Characterization and Analysis of the Skin Microbiota in Acne: Impact of Systemic Antibiotics

Abstract

Systemic antibiotics are extensively used to control moderate to severe acne. Hence, it is crucial to understand their impact on the skin microbiota, which is supposedly perturbed. The purpose of this study was to compare the makeup and diversity of the skin microbiota in acne patients before and after taking oral antibiotics. A longitudinal cohort study was performed on 20 participants with moderate to severe facial acne with no recent use of oral and topical antibiotics/retinoids. Patients were prescribed oral doxycycline, 100 mg, twice daily for six weeks. Skin areas on the cheek were sampled for 16S ribosomal RNA gene sequencing at baseline, and after six weeks of doxycycline treatment. Ten males and 10 females aged 11 to 44 years with a median Investigator’s Global Assessment score of 3 (moderate) were enrolled. At baseline, Cutibacterium acnes (formerly Propionibacterium acnes) was the most dominant species followed by Staphylococcus epidermidis. Acne severity showed a positive correlation with the abundance of Cutibacterium acnes. Across all subjects, antibiotic treatment reduced clinical acne grades and was associated with a 1.96-fold reduction in the relative abundance of Cutibacterium acnes (p = 0.01, 95% CI −22% to −3%). Marked changes were also identified in other bacterial species, such as Cutibacterium granulosum (formerly Propionibacterium granulosum), which increased by 4.46-fold (p = 0.02, 95% CI 0.004% to 0.9%) in the treated samples. In general, antibiotics administration was associated with an increase in bacterial diversity (alpha diversity). Principal coordinates analysis showed mild clustering of samples by patient (analysis of similarity, R = 0.135, p = 0.04) whereas there was scant clustering with treatment (ANOSIM, R = 0.005; p = 0.29). In conclusion, we found individuals with acne to have a unique microbial signature. Acne treatment with systemic antibiotics was associated with changes in the composition and diversity of skin microbiota, especially Cutibacterium acnes, which correlates with acne severity. Our study provides insight into the skin microbiota in acne and how it is modulated by systemic antibiotics.

Human Skin Microbiome: Impact of Intrinsic and Extrinsic Factors on Skin Microbiota

“…The number of Snodgrassella alvi also decreased (3.85-fold). On the other hand, a statistically significant increase in the number of Cutibacterium granulosum (4.46 times) was observed [ 81 ].…”

Corynebacterium matruchotii Demography and Adhesion Determinants in the Oral Cavity of Healthy Individuals

“…C. matruchotii colonizes the oral cavity, the skin [ 46 ], and likely the nose and nasopharynx, but is not detected in the gastrointestinal tract or human milk, but the association between C. matruchotii and health is still unclear. Interestingly, abundance of the Corynebacterium genus was negatively associated with head and neck squamous cell cancer risk, which also parallels less smoking [ 47 ].…”

Topical Probiotics in Dermatological Therapy and Skincare: A Concise Review

“…Challenges in current acne treatment include compliance with topical treatments that can commonly disrupt the skin barrier, causing dryness and skin irritation. Park et al noted that probiotics modify several factors in the pathophysiology of acne development and can potentially improve compliance as well [ 7 ]. The connection between gut microbiota and acne has attracted attention.…”