claim that there is a relationship between acne and the consumption of milk or other dairy products. There is the hypothesis that consuming highly glycaemic food and milk can increase the level of insulin. This can lead to inflammation, androgenic stimulation, and the formation of blackheads and whiteheads [4].

2. Skin Microbiome

The term microbiome (microbiota) describes the entirety of microorganisms present in a given habitat. The skin is the most external organ of our body and is inhabited by bacteria, viruses, fungi, and mites. Most of the microorganisms that inhabit the skin are harmless to the skin and live in symbiosis with skin cells [5,6,7,8].
The main types of dermal colonisation are the following bacteria: Actinobacteria (Micrococcus spp.), Firmicutes (nonhaemolytic aerobes and anaerobes), Staphylococci (Staphylococcus spp.), Clostridium spp., ahaemolytic Streptococci (Streptococcus spp.), Enterococci (Enterococcus spp., Sphingobacterium spp., Chryseobacterium spp.), Proteobacteria (Janthinobacterium spp., Serratia spp., Halomonas spp., Delftia spp., Comamonas spp.) [9,10]. Bacteria inhabiting the surface of the skin include S. epidermidis, S. saprophyticus, S. hominis, S. warneri, S. haemolyticus, and S.capitis, bacteria of the genus Cutibacterium (C. acnes, C. jeikeium) and bacteria of the genus Micrococcus (M. luteus, M. varians, M. lylae, M. sedentarius, M. roseus, M. kristinae, and M. nishinomiyaensis). The skin can also be inhabited by pathogenic bacteria such as group A Streptococci (S. pyogenes) and Gram-negative bacilli (P. aeruginosa) [11,12].
On the surface of human skin, there are also fungi of genera Malassezia (M. furfur, M. sympodialis, M. globosa, M. restricta, M. slooffiae, M. yamatoensis, M. obtusa, M. dermatis, and M. japonica), Penicillium (P. chrysogenum, P. lanosum), Aspergillus (A. candidus, A. terreus, A. versicolor), Candida (C. tropicalis, C. parapsilosis, C.orthopsilosis), Chaetomium, Chrysosporium, Cladosporium, Mucor, Debaryomyces, Cryptococcus (C. flavus, C. dimmennae, C.diffluent), Trichophyton and Rhodotorula. Pathogenic fungi that are capable of causing skin diseases include the following dermatophytes (Microsporum, Trichophyton, Epidermophyton) [9,13,14,15,16].
As mentioned above, the skin microbiome also includes mites. Demodex spp. are characteristic of sebaceous glands and hair follicles, with the most numerous representatives being D. folliculorum (hair follicles), D. brevis (sebaceous glands and Meibomian glands). Demodex mites are carriers of a proinflammatory Gram-negative bacterium Bacillus oleronius, which is considered to cause inflammatory responses [17].
The skin virome has been investigated, but it constitutes a large part of the skin microbiome, which is due to the difficulties associated with viral sequencing [13]. The viral skin flora is complex and heterogeneous with multiple polyomaviruses (Polyomaviridae), circoviruses (Circoviridea), and papillomaviruses (Papillomaviridae) detected on healthy skin [18,19,20]. The gut microbiome also contains a small proportion of both DNA viruses (Anelloviridae, Geminiviridae, Herpesviridae, Nanoviridae, Papillomaviridae, Parvoviridae, Polyomaviridae, Adenoviridae and Circoviridaeas) andRNA viruses (Caliciviridae, Picornaviridae, Reoviridae) [21]. The human virome also comprises phagesthat appear in the microbiome very early in life. They play an important role in the regulation of the bacterial microbiota. The most impotent phage genes are Caudovirales and Microviridae [21,22].
Little is known about Archaea. Recent studies using quantitative PCR of archaeal gene sequencing found Archeae accounting for up to 4.2% of the total skin microbiome. Most of the Archeae are Thaumarchaeota [23].
Bacterial composition depends on the use of cosmetics, environmental factors, profession, exposure to UV radiation, antibiotics, and humidity [24,25,26]. The microbiome landscape of the skin changes with age; in newborns, the skin microbiome largely depends on the type of delivery, while in children, Firmicutes becomes dominant. Gender also contributes to the composition of the skin microbiome. The surfaces of the hands and forearms of women are colonised by more diverse microorganisms, while men have more Malassezia than women do. These elements are influenced by make-up, among other things [24,27]. Environmental and endocrine factors specifically influence the virulence of C. acnes [28,29]. In recent times, the skin microbiome has often been analysed in relation to the etiopathogenesis of dermatological diseases. Atopic dermatitis, psoriasis, rosacea, and hidradenitis suppurativa play the best-known roles in the microbiome.
Recently, the relationship between clinical manifestations of atopic dermatitis and the skin microbiome of atopic patients has been analysed. Research shows that pathological microflora dominates in patients with exacerbations of the disease and severe lesions. Conversely, the commensal microflora appeared again on the skin with clinical improvement. Furthermore, a dysfunction of the skin barrier function observed in patients with atopic dermatitis facilitates the colonisation by S. aureus, which translates into a numerical increase in its colonies on the skin of affected patients. S. aureus can modulate inflammatory responses via mediators; and thus, control inflammation. The surface of the skin and the intestines participates in the development of allergy or asthma due to the immunological pathways of these organs. Changes in the skin microflora with age promote the maturation of the immune system by providing epitopes for immunity-boosting training. Other factors responsible for changes in the skin microbiome include topical medications (corticosteroids, immunomodulators) and topical preparations (moisturisers, emollients) recommended for primary and secondary prophylaxis. Overall, stimulating the growth of symbiotic bacteria can restore the balance of the microbiome, thereby reducing the symptoms of inflammation in atopic patients. The presence of Gram-positive bacteria on the skin (Streptococcus, Lactococcus, and Streptomyces) restrains the spread of other pathogenic bacteria. For this reason, some emollients containingsymbiotic bacteria improve skin condition, acting similarly to probiotics.
A link between the skin microbiome and psoriasis has also been observed. Current research highlights that patients with psoriasis have a different skin microbiome than that of healthy people. Studies have shown that some microorganisms can alter the course of the disease, for example, bacteria including S. aureus and S. pyogenes, viruses (Papillomaviridae and endogenous Retroviridae), and fungi (Malassezia spp. and Candida albicans). Interestingly, high concentrations of Malassezia spp. detected in the lesion of patients with psoriasis resulted in an increased risk of irritation when the skin was treated with topical calcipotriol. Furthermore, antifungal agents improve the condition of nail plates in psoriasis, which may be caused by the elimination of fungi and their ability to worsen skin lesions. Phototherapy, with its ability to improve oxidative stress parameters, could also change the microflora of the skin and improve its condition. The association among psoriasis, changes in skin microbiota, and systemic oxidative stress parameters after narrowband UVB therapy is an interesting topic of further research.
The exact pathophysiology of rosacea is still poorly understood, but current theories focus on the role of the cutaneous microbiome, specifically D. folliculorum and a few commensal bacteria, in the propagation of an inflammatory response. However, the theory of microbial induction extends beyond the skin to include the gastrointestinal microbiome and complications therein. Additional gastrointestinal pathologies have been implicated, including infection by H.pylori and irritable bowel syndrome. The treatment of rosacea with topical antibiotics and antiparasitic agents has long reigned supreme, followed by oral agents of the tetracycline class. Future studies should further investigate the role of the gastrointestinal microbiome in the pathogenesis of rosacea, as intraluminal agents such as rifaxim in have beneficial effects.
In hidradenitis suppurativa, also called acne inversa, dysregulated microbiome is mentioned among other causative factors [30]. Research reports differences between lesional and nonlesional skin in people with and without hidradenitis suppurativa in terms of the composition of the skin microbiome. In patients with hidradenitis suppurativa, the microbiome of skin lesions included Cutibacterium species, Porphyromonas and Peptoniphilus species, while in the microbiome of nonlesional skin, Acinetobacter and Moraxella species dominated. No C. acnes was found in patients with hidradenitis suppurativa [31]. Evidence of differences in the composition of the gastrointestinal microbiome is limited but suggests that the gut microbiome of patients with hidradenitis suppurativa may be altered when compared to that of healthy people [32].

3. Skin Microbiota in Acne

Cutibacterium acnes is considered to be the most likely acne pathogen. Its classification and terminology (former names Propionibacterium and Corynebacterium) were updated by the Microbiology Society [33,34]. C. acnes is a bacterium found in areas rich in sebum, such as the scalp, face, chest, and back. However, most of this bacterium is found on the scalp and face, then on the upper limbs, and the least on the lower limbs. C. acnes is observed with age, it rarely occurs on the skin of children, increases in adolescence and adulthood, and then decreases after the age of 50 years [12,35]. Although the role of C. acnes in the pathophysiology of acne is not fully understood, its main role is that it helps in keeping the skin pH low by releasing free fatty acids and inhibiting the multiplication of S. aureus and Streptococcus. The population of C. acnes strains is diverse depending on the characteristics of the cohorts of the examined patients. Strains can be classified into ribotypes (RT) on the basis of C. acnes 16S rDNA sequences [36]. Fitz-Gibbon et al. showed a strong association between C. acnes strains of RT4 and RT5. Strains of RT6 were linked with healthy skin. They also concluded that RT7, RT8, RT9 and RT10, and interactions that may take place among the different strains, may contribute to the development of the disease [37]. C. acnes, in comparison with healthy strains, contains additional virulence genes [38]. In contrast, Johnson et al. found that acne-related strains generate more porphyrin, which can cause inflammation in keratinocytes [39]. Association with acne causes inflammation in keratinocytes, peripheral blood mononuclear cells and sebocytes, while strains in healthy patients do not [40,41], and hyperkeratinisation of hair sebaceous units [42,43]. C. acnes stimulates the innate and specific response. It expresses pattern recognition receptors (PRRs) and receptors from the toll-like receptor (TLR) family, of which TLR-2 and TLR-4 play a key role. The TLR-2 receptor activates the NF-B pathway and produces cytokines such as Il-1, Il-6, Il-8, IL-10, Il-112, and TNF. Cytokines IL-1 and IL-6 stimulate the proliferation of keratinocytes, Il-1 is a proinflammatory cytokine and increases the production of sebum and reduces the content of linoleic acid. Proinflammatory factors activate transcription factor Ap-1, which induces the gene for matrix metalloproteinase. This process is followed by the synthesis of metalloproteins involved in the destruction of connective tissue [44]. C. acnes, due to the presence of lipase, hydrolyses di- and triglycerides that are part of sebum into free fatty acids, have an irritating and proinflammatory effect, and intensify follicular keratosis. Additionally, C. acnes produces protease hyaluronidase and neuraminidases, which also have a proinflammatory effect. In the pathogenesis of acne, insulin growth factor 1(IGF-1) stimulating the production of sebum also plays a role. It increases skin eruptions in women, while in men, it causes seborrhoea [45]. C. acnes and a hyperglycaemic diet stimulate the proliferation of keratinocytes and the formation of comedones [46].
Human skin is colonised by many microbes, and although C. acnes is most associated with acne eradication, other microbes also influence the development of this disease. On the basis of scientific studies, C. granulosum is more virulent than C. acnes, and is found in comedones and pustules in acne patients [47]. Malassezia is also believed to be an acne-causing organism [48]. Many studies showed that Malassezia also hydrolyses triglycerides to free fatty acids, which cause hyperkeratinisation of the hair follicle ducts and the formation of comedones [49].

4. Influence of Intestinal Microbiota on Acne Lesions

The intestinal microbiota is greatly important in the formation of acne lesions. It is also responsible for the proper immunity of the organism and defence by microorganisms, thus determining tolerance to substances supplied to the human body with food, leading to an immune response [50]. Acne and the condition of the digestive tract are both associated with the quality of microbiome inhabiting intestines. In addition, both skin and the intestines are very densely vascularised and innervated. They perform neuroendocrine and immune functions, among others. An increasing number of studies indicate that the health of the intestines is related to the health of the skin [51,52]. Research on the microbiota is still incomplete, as what influence it has on the condition of the skin has not been fully investigated. The Western diet disturbs the balance between beneficial and pathogenic microorganisms, which contributes to inflammation, including inflammatory skin diseases. Stress also disturbs eubiosis, and bacteria Lactobacillus and Bifidobacterium are particularly sensitive to its effects. In stressful situations, microorganisms can produce neurotransmitters that are inflammatory for the body. The microbiota also modifies the production of short-chain fatty acids (SCFAs), which fulfil many functions, e.g., nourishing intestinal cells and modulating brain activity. One such acid is propionic acid, which is toxic to S. aureus. Hence, SCFAs may also affect the skin’s resistance to cutaneous Staphylococcus and C. Acnes [53,54]. However, the gut microbiota is still a poorly understood topic, and only a few scientists have studied the gut flora of acne patients, as shown in Table 1.
Although knowledge on the human microbiome has significantly expanded in recent years, the microbiological environment in humans is complex and unique. Over the past several decades, researchers have searched for the relationship between the microbiota and C. acnes. Recent studies have shown that C. acnes strains dominate in acne vulgaris, but all limitations and methods of skin sampling indicate the need for more extensive research in this area.

5. Externally Used Probiotics in Dermatology and Cosmetology

Probiotics are defined as “live microorganisms that, when administered in adequate amounts, confer a health benefit on the host” [59]. They do not show carcinogenic effects, but instead show a protective effect and are safe to use. The best-known microorganisms with probiotic effects are Lactobacillus and Bifidobacterium. They belong to anaerobic bacteria, are normal micro white flora, and are Gram-positive. In order for probiotic microorganisms to be safe for human health, they must be nonpathogenic and nontoxic [59,60,61]. As early as 1900, Louis Pasteur defined the microorganisms responsible for fermentation and stated that “lactobacilli might counteract the putrefactive effects of gastrointestinal metabolism that contributed to illness and ageing” [62].
Probiotics may be used in various product categories such as drugs, cosmetics, dietary supplements, and food and food additives. Their use in oral preparations is well-regulated, while their use in cosmetics still requires to be regulated. There is no legal regulation for topical probiotics [63,64]. According to the FDA, a cosmetic is “a product (excluding pure soap) intended to be applied to the human body for cleansing, beautifying, promoting attractiveness, or altering the appearance” [65], yet probiotics are living microorganisms that are ingested [59]. The International Cooperation on Cosmetics Regulation (ICCR) developed categories of microbiome-related products that included probiotics and postbiotics. Postbiotics were defined as “preparations of inanimate microorganisms and/or their components that confer a health benefit on the host”. They can also be used on a host surface, including the mucosa and skin [66,67]. The action of probiotics is based on binding them to the epidermal surface, inhibiting pathogens, producing antimicrobial substances, and increasing immunomodulatory properties. Immunomodulatory properties transformthe probiotic cosmetic into a preparation that can be used in the case of dermatological skin diseases. Probiotics began to be used as an ingredient in intimate hygiene products, hair shampoos, creams, and toothpaste. The most common strains that probiotic cosmetics contain include Bacillus sabtilis, Lactobacillus acidophilus, Lactobacillus casei, Lactoccocuslactis, and Lactobacillus plantarum. These probiotics have a deep moisturising effect, stimulating the production of lipids, and repair processes in the epidermis. The benefits of their use are as follows: the number of unfavourable pathogens is eliminated or reduced, the production of toxic metabolites is reduced, the production of antibodies is increased, the homeostasis of the immune system is restored, and the synthesis of the cytokines is regulated [68,69,70,71].
When it comes to the use of probiotics in cosmetology and dermatology, these are mainly products for washing and caring for skin with atopic dermatitis, acne-prone skin, skin with eczema, psoriasis, and after invasive treatments in the field of cosmetology or medicine, e.g., exfoliation with acids. Acne is a disease that manifests itself in the appearance of blotchy skin eruptions. Astudy by Di Marzio et al. showed that the external application of Streptococcus thermophilus to the skin for a period of 7 days increased the production of ceramides [72]. Other researchers found that these studies were helpful in the treatment of acne, as ceramides such as phytosphingosine provide antimicrobial and anti-inflammatory activity against Cutibacteriumacnes [73]. Kang et al. tested the action of lotion with E. faecalis with mild-to-moderate acne. The study exhibited diminution of papules and pustules among patients, and showed that it could be an alternative treatment to typical antibiotics. Topically applied probiotics can act as a protective shield, preventing colonisation by other pathogens [74,75].
For several years in cosmetology, probiotics have been added to everyday care products. Their main role is to protect against harmful pathogens and reduce inflammation [76]. Fragments of cell walls and inanimate bacteria are contained in such cosmetic products as serums, ointments, creams, body balms, body gels, and shampoos. Products with antiwrinkle, antiageing, and moisturising properties are used thanks to lactic acid. The use of such products promotes the regeneration of damaged skin, e.g., as a result of excessive sunbathing. Probiotics also protect the skin of the hands and the nail plate, and have an anti-itching effect. Research shows that the use of probiotics also has a favourable effect on the regulation of pH thanks to the use of facial cleansing fluids, peels, and toning preparations [77,78]. The use of preparations influences the development of normal microflora, thanks to which a protective barrier is created. The epidermis maintains adequate moisture and strengthens the skin’s resistance to all negative external factors. The use of bacteria such as Streptococcus salivarium spp. and S. thermophilus S244 in cosmetics leads to the production of enzymes that moisturise the skin, thus reducing skin dryness and slowing down ageing processes [79].

6. Oral Probiotics for Acne Vulgaris

So far, little research exists on the effect of probiotics on acne-prone skin. However, there are studies that show the positive impact of their use. Jung et al. investigated 45 women taking the minocycline antibiotic. They examined whether probiotic supplementation would reduce side effects and whether there would be a synergistic effect when using these two products. The participants were divided into 3 groups: the first group received a probiotic, the second group received an antibiotic, and the third group received an antibiotic and a probiotic. After completing the research, the scientists deduced that probiotics could be considered to be a therapeutic or auxiliary option in the treatment of acne. There was a synergistic anti-inflammatory effect, while probiotics minimised the appearance of side effects resulting from the use of antibiotic therapy [80]. In 2010, the ability of konjac glucomannan hydrolysates and probiotics (L. casei, L. plantarum, L. gasseri, L. lactis) to inhibit C. acnes was investigated. Studies showed that all tested strains and konjac glucomannan hydrolysates significantly inhibited the growth of bacteria. The researchers recommended further research in terms of the therapeutic or prophylactic use of the above-mentioned synbiotics [81].
Kang et al. conducted a study in which the role of E. faecalis SL-5 on C. acnes was examined. Aspecial concentrated powder of CBT SL-5 was prepared that used cell-free culture supernatant from E. faecalis SL-5. The study concluded that this bacteriocin was able to reduce inflammation. The researchers suggested that E. faecalis can be an alternative option in future acne therapy [74]. In another study that ran over a two-month period, 15 females were recruited. Patients used a base cream on the left side of their face, and a base cream containing heat-killed L. plantarum-GMNL6 (1 × 109 cells/g of cream)on the right side. The face quality was checked, and moisturising and skin colour tests were conducted. The E (erythema) and M (melanin)indices were determined. The hydration level of the skin was checked before and after the study. DNA was extracted from the head. After completion of the research, iL. plantarum-GMNL6 enhanced collagen synthesis and the gene expression of serine palmitoyltransferase small subunit A. It reduced melanin synthesis, a biofilm of S. aureus, and the proliferation of C. acnes. Skin moisture, spots, and porphyrins were improved [82].
Espinoza-Monje et al. were the first who characterised the antimicrobial and immunomodulatory features of Weissellaviridescens UCO-SMC3. The scientists isolated lactic acid bacteria from garden-culture (Helix aspersa Müller) slime and selected W. viridescens UCO-SMC3. Their study showed that the UCO-SMC3 strain is resistant to unfavourable gastrointestinal conditions. Oral and topical administration of the strains was used, which lead to a favourable modulation of the inflammatory response. The cream applied to volunteers with acne vulgaris reduced skin eruptions [83]. Korean researchers used the synergyof probiotic lactic acid bacteria (LAB) with curcuma longa extract (CLE) as a symbiotic against C. acnes. They concluded that the combination of probiotic LAB and CLE produced cooperation antibacterial effects against C. acnes, which gives hope for the use of these preparations in the medical and cosmetic industries as preparations to treat or soothe acne vulgaris [84].

7. Conclusions

Acne is a skin disease with an inflammatory background. Using antibiotics or isotretinoin has a negative effect on the intestinal flora. Patients with severe acne are frequently treated with oral isotretinoin (13-cis-retinoic acid), often with dramatic results. Isotretinoin is an ideal medication based on its mechanisms of action, which include a reduction in sebum production, the inhibition of comedo formation, and modulation of the inflammatory response; a course of therapy may lead to prolonged remission even in the most severe cases. Unfortunately, isotretinoin is associated with a wide array of adverse effects, and only practitioners who are experienced with its use should prescribe it. It may cause arthralgias, stiffness, tendonitis, serum lipid abnormalities, alopecia, photosensitivity, mucosal and skin dryness, liver function test abnormalities, pancreatitis, depression, anaemia, and leukopenia. Scientists are constantly looking for new solutions that would bring good results when it comes to the treatment of acne. Research shows that the use of probiotics may reduce skin eruptions. The intestinal microbiota is greatly important in the formation of acne lesions. It is also responsible for the proper immunity of the organism. Acne is a disease that can be linked to the condition of the digestive tract and its microbiome. Research shows that the use of probiotics may reduce skin eruptions. The probiotic supplementation and cosmetics markets are dynamically developing. The use of internal supplementation and cosmetics with probiotics give hope for the improvement of the skin condition of people suffering from acne.

Author Contributions

Conceptualisation and methodology, K.C., D.N. and I.D.-U.; formal analysis, K.C., D.N. and I.D.-U.; writing—original draft preparation, K.C., D.N., I.D.-U., R.S. and B.A.; writing—review and editing, K.C. and D.N. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

Not applicable.

Informed Consent Statement

Not applicable.

Data Availability Statement

Not applicable.

Conflicts of Interest

The authors declare no conflict of interest.

References

  1. Chilicka, K.; Rogowska, A.M.; Szyguła, R.; Dzieńdziora-Urbińska, I.; Taradaj, J. A comparison of the effectiveness of azelaic and pyruvic acid peels in the treatment of female adult acne: A randomized controlled trial. Sci. Rep. 2020, 10, 12612. [Google Scholar] [CrossRef] [PubMed]
  2. Gieler, U.; Gieler, T.; Kupfer, J.P. Acne and quality of life—Impact and management. J. Eur. Acad. Dermatol. Venereol. 2015, 29 (Suppl. S4), 12–14. [Google Scholar] [CrossRef] [PubMed]
  3. Ray, C.; Trivedi, P.; Sharma, V. Acne and its treatment lines. Int. J. Res. Pharma. Sci. 2013, 1, 1–16. [Google Scholar]
  4. Melnik, B.C. Evidence for acne-promoting effects of milk and other insulinotropic dairy products. Nestlé Nutr. Workshop Ser. Pediatric Program 2011, 67, 131–145. [Google Scholar]
  5. Grice, E.A.; Segre, J.A. The skin microbiome. Nat. Rev. Microbiol. 2011, 9, 244–253. [Google Scholar] [CrossRef] [PubMed]
  6. Belkaid, Y.; Hand, T.W. Role of the microbiota in immunity and inflammation. Cell 2014, 157, 121–141. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  7. Malinowska, M.; Tokarz-Deptuła, B.; Deptuła, W. Mikcobiome of the men. Post Mikrobiol. 2017, 56, 33–42. [Google Scholar]
  8. Adamczyk, K.; Garncarczyk, A.A.; Antończak, P.P. The microbiome of the skin. Dermatol. Rev./Przegl. Dermatol. 2018, 105, 285–297. [Google Scholar] [CrossRef]
  9. Rahim, K.; Saleha, S.; Zhu, X.; Huo, L.; Basit, A.; Franco, O.L. Bacterial Contribution in Chronicity of Wounds. Microb. Ecol. 2017, 73, 710–721. [Google Scholar] [CrossRef]
  10. Findley, K.; Oh, J.; Yang, J.; Conlan, S.; Deming, C.; Meyer, J.A.; Schoenfeld, D.; Nomicos, E.; Park, M.; Becker, J.; et al. Topographic diversity of fungal and bacterial communities in human skin. Nature 2013, 498, 367–370. [Google Scholar] [CrossRef]
  11. Percival, S.L.; Emanuel, C.; Cutting, K.F.; Williams, D.W. Microbiology of the skin and the role of biofilms in infection. Int. Wound J. 2012, 9, 14–32. [Google Scholar] [CrossRef] [PubMed]
  12. Grice, E.A.; Kong, H.H.; Conlan, S.; Deming, C.B.; Davis, J.; Young, A.C.; Program, N.C.S.; Bouffard, G.G.; Blakesley, R.W.; Murray, P.R.; et al. Topographical and temporal diversity of the human skin microbiome. Science 2009, 324, 1190–1192. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  13. Schommer, N.N.; Gallo, R.L. Structure and function of the human skin microbiome. Trends Microbiol. 2013, 21, 660–668. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  14. Gaitanis, G.; Magiatis, P.; Hantschke, M.; Bassukas, I.D.; Velegraki, A. The Malassezia genus in skin and systemic diseases. Clin. Microbiol. Rev. 2012, 25, 106–141. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  15. Glatz, M.; Bosshard, P.P.; Hoetzenecker, W.; Schmid-Grendelmeier, P. The role of Malassezia spp. in atopic dermatitis. J. Clin. Med. 2015, 4, 1217–1228. [Google Scholar] [CrossRef] [Green Version]
  16. Jagielski, T.; Rup, E.; Macura, A.B.; Bielecki, J. Characterization of fungi of the Malassezia genus. I. Microbiological and immunological aspect. Post Mikrobiol. 2013, 52, 295–305. [Google Scholar]
  17. Ellis, S.R.; Nguyen, M.; Vaughn, A.R.; Notay, M.; Burney, W.A.; Sandhu, S.; Sivamani, R.K. The Skin and Gut Microbiome and Its Role in Common Dermatologic Conditions. Microorganisms 2019, 7, 550. [Google Scholar] [CrossRef] [Green Version]
  18. Bikowski, J.B.; Del Rosso, J.Q. Demodex dermatitis: A retrospective analysis of clinical diagnosis and successful treatment with topical crotamiton. J. Clin. Aesthet. Dermatol. 2009, 2, 20–25. [Google Scholar]
  19. Kong, H.H.; Andersson, B.; Clavel, T.; Common, J.E.; Jackson, S.A.; Olson, N.D.; Segre, J.A.; Traidl-Hoffmann, C. Performing skin microbiome research: A method to the madness. J. Investig. Dermatol. 2017, 137, 561–568. [Google Scholar] [CrossRef] [Green Version]
  20. Oh, J.; Byrd, A.L.; Park, M.; Kong, H.H.; Segre, J.A.; NISC Comparative Sequencing Program. Temporal stability of the human skin microbiome. Cell 2016, 165, 854–866. [Google Scholar] [CrossRef] [Green Version]
  21. Liang, G.; Bushman, F.D. The human virome: Assembly, composition and host interactions. Nat. Rev. Microbiol. 2021, 19, 514–527. [Google Scholar] [CrossRef] [PubMed]
  22. Hannigan, G.D.; Meisel, J.S.; Tyldsley, A.S.; Zheng, Q.; Hodkinson, B.P.; SanMiguel, A.J.; Minot, S.; Bushman, F.D.; Grice, E.A. The human skin double-stranded DNA virome: Topographical and temporal diversity, genetic enrichment, and dynamic associations with the host microbiome. mBio 2015, 6, e01578-15. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  23. Probst, A.J.; Auerbach, A.K.; Moissl-Eichinger, C. Archaea on Human Skin. PLoS ONE 2013, 8, e65388. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  24. Faergemann, J.; Larkö, O. The effect of UV-light on human skin microorganisms. Acta Derm. Venereol. 1987, 67, 69–72. [Google Scholar] [PubMed]
  25. Skowron, K.; Bauza-Kaszewska, J.; Kraszewska, Z.; Wiktorczyk-Kapischke, N.; Grudlewska-Buda, K.; Kwiecińska-Piróg, J.; Wałecka-Zacharska, E.; Radtke, L.; Gospodarek-Komkowska, E. Human Skin Microbiome: Impact of Intrinsic and Extrinsic Factors on Skin Microbiota. Microorganisms 2021, 9, 543. [Google Scholar] [CrossRef]
  26. Gannesen, A.V.; Borrel, V.; Lefeuvre, L.; Netrusov, A.I.; Plakunov, V.K.; Feuilloley, M.G.J. Effect of two cosmetic compounds on the growth, biofilm formation activity, and surface properties of acneic strains of Cutibacterium acnes and Staphylococcus aureus. Microbiologyopen 2019, 8, e00659. [Google Scholar] [CrossRef]
  27. Staudinger, T.; Pipal, A.; Redl, B. Molecular analysis of the prevalent microbiota of human male and female forehead skin compared to forearm skin and the influence of make-up. J. Appl. Microbiol. 2011, 110, 1381–1389. [Google Scholar] [CrossRef]
  28. Borrel, V.; Gannesen, A.V.; Barreau, M.; Gaviard, C.; Duclairoir-Poc, C.; Hardouin, J.; Konto-Ghiorghi, Y.; Lefeuvre, L.; Feuilloley, M.G.J. Adaptation of acneic and non acneic strains of Cutibacterium acnes to sebum-like environment. Microbiologyopen 2019, 8, e00841. [Google Scholar] [CrossRef] [Green Version]
  29. Borrel, V.; Thomas, P.; Catovic, C.; Racine, P.-J.; Konto-Ghiorghi, Y.; Lefeuvre, L.; Duclairoir-Poc, C.; Zouboulis, C.C.; Feuilloley, M.G.J. Acne and Stress: Impact of Catecholamines on Cutibacterium acnes. Front. Med. 2019, 6, 155. [Google Scholar] [CrossRef]
  30. Zouboulis, C.C.; Benhadou, F.; Byrd, A.S.; Chandran, N.S.; Giamarellos-Bourboulis, E.J.; Fabbrocini, G.; Frew, J.W.; Fujita, H.; González-López, M.A.; Guillem, P.; et al. What causes hidradenitis suppurativa?—15 years after. Exp. Dermatol. 2020, 29, 1154–1170. [Google Scholar] [CrossRef]
  31. Ring, H.C.; Thorsen, J.; Saunte, D.M.; Lilje, B.; Bay, L.; Riis, P.T.; Larsen, N.; Andersen, L.O.; Nielsen, H.V.; Miller, I.M.; et al. The Follicular Skin Microbiome in Patients with Hidradenitis Suppurativa and Healthy Controls. JAMA Dermatol. 2017, 153, 897–905. [Google Scholar] [CrossRef]
  32. Wark, K.J.L.; Cains, G.D. The Microbiome in Hidradenitis Suppurativa: A Review. Dermatol. Ther. 2021, 11, 39–52. [Google Scholar] [CrossRef]
  33. Scholz, C.F.P.; Kilian, M. The natural history of cutaneous propionibacteria, and reclassification of selected species within the genus Propionibacterium to the proposed novel genera Acidipropionibacterium gen. nov., Cutibacterium gen. nov. and Pseudopropionibacterium gen. nov. Int. J. Syst. Evol. Microbiol. 2016, 66, 4422–4432. [Google Scholar] [CrossRef]
  34. Dekio, I.; McDowell, A.; Sakamoto, M.; Tomida, S.; Ohkuma, M. Proposal of new combination, Cutibacterium acnes subsp. elongatum comb. nov., and emended descriptions of the genus Cutibacterium, Cutibacterium acnes subsp. acnes and Cutibacterium acnes subsp. defendens. Int. J. Syst. Evol. Microbiol. 2019, 69, 1087–1092. [Google Scholar] [CrossRef]
  35. Patel, A.; Calfee, R.P.; Plante, M.; Fischer, S.A.; Green, A. Propionibacterium acnes colonization of the human shoulder. J. Shoulder Elb. Surg 2009, 18, 897–902. [Google Scholar] [CrossRef]
  36. Fitz-Gibbon, S.; Tomida, S.; Chiu, B.H.; Nguyen, L.; Du, C.; Liu, M.; Elashoff, D.; Erfe, M.C.; Loncaric, A.; Kim, J.; et al. Propionibacterium acnes strain populations in the human skin microbiome associated with acne. J. Investig. Dermatol. 2013, 133, 2152–2160. [Google Scholar] [CrossRef] [Green Version]
  37. Barnard, E.; Shi, B.; Kang, D.; Craft, N.; Li, H. The balance of metagenomic elements shapes the skin microbiome in acne and health. Sci. Rep. 2016, 6, 39491. [Google Scholar] [CrossRef] [Green Version]
  38. Tomida, S.; Nguyen, L.; Chiu, B.H.; Liu, J.; Sodergren, E.; Weinstock, G.M.; Li, H. Pan-genome and comparative genome analyses of propionibacterium acnes reveal its genomic diversity in the healthy and diseased human skin microbiome. mBio 2013, 4, e00003-13. [Google Scholar] [CrossRef] [Green Version]
  39. Schaller, M.; Loewenstein, M.; Borelli, C.; Jacob, K.; Vogeser, M.; Burgdorf, W.H.; Plewig, G. Induction of a chemoattractive proinflammatory cytokine response after stimulation of keratinocytes with Propionibacterium acnes and coproporphyrin III. Br. J. Dermatol. 2005, 153, 66–71. [Google Scholar] [CrossRef]
  40. Nagy, I.; Pivarcsi, A.; Koreck, A.; Széll, M.; Urbán, E.; Kemény, L. Distinct strains of Propionibacterium acnes induce selective human beta-defensin-2 and interleukin-8 expression in human keratinocytes through toll-like receptors. J. Investig. Dermatol. 2005, 124, 931–938. [Google Scholar] [CrossRef] [Green Version]
  41. Yu, Y.; Champer, J.; Agak, G.W.; Kao, S.; Modlin, R.L.; Kim, J. Different Propionibacterium acnes Phylotypes Induce Distinct Immune Responses and Express Unique Surface and Secreted Proteomes. J. Investig. Dermatol. 2016, 136, 2221–2228. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  42. Dréno, B. What is new in the pathophysiology of acne, an overview. J. Eur. Acad Dermatol. Venereol. 2017, 31 (Suppl. S5), 8–12. [Google Scholar] [CrossRef] [PubMed]
  43. Beylot, C.; Auffret, N.; Poli, F.; Claudel, J.P.; Leccia, M.T.; Del Giudice, P.; Dreno, B. Propionibacterium acnes: An update on its role in the pathogenesis of acne. J. Eur. Acad Dermatol. Venereol. 2014, 28, 271–278. [Google Scholar] [CrossRef] [PubMed]
  44. Das, S.; Reynolds, R.V. Recent advances in acne pathogenesis: Implications for therapy. Am. J. Clin. Dermatol. 2014, 15, 479–488. [Google Scholar] [CrossRef] [PubMed]
  45. Goodfellow, A.; Alaghband-Zadeh, J.; Carter, G.; Cream, J.J.; Holland, S.; Scully, J.; Wise, P. Oral spironolactone improves acne vulgaris and reduces sebum excretion. Br. J. Dermatol. 1984, 111, 209–214. [Google Scholar] [CrossRef] [PubMed]
  46. Moradi Tuchayi, S.; Makrantonaki, E.; Ganceviciene, R.; Dessinioti, C.; Feldman, S.R.; Zouboulis, C.C. Acne vulgaris. Nat. Rev. Dis. Primers 2015, 1, 15029. [Google Scholar] [CrossRef]
  47. Whiteside, J.A.; Voss, J.G. Incidence and lipolytic activity of Propionibacterium acnes (Corynebacterium acnes group I) and P. granulosum (C. acnes group II) in acne and in normal skin. J. Investig. Dermatol. 1973, 60, 94–97. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  48. Hu, G.; Wei, Y.P.; Feng, J. Malassezia infection: Is there any chance or necessity in refractory acne? Chin. Med. J. 2010, 123, 628–632. [Google Scholar]
  49. Katsuta, Y.; Iida, T.; Inomata, S.; Denda, M. Unsaturated fatty acids induce calcium influx into keratinocytes and cause abnormal differentiation of epidermis. J. Investig. Dermatol. 2005, 124, 1008–1013. [Google Scholar] [CrossRef] [Green Version]
  50. Benson, K.F.; Redman, K.A.; Carter, S.G.; Keller, D.; Farmer, S.; Endres, J.R.; Jensen, G.S. Probiotic metabolites from Bacillus coagulans GanedenBC30™ support maturation of antigen-presenting cells in vitro. World J. Gastroenterol. 2012, 18, 1875–1883. [Google Scholar] [CrossRef]
  51. Salvucci, E. Microbiome, holobiont and the net of life. Crit. Rev. Microbiol. 2016, 42, 485–494. [Google Scholar] [CrossRef] [PubMed]
  52. Lee, Y.B.; Byun, E.J.; Kim, H.S. Potential Role of the Microbiome in Acne: A Comprehensive Review. J. Clin. Med. 2019, 8, 987. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  53. Bowe, W.; Patel, N.B.; Logan, A.C. Acne vulgaris, probiotics and the gut-brain-skin axis: From anecdote to translational medicine. Benef. Microbes 2014, 5, 185–199. [Google Scholar] [CrossRef] [PubMed]
  54. Salem, I.; Ramser, A.; Isham, N.; Ghannoum, M.A. The Gut Microbiome as a Major Regulator of the Gut-Skin Axis. Front. Microbiol. 2018, 9, 1459. [Google Scholar] [CrossRef] [Green Version]
  55. Loveman, D.E.; Noojin, R.O.; Winkler, C.H., Jr. Comparative studies of enteric bacterial flora in acne vulgaris. J. Investig. Dermatol. 1955, 25, 135–137. [Google Scholar] [CrossRef] [Green Version]
  56. Volkova, L.A.; Khalif, I.L.; Kabanova, I.N. Impact of the impaired intestinal microflora on the course of acne vulgaris. Klin. Med. 2001, 79, 39–41. [Google Scholar]
  57. Deng, Y.; Wang, H.; Zhou, J.; Mou, Y.; Wang, G.; Xiong, X. Patients with Acne Vulgaris Have a Distinct Gut Microbiota in Comparison with Healthy Controls. Acta Derm. Venereol. 2018, 98, 783–790. [Google Scholar] [CrossRef] [Green Version]
  58. Yan, H.M.; Zhao, H.J.; Guo, D.Y.; Zhu, P.Q.; Zhang, C.L.; Jiang, W. Gut microbiota alterations in moderate to severe acne vulgaris patients. J. Dermatol. 2018, 45, 1166–1171. [Google Scholar] [CrossRef]
  59. Hill, C.; Guarner, F.; Reid, G.; Gibson, G.R.; Merenstein, D.J.; Pot, B.; Morelli, L.; Canani, R.B.; Flint, H.J.; Salminen, S.; et al. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nat. Rev. Gastroenterol. Hepatol. 2014, 11, 506–514. [Google Scholar] [CrossRef] [Green Version]
  60. Rusu, E.; Enache, G.; Cursaru, R.; Alexescu, A.; Radu, R.; Onila, O.; Cavallioti, T.; Rusu, F.; Posea, M.; Jinga, M.; et al. Prebiotics and probiotics in atopic dermatitis. Exp. Ther. Med. 2019, 18, 926–931. [Google Scholar] [CrossRef]
  61. Fanfaret, I.S.; Boda, D.; Ion, L.M.; Hosseyni, D.; Leru, P.; Ali, S.; Corcea, S.; Bumbacea, R. Probiotics and prebiotics in atopic dermatitis: Pros and cons (Review). Exp. Ther. Med. 2021, 22, 1376. [Google Scholar] [CrossRef] [PubMed]
  62. Gasbarrini, G.; Bonvicini, F.; Gramenzi, A. Probiotics History. J. Clin. Gastroenterol. 2016, 50 (Suppl. S2), S116–S119. [Google Scholar] [CrossRef] [PubMed]
  63. França, K. Topical Probiotics in Dermatological Therapy and Skincare: A Concise Review. Dermatol. Ther. 2021, 11, 71–77. [Google Scholar] [CrossRef] [PubMed]
  64. Lee, G.R.; Maarouf, M.; Hendricks, A.J.; Lee, D.E.; Shi, V.Y. Topical probiotics: The unknowns behind their rising popularity. Derm. Online J. 2019, 25, 5. [Google Scholar] [CrossRef]
  65. Puebla-Barragan, S.; Reid, G. Probiotics in Cosmetic and Personal Care Products: Trends and Challenges. Molecules 2021, 26, 1249. [Google Scholar] [CrossRef]
  66. Salminen, S.; Collado, M.C.; Endo, A.; Hill, C.; Lebeer, S.; Quigley, E.M.M.; Sanders, M.E.; Shamir, R.; Swann, J.R.; Szajewska, H.; et al. The International Scientific Association of Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of postbiotics. Nat. Rev. Gastroenterol. Hepatol. 2021, 18, 649–667. [Google Scholar] [CrossRef]
  67. Report of the ICCR: ICCR Microbiome and Cosmetics—Survey of Products Ingredients Terminologies and Regulatory Approach. 2021. Available online: https://www.iccr-cosmetics.org/ (accessed on 1 March 2022).
  68. Reisch, M.S. Cosmetics: The next microbiome frontier. Mitsui Chem. Catal. Sci. Award. 2017, 95, 30–34. [Google Scholar]
  69. Fuchs-Tarlovsky, V.; Marquez-Barba, M.F.; Sriram, K. Probiotics in dermatologic practice. Nutrition 2016, 32, 289–295. [Google Scholar] [CrossRef]
  70. Nowicka, D.; Chilicka, K.; Dzieńdziora-Urbińska, I. Host-Microbe Interaction on the Skin and Its Role in the Pathogenesis and Treatment of Atopic Dermatitis. Pathogens 2022, 11, 71. [Google Scholar] [CrossRef]
  71. Nowicka, D.; Grywalska, E. Staphylococcus aureus and host Immunity in recurrent furunculosis. Dermatology 2019, 235, 295–305. [Google Scholar] [CrossRef]
  72. Di Marzio, L.; Cinque, B.; De Simone, C.; Cifone, M.G. Effect of the lactic acid bacterium Streptococcus thermophilus on ceramide levels in human keratinocytes in vitro and stratum corneum in vivo. J. Investig. Dermatol. 1999, 113, 98–106. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  73. Bowe, W.P.; Logan, A.C. Acne vulgaris, probiotics and the gut-brain-skin axis—Back to the future? Gut Pathog. 2011, 3, 1. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  74. Kang, B.S.; Seo, J.G.; Lee, G.S.; Kim, J.H.; Kim, S.Y.; Han, Y.W.; Kang, H.; Kim, H.O.; Rhee, J.H.; Chung, M.J.; et al. Antimicrobial activity of enterocins from Enterococcus faecalis SL-5 against Propionibacterium acnes, the causative agent in acne vulgaris, and its therapeutic effect. J. Microbiol. 2009, 47, 101–109. [Google Scholar] [CrossRef]
  75. Brook, I. Bacterial interference. Crit. Rev. Microbiol. 1999, 25, 155–172. [Google Scholar] [CrossRef]
  76. Kurkowska, N.; Musiał, C. Probiotics in acne skin care. A review of the latest scientific reports. Aesthetic Cosmetol. Med. 2021, 2, 91–98. [Google Scholar] [CrossRef]
  77. Kurzekar, N.; Waseule, D. Probiotics in skin care products—A review. IJRTI 2018, 3, 166–175. [Google Scholar]
  78. Al-Ghazzewi, F.H.; Tester, R.F. Impact of prebiotics and probiotics on skin health. Benef. Microbes 2014, 5, 99–107. [Google Scholar] [CrossRef]
  79. Zommiti, M.; Feuilloley, M.G.J.; Connil, N. Update of Probiotics in Human World: A Nonstop Source of Benefactions till the End of Time. Microorganisms 2020, 8, 1907. [Google Scholar] [CrossRef]
  80. Jung, G.W.; Tse, J.E.; Guiha, I.; Rao, J. Prospective, randomized, open-label trial comparing the safety, efficacy, and tolerability of an acne treatment regimen with and without a probiotic supplement and minocycline in subjects with mild to moderate acne. J. Cutan. Med. Surg. 2013, 17, 114–122. [Google Scholar] [CrossRef]
  81. Al-Ghazzewi, F.H.; Tester, R.F. Effect of konjac glucomannan hydrolysates and probiotics on the growth of the skin bacterium Propionibacterium acnes in vitro. Int. J. Cosmet. Sci. 2010, 32, 139–142. [Google Scholar] [CrossRef]
  82. Tsai, W.-H.; Chou, C.-H.; Chiang, Y.-J.; Lin, C.-G.; Lee, C.-H. Regulatory effects of Lactobacillus plantarum-GMNL6 on human skin health by improving skin microbiome. Int. J. Med. Sci. 2021, 18, 1114–1120. [Google Scholar] [CrossRef] [PubMed]
  83. Espinoza-Monje, M.; Campos, J.; Alvarez Villamil, E.; Jerez, A.; DenticeMaidana, S.; Elean, M.; Salva, S.; Kitazawa, H.; Villena, J.; García-Cancino, A. Characterization of Weissellaviridescens UCO-SMC3 as a Potential Probiotic for the Skin: Its Beneficial Role in the Pathogenesis of Acne Vulgaris. Microorganisms 2021, 9, 1486. [Google Scholar] [CrossRef] [PubMed]
  84. Kim, J.; Kim, H.; Jeon, S.; Jo, J.; Kim, Y.; Kim, H. Synergistic Antibacterial Effects of Probiotic Lactic Acid Bacteria with Curcuma longa Rhizome Extract as Synbiotic against Cutibacterium acnes. Appl. Sci. 2020, 10, 8955. [Google Scholar] [CrossRef]
Table 1. Summary of available studies on gut flora in acne patients.
Table 1. Summary of available studies on gut flora in acne patients.
Author and Study YearResearch Conclusions
Loveman et al., 1955 [55]People with acne show a significantly different intestinal flora compared to the control group.
Volkova et al., 2001 [56]Acne patients showed less variability in the gut microflora and a higher ratio of Bacierioidetes to Firmicutes being an entero type of the Western diet.
Deng et al., 2018 [57]Reduction in the number of Bifidobacterium, Lactobacillus, Coprobacillus, Butyricicoccus, and Allobusulum in acne patients compared to the control group.
Yan et al., 2018 [58]Bacterioidetes spp. that escalated under stressful conditions were isolated in acne patients.
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Share and Cite

MDPI and ACS Style

Chilicka, K.; Dzieńdziora-Urbińska, I.; Szyguła, R.; Asanova, B.; Nowicka, D. Microbiome and Probiotics in Acne Vulgaris—A Narrative Review. Life 2022, 12, 422. https://doi.org/10.3390/life12030422

AMA Style

Chilicka K, Dzieńdziora-Urbińska I, Szyguła R, Asanova B, Nowicka D. Microbiome and Probiotics in Acne Vulgaris—A Narrative Review. Life. 2022; 12(3):422. https://doi.org/10.3390/life12030422

Chicago/Turabian Style

Chilicka, Karolina, Iwona Dzieńdziora-Urbińska, Renata Szyguła, Binnaz Asanova, and Danuta Nowicka. 2022. "Microbiome and Probiotics in Acne Vulgaris—A Narrative Review" Life 12, no. 3: 422. https://doi.org/10.3390/life12030422

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

Article Metrics

Back to TopTop