Objective Our main objective was to compare Cutibacterium acnes (C. acnes) skin colonisation in patients with mild to moderate acne versus healthy controls and secondly, to evaluate a Myrtacine â -based cream on C. acnes total population and antibioresistant Cutibacteria in patients with acne.Methods In 60 acne patients (Global Acne Severity Scale, GEA grades 2-3), of mean age 20 [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] Results We first showed (i) high and similar levels of C. acnes colonisation in superficial pilosebaceous follicles and detection of EryR and ClnR strains in both acne and control groups; (ii) different repartition of phylotypes in acne patients versus healthy control, with a predominance of phylotype IA in acne patients and a link between phylotype IA and erythromycin resistance. Besides, after treatment with the Myrtacine â -based cream in acne patients, there was no change in C. acnes total load, but a significant decrease of EryR Cutibacteria, reduced porphyrin production by C. acnes, a decrease in acne severity (GEA), associated with reduced retentional and inflammatory lesions.Conclusion Cutibacterium acnes colonisation was not significantly different in acne versus control groups. Phylotype IA was predominant in acne patient and in EryR C. acnes. A Myrtacine â -based cream significantly reduced the level of EryR Cutibacteria in vivo and improved acne lesions.