Skin Microbiome and Acne Vulgaris: Role of Dysbiosis in Pathophysiology and Therapeutic Perspectives — a Literature Review
Year: 2026
Type: article
Abstract: Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit in which the skin microbiome plays an important role in the interaction between microorganisms, the skin barrier, and the immune response. In this context, Cutibacterium acnes has been investigated not only in terms of its abundance but also regarding phylotype diversity, dysbiosis, and functional characteristics. This review aimed to analyze the available evidence on the relationship between the skin microbiome and acne vulgaris, with emphasis on the role of C. acnes, changes in the microbial community, and microbiome-modulating strategies. A narrative literature review was conducted using the PICO framework, with the selection of eight studies published between 2019 and 2026, including experimental and observational studies, narrative reviews, systematic reviews, and a meta-analysis. The analyzed studies demonstrated an association between alterations in microbial diversity, specific C. acnes phylotypes, biofilm formation, and inflammatory processes related to acne. Conventional acne treatments were also found to modify the composition and diversity of the skin microbiota. Microbiome-modulating strategies, including probiotics, prebiotics, and postbiotics, showed promising results in part of the literature; however, clinical findings remained heterogeneous. A recent meta-analysis of Lactobacillus-based therapies did not demonstrate a statistically significant reduction in acne lesions. In conclusion, the skin microbiome is relevant to the pathophysiology of acne vulgaris and represents a promising field for the development of new therapeutic approaches. Nevertheless, larger, standardized clinical studies with longer follow-up are needed to establish their clinical applicability.
Source: Artefactum
Authors: Raphael Henrique Borges Naves, Tallitha Grawnth Santos Vidal, Luma Gabriella Santos Toledo, Ana Vitória Pacheco Marques Ribeiro, Guilherme Parreira Neves, Isadora Kríscia Gomes Ribeiro, Wilker Diniz Duarte, Matheus Luiz de Jesus Maciel, Maria Luiza Araújo Costa Simões, Anna Karollyna Moreira Martins Magalhães
Language: English
Subfield: Dermatology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7220988239