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 Mar-Apr;17(2):114-22. doi: 10.2310/7750.2012.12026.


Background: Systemic antibiotics are an effective treatment for acne vulgaris. However, intolerable side effects may invariably occur.

Objective: To determine whether probiotics reduce the side effects imparted by systemic antibiotics while working synergistically with the latter in treating inflammatory acne.

Methods: Forty-five 18- to 35-year-old females were randomly assigned to one of three arms in this prospective, open-label study. Group A received probiotic supplementation, whereas group B received only minocycline. Group C was treated with both probiotic and minocycline. Clinical and subjective assessments were completed at baseline and during the 2-, 4-, 8-, and 12-week follow-up visits.

Results: All patients demonstrated a significant improvement in total lesion count 4 weeks after treatment initiation (p < .001), with continued improvement seen with each subsequent follow-up visit (p < .01). At the 8- and 12-week follow-up visits, group C had a significant decrease in total lesion count versus groups A (p < .001) and B (p < .01). Two patients (13%) from group B failed to complete the study secondary to vaginal candidiasis.

Conclusion: Probiotics may be considered a therapeutic option or adjunct for acne vulgaris by providing a synergistic antiinflammatory effect with systemic antibiotics while also reducing potential adverse events secondary to chronic antibiotic use.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Acne Vulgaris / drug therapy*
  • Adolescent
  • Adult
  • Anti-Bacterial Agents / adverse effects
  • Anti-Bacterial Agents / therapeutic use*
  • Bifidobacterium
  • Drug Synergism
  • Drug Therapy, Combination
  • Female
  • Humans
  • Lactobacillus acidophilus
  • Lactobacillus delbrueckii
  • Minocycline / adverse effects
  • Minocycline / therapeutic use*
  • Probiotics / therapeutic use*
  • Quality of Life
  • Young Adult


  • Anti-Bacterial Agents
  • Minocycline