Isotretinoin and lymecycline treatments modify the skin microbiota in acne

Abstract

Oral retinoids and tetracyclines have a major role in acne treatment. Here, we report for the first time the effect of isotretinoin and lymecycline therapy on the skin microbiota in cheek, back and armpit swab samples of acne vulgaris patients using 16S ribosomal RNA (16S rRNA) gene amplicon sequencing. Propionibacterium acnes was the most common in sebaceous areas of healthy and untreated acne skin and more abundant in back than cheek samples. Five taxa, including a Streptococcus taxon, differed significantly between the cheek samples of healthy controls and acne patients, and acne severity was positively correlated with the abundance of Propionibacterium. Both treatments reduced clinical acne grades and the abundance of Propionibacterium, while the abundance of several other taxa was significantly higher in treated cheek samples compared with untreated ones. Less variation was observed in back samples and none in armpit samples. There were no differences in alpha diversity between control and acne patients in any of the sampled skin areas, but the diversity of the microbiota on the cheek and the back was significantly increased after acne treatments. This study provides insight into the skin microbiota in acne and how it is modulated by systemic acne treatment.

A systematic literature review of the human skin microbiome as biomarker for dermatological drug development

“…Acne improved and Propionibacterium abundance decreased after various treatments, together with an increase of microbial diversity in the two controlled studies. Moreover, a positive correlation between Propionibacterium abundance and acne severity grade was found 54, 55.…”

“…Moreover, acne improved and Propionibacterium decreased after treatment, while the microbial diversity increased 54, 55. Taking into account that a clear pathophysiological role of P. acnes exists and antimicrobial interventions are effective in AV 72, 73, the adoption of the skin microbiome as biomarker in acne drug development programmes is, although still in its infancy, suggested by our review (Table 2).…”

“…In AV, a strong, positive correlation between Propionibacterium and acne severity grade is reported 55. Moreover, acne improved and Propionibacterium decreased after treatment, while the microbial diversity increased 54, 55.…”

“…Five studies investigated the skin microbiome in patients with AV, Table 1 51, 52, 53, 54, 55. Three (3) were case–control studies and two (2) were small single‐centre, controlled studies, of whom one was a double‐blind, randomized‐controlled trial.…”

Skin microbiome differences relate to the grade of acne vulgaris

“…Culture‐independent technologies have revealed close relationships between the skin microbiome and chronic inflammatory dermatoses, such as atopic dermatitis, psoriasis and acne vulgaris (acne) . 16S rRNA gene sequencing showed that the skin microbiome is closely correlated with acne, and the dominant bacterial communities on the skin of acne patients were Cutibacterium , Staphylococcus , Corynebacterium , Streptococcus and Micrococcus …”