Microbial strains such as Cutibacterium acnes may act as contributors to the pathogenesis of acne. Since this disease is widely prevalent among adolescents and adults, the overutilization of antimicrobial agents may breed resistance and alter commensal microflora.

A recent study characterized the impact of acne treatment on the diversity and relative abundance of the cutaneous microbial community, particularly of the bacterial flora.

It searched Embase, MEDLINE and the Cochrane Central Register of Controlled Trials (CENTRAL) and included interventional and observational studies examining patients receiving acne treatment with culture-independent, community-level analysis of the cutaneous microbiome.

The analysis included nine studies with 170 treated acne patients. Five studies documented a significant shift in alpha diversity following treatment, 3 of which examining systemic antibiotics documented significant increases in diversity. Two of 3 studies examining the effects of benzoyl peroxide documented a decrease in diversity. However, trends in diversity remained heterogeneous among studies.

Although individual variability in microbiome composition and study-level heterogeneity in study sampling techniques may limit quantitative synthesis, these results support that acne treatment, including those not considered to have antimicrobial properties, alters the composition of the cutaneous microbiome.

Source: Lam M, Hu A, Fleming P, et al. The impact of acne treatment on skin bacterial microbiota: a systematic review. J Cutan Med Surg. 2022;26(1):93-7.