Evaluating the Effectiveness of Probiotic Supplementation in Combination With Doxycycline for the Treatment of Moderate Acne: A Randomized Double-Blind Controlled Clinical Trial.

RCT acne acne vulgaris doxycycline efficacy lactobacillus microbial supplement microbiome probiotic safety

Journal

Journal of cosmetic dermatology
ISSN: 1473-2165
Titre abrégé: J Cosmet Dermatol
Pays: England
ID NLM: 101130964

Informations de publication

Date de publication:
16 Oct 2024
Historique:
revised: 10 09 2024
received: 13 08 2024
accepted: 20 09 2024
medline: 16 10 2024
pubmed: 16 10 2024
entrez: 16 10 2024
Statut: aheadofprint

Résumé

Acne is a chronic inflammatory skin disease that negatively affects patients' quality of life. Increasing antibiotic resistance is making acne less responsive to treatment. Probiotics are live microorganisms that can provide health benefits by fighting pathogens and maintaining intestinal homeostasis and skin microbiome balance. This study investigates the effects of probiotics in the treatment of acne vulgaris. In this randomized controlled clinical trial, 80 patients with moderate acne were divided into two groups of 40. All patients received the same topical treatment, which consisted of a daily antibacterial face wash and Adapalene gel every other night. The control group received one capsule of doxycycline (100 mg) daily, whereas the intervention group received one probiotic capsule daily in addition to doxycycline. Patients underwent photography of facial acne lesions, and treatment response was assessed using the global acne grading system (GAGS) and acne grading method at baseline, as well as during follow-up visits at 1, 2, and 3 months. The global acne grading system indicated that both groups showed improvement. However, analyses revealed that outcomes were significantly better in the doxycycline plus probiotics group for the forehead (p = 0.018), chin (p = 0.021), and nose (p = 0.021). No significant differences were observed for the left and right cheeks, back, and chest areas, with the mean GAGS score reduction between the two groups differing by only 2%. Treatment with probiotics significantly reduced the severity of lesions compared to the control group (p < 0.001). The acne grading method also indicated that the intervention group had a significantly better treatment response than the control group (p < 0.001). Furthermore, treatment with probiotics did not result in any side effects. Probiotics can serve as an effective and safe treatment option, enhancing the outcomes of routine acne treatments, particularly for patients with acne on the forehead, chin, and nose.

Sections du résumé

BACKGROUND BACKGROUND
Acne is a chronic inflammatory skin disease that negatively affects patients' quality of life. Increasing antibiotic resistance is making acne less responsive to treatment. Probiotics are live microorganisms that can provide health benefits by fighting pathogens and maintaining intestinal homeostasis and skin microbiome balance. This study investigates the effects of probiotics in the treatment of acne vulgaris.
METHODS METHODS
In this randomized controlled clinical trial, 80 patients with moderate acne were divided into two groups of 40. All patients received the same topical treatment, which consisted of a daily antibacterial face wash and Adapalene gel every other night. The control group received one capsule of doxycycline (100 mg) daily, whereas the intervention group received one probiotic capsule daily in addition to doxycycline. Patients underwent photography of facial acne lesions, and treatment response was assessed using the global acne grading system (GAGS) and acne grading method at baseline, as well as during follow-up visits at 1, 2, and 3 months.
RESULTS RESULTS
The global acne grading system indicated that both groups showed improvement. However, analyses revealed that outcomes were significantly better in the doxycycline plus probiotics group for the forehead (p = 0.018), chin (p = 0.021), and nose (p = 0.021). No significant differences were observed for the left and right cheeks, back, and chest areas, with the mean GAGS score reduction between the two groups differing by only 2%. Treatment with probiotics significantly reduced the severity of lesions compared to the control group (p < 0.001). The acne grading method also indicated that the intervention group had a significantly better treatment response than the control group (p < 0.001). Furthermore, treatment with probiotics did not result in any side effects.
CONCLUSION CONCLUSIONS
Probiotics can serve as an effective and safe treatment option, enhancing the outcomes of routine acne treatments, particularly for patients with acne on the forehead, chin, and nose.

Identifiants

pubmed: 39410868
doi: 10.1111/jocd.16614
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024 The Author(s). Journal of Cosmetic Dermatology published by Wiley Periodicals LLC.

Références

A. C. Perkins, J. Maglione, G. G. Hillebrand, K. Miyamoto, and A. B. Kimball, “Acne Vulgaris in Women: Prevalence Across the Life Span,” Journal of Women's Health 21, no. 2 (2012): 223–230.
M. Patel, W. P. Bowe, C. Heughebaert, and A. R. Shalita, “The Development of Antimicrobial Resistance Due to the Antibiotic Treatment of Acne Vulgaris: A Review,” Journal of Drugs in Dermatology 9, no. 6 (2010): 655–664.
A. J. Cooper, “Systematic Review of Propionibacterium Acnes Resistance to Systemic Antibiotics,” Medical Journal of Australia 169, no. 5 (1998): 259–261.
R. J. Hay, N. E. Johns, H. C. Williams, et al., “The Global Burden of Skin Disease in 2010: An Analysis of the Prevalence and Impact of Skin Conditions,” Journal of Investigative Dermatology 134, no. 6 (2014): 1527–1534.
J. I. Silverberg and N. Silverberg, “Epidemiology and Extracutaneous Comorbidities of Severe Acne in Adolescence: A US Population‐Based Study,” British Journal of Dermatology 170, no. 5 (2014): 1136–1142.
N. D. Cresce, S. A. Davis, W. W. Huang, and S. R. Feldman, “The Quality of Life Impact of Acne and Rosacea Compared to Other Major Medical Conditions,” Journal of Drugs in Dermatology 13, no. 6 (2014): 692–697.
K. L. Anderson, E. H. Dothard, K. E. Huang, and S. R. Feldman, “Frequency of Primary Nonadherence to Acne Treatment,” JAMA Dermatology 151, no. 6 (2015): 623–626.
B. A. Yentzer, R. A. Ade, J. M. Fountain, et al., “Simplifying Regimens Promotes Greater Adherence and Outcomes With Topical Acne Medications: A Randomized Controlled Trial,” Cutis 86, no. 2 (2010): 103–108.
S. Awan and J. Lu, “Management of Severe Acne During Pregnancy: A Case Report and Review of the Literature,” International Journal of Women's Dermatology 3, no. 3 (2017): 145–150.
A. Layton, E. A. Eady, M. Peat, et al., “Identifying Acne Treatment Uncertainties Via a James Lind Alliance Priority Setting Partnership,” BMJ Open 5, no. 7 (2015): e008085.
D. Thiboutot, H. Gollnick, V. Bettoli, et al., “New Insights Into the Management of Acne: An Update From the Global Alliance to Improve Outcomes in Acne Group,” Journal of the American Academy of Dermatology 60, no. 5 (2009): S1–S50.
S. Hacivelioglu, A. N. Gungor, M. Gencer, et al., “Acne Severity and the Global Acne Grading System in Polycystic Ovary Syndrome,” International Journal of Gynaecology and Obstetrics 123, no. 1 (2013): 33–36, https://doi.org/10.1016/j.ijgo.2013.05.005.
I. A. Hasan, Z. N. Mahdi, and R. K. Obeed, “Evaluation of the Efficacy of RF Microneedling and Oral Isotretinoin in Comparison With Oral Isotretionoin Alone in the Treatment of Acne Vulgaris,” Postepy Dermatologii I Alergologii 40, no. 1 (2023): 111–114, https://doi.org/10.5114/ada.2022.124109.
A. S. Bazargan, A. Jafarzadeh, F. Danandeh, and S. Salehi, “Investigating Metabolic Syndrome Markers and Body Mass Index Changes in Patients With Acne Vulgaris Treated With Isotretinoin: A Prospective Study,” Journal of Cosmetic Dermatology (2024), https://doi.org/10.1111/jocd.16533. Epub ahead of print. PMID: 39143842.
H. Gollnick, W. Cunliffe, D. Berson, et al., “Management of Acne: A Report From a Global Alliance to Improve Outcomes in Acne,” Journal of the American Academy of Dermatology 49, no. 1 (2003): S1–S37.
B. Dreno, D. Thiboutot, H. Gollnick, et al., “Antibiotic Stewardship in Dermatology: Limiting Antibiotic Use in Acne,” European Journal of Dermatology 24, no. 3 (2014): 330–334.
A. Nast, B. Dréno, V. Bettoli, et al., “European Evidence‐Based (S3) Guidelines for the Treatment of Acne,” Journal of the European Academy of Dermatology and Venereology 26 (2012): 1–29.
World Health Organization, “Antibiotic Resistance‐A Threat to Global Health Security,” 2014.
N. Abdel Fattah and Y. Darwish, “In Vitro Antibiotic Susceptibility Patterns of Propionibacterium Acnes Isolated From Acne Patients: An Egyptian University Hospital‐Based Study,” Journal of the European Academy of Dermatology and Venereology 27, no. 12 (2013): 1546–1551.
K. Nakase, H. Nakaminami, N. Noguchi, S. Nishijima, and M. Sasatsu, “First Report of High Levels of Clindamycin‐Resistant Propionibacterium Acnes Carrying Erm (X) in Japanese Patients With Acne Vulgaris,” Journal of Dermatology 39, no. 9 (2012): 794–796.
O. Mills, Jr., C. Thornsberry, C. W. Cardin, K. A. Smiles, and J. J. Leyden, “Bacterial Resistance and Therapeutic Outcome Following Three Months of Topical Acne Therapy With 2% Erythromycin Gel Versus Its Vehicle,” Acta Dermato‐Venereologica 82, no. 4 (2002): 260–265.
R. M. Levy, E. Y. Huang, D. Roling, J. J. Leyden, and D. J. Margolis, “Effect of Antibiotics on the Oropharyngeal Flora in Patients With Acne,” Archives of Dermatology 139, no. 4 (2003): 467–471.
B. S. Kang, J. G. Seo, G. S. Lee, et al., “Antimicrobial Activity of Enterocins From Enterococcus Faecalis SL‐5 Against Propionibacterium Acnes, the Causative Agent in Acne Vulgaris, and Its Therapeutic Effect,” Journal of Microbiology 47, no. 1 (2009): 101–109.
N. Muizzuddin, W. Maher, M. Sullivan, S. Schnittger, and T. Mammone, “Physiological Effect of a Probiotic on Skin,” Journal of Cosmetic Science 63, no. 6 (2012): 385–395. PMID: 23286870.
H. C. Williams, R. P. Dellavalle, and S. Garner, “Acne Vulgaris,” Lancet 379, no. 9813 (2012): 361–372.
R. Siver, “Lactobacillus for the Control of Acne,” Journal of the Medical Society of New Jersey 59 (1961): 52–53.
F. Marchetti, R. Capizzi, and A. Tulli, “Efficacy of Regulators of the Intestinal Bacterial Flora in the Therapy of Acne Vulgaris,” La Clinica Terapeutica 122, no. 5 (1987): 339–343.
G. W. Jung, J. E. Tse, I. Guiha, and J. Rao, “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,” Journal of Cutaneous Medicine and Surgery 17, no. 2 (2013): 114–122.
J. Kim, Y. J. Ko, J. J. Cha, et al., “Dietary Effect of Lactoferrin‐Enriched Fermented Milk on Skin Surface Lipid and Clinical Improvement of Acne Vulgaris,” Nutrition 26, no. 9 (2010): 902–909.

Auteurs

Najmolsadat Atefi (N)

Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Masoumeh Mohammadi (M)

Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Mohammad Bodaghabadi (M)

Department of Geriatric and Gerentology, Semnan University of Medical Sciences, Semnan, Iran.

Marjan Mehrali (M)

School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Elham Behrangi (E)

Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Mohammadreza Ghassemi (M)

Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Alireza Jafarzadeh (A)

Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Azadeh Goodarzi (A)

Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Classifications MeSH