Distinct skin microbiome modulation following different topical acne treatments in mild acne vulgaris patients: A randomized, investigator‐blinded exploratory study
Abstract
The effects of topical non‐antibiotic acne treatment on skin microbiota have rarely been demonstrated. In the study, we randomized 45 mild acne vulgaris participants into three treatment groups, including a cream‐gel dermocosmetic containing Aqua Posae Filiformis, lipohydroxy acid, salicylic acid, linoleic acid, niacinamide and piroctone olamine (DC), retinoic acid 0.025% cream (VAA) and benzoyl peroxide 2.5% gel (BP). At months 0, 1 and 3, skin specimens were swabbed from the cheek and forehead and sequenced by targeting V3‐V4 regions of the 16 S rRNA gene. QIIME2 was used to characterize bacterial communities. Acne severity, sebum level and tolerability were assessed concomitantly in each visit. We found that both VAA and BP could significantly reduce the bacterial diversity at month 1 (p‐value = 0.010 and 0.004 respectively), while no significant reduction was observed in DC group. The microbiota compositions also significantly altered for beta diversity in all treatments (all p‐value = 0.001). An increased Cutibacterium with decreased Staphylococcus relative abundance was observed at months 1 and 3 in DC group, while an opposite trend was demonstrated in VAA and BP groups. These findings suggest a potential impact of DC, VAA and BP on the diversity and composition profiles of the skin microbiota in mild acne participants.
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Two randomized controlled trials had numerically but not statistically superior reductions in acne lesion counts with dermocosmetics.
“two RCTs had numerically but not statistically superior reductions”
From International expert consensus recommendations for the use of dermocosmetics in acne. (2025) · cites this paper as [26]
Five randomized controlled trials showed significantly superior reductions in acne lesion counts with dermocosmetics versus comparators.
“Five RCTs showed significantly superior reductions in acne lesion counts with dermocosmetics versus comparators”
From International expert consensus recommendations for the use of dermocosmetics in acne. (2025) · cites this paper as [26]
Change in casual surface oil was an outcome in six randomized controlled trials and two non-randomized studies deemed low quality, involving collectively 362 patients managed with dermocosmetics and 261 patients in comparator or placebo groups.
“Change in casual surface oil was an outcome in six RCTs and two non‐RCTs deemed low quality studies involving collectively 362 patients managed with dermocosmetics and 261 patients in comparator or placebo groups.”
From International expert consensus recommendations for the use of dermocosmetics in acne. (2025) · cites this paper as [26]
Two randomized controlled trials showed reductions in acne lesion counts comparable to benzoyl peroxide 2.5% and 5% and retinoic acid 0.025%.
“two showed reductions comparable to BPO 2.5% and 5% and retinoic acid 0.025%.”
From International expert consensus recommendations for the use of dermocosmetics in acne. (2025) · cites this paper as [26]
The two low-quality studies showed numerical improvements in oiliness but not statistical differences.
“The two low‐quality studies showed numerical improvements in oiliness but not statistical differences.”
From International expert consensus recommendations for the use of dermocosmetics in acne. (2025) · cites this paper as [26]
The randomized controlled trials showed that use of dermocosmetics was associated with a reduction in skin oiliness that was statistically significant in two studies and numerically superior in three studies.
“The RCTs showed that use of dermocosmetics was associated with a reduction in skin oiliness that was statistically significant in two studies and numerically superior in three studies.”
From International expert consensus recommendations for the use of dermocosmetics in acne. (2025) · cites this paper as [26]
Tolerability was an outcome in seven studies: two randomized controlled trials and five low-quality studies, collectively including 229 patients in dermocosmetic groups and 175 in comparator groups.
“Tolerability was an outcome in seven studies: two RCTs and five low‐quality studies that collectively included 229 patients in dermocosmetic groups and 175 in comparator groups.”
From International expert consensus recommendations for the use of dermocosmetics in acne. (2025) · cites this paper as [26]
In both randomized controlled trials assessing tolerability, the dermocosmetic was better tolerated than comparators (benzoyl peroxide and retinoic acid 0.025%).
“In both RCTs, tolerability of the dermocosmetic was better than that of comparators (BPO and retinoic acid 0.025%).”
From International expert consensus recommendations for the use of dermocosmetics in acne. (2025) · cites this paper as [26]
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- Authors
- Wongtada, C., Prombutara, P., Asawanonda, P., Noppakun, N., Kumtornrut, C., & Chatsuwan, T.
- Affiliations
- Chulalongkorn University (TH)
- Corresponding author
- Kumtornrut, Chanat
- Chatsuwan, Tanittha
- ORCID
- Venue
- Experimental Dermatology
- Publisher
- Wiley
- Published
- 2023-03-18
- Volume
- 32
- Issue
- 6
- Pages
- 906-914
- ISSN
- 0906-6705 (ISSN-L)
- 1600-0625
- OpenAlex
- W4322100261
- Cited by
- 17
- References
- 40
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 6 · 2023: 1
- FWCI
- 4.69
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Experimental Dermatology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Dermatology › Acne and Rosacea Treatments and Effects
- Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
- Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
- Keywords
- acne, skin microbiome, topical acne treatment, benzoyl peroxide, Propionibacterium, Staphylococcus, bacterial diversity, 16S rRNA gene sequencing, mild acne
- MeSH terms
- Acne Vulgaris, Anti-Bacterial Agents, Benzoyl Peroxide, Humans, Skin, Treatment Outcome, Microbiota
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