Safety and Efficacy of Topically Applied Selected Cutibacterium acnes Strains over Five Weeks in Patients with Acne Vulgaris: An Open-label, Pilot Study

Acta Derm Venereol. 2019 Dec 1;99(13):1253-1257. doi: 10.2340/00015555-3323.

Abstract

Imbalance in skin microflora, particularly related to certain Cutibacterium acnes strains, may trigger acne. Application of non-acne-causing strains to the skin may modulate the skin microbiome and thereby lead to a reduction in acne. This pilot study evaluates the safety and efficacy of microbiome modulation on acne-prone skin. The study had 2 phases: active induction (5% benzoyl peroxide gel, 7 days) and interventional C. acnes strains treatment (5 weeks). Patients were randomized to either topical skin formulations PT1 (2 strains of C. acnes Single Locus Sequence Typing [SLST] type C3 and K8, 50% each) or PT2 (4 strains of C. acnes SLST type C3 [55%], K8 [5%], A5 [30%] and F4 [10%]). Safety and efficacy was evaluated in 14 patients (PT1=8/14, PT2=6/14). Skin microbiome composition shifted towards study formulations. No untoward adverse events, visible irritation, or significant flare-up were observed. Non-inflamed lesions and skin pH were reduced. Comedone counts improved clinically with no deterioration in inflammatory lesions.

Keywords: microbiome; skin; acne vulgaris.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Acne Vulgaris / drug therapy*
  • Acne Vulgaris / microbiology
  • Acne Vulgaris / therapy
  • Administration, Topical
  • Adolescent
  • Benzoyl Peroxide / therapeutic use*
  • Female
  • Humans
  • Male
  • Microbiota / drug effects*
  • Patient Safety*
  • Pilot Projects
  • Prognosis
  • Propionibacteriaceae / pathogenicity*
  • Propionibacterium acnes / pathogenicity*
  • Skin / microbiology
  • Time Factors
  • Transformation, Bacterial
  • Treatment Outcome
  • Young Adult

Substances

  • Benzoyl Peroxide

Supplementary concepts

  • Cutibacterium avidum