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Efficacy of an Oral Probiotic in the Treatment of Patients With Acne Vulgaris
abstract
This abstract is available on the publisher's site.
Access this abstract nowThe relevance of the gut microbiota in some skin inflammatory diseases, including acne vulgaris, has been emphasized. Probiotics could play a role in the modulation of the microbiota, improving the clinical course of this disease. A 12-week randomized, double-blind, placebo-controlled, clinical trial with patients aged 12 to 30 years with acne vulgaris was conducted. The study product was a capsule composed of the probiotic Lacticaseibacillus rhamnosus (CECT 30031) and the cyanobacterium Arthrospira platensis (BEA_IDA_0074B). Patients with improvement in the Acne Global Severity Scale were 10/34 (29.41%) in the placebo group compared with 20/40 (50%) in the probiotic group (p = 0.03). A significant reduction (p = 0.03) in the number of non-inflammatory acne lesions was observed in the probiotic group (-18.60 [-24.38 to -12.82]) vs the placebo group (-10.54 [-17.43 to -3.66]). Regarding the number of total lesions, a reduction almost reaching statistical significance (p = 0.06) was observed in the probiotic group (-27.94 [-36.35 to -19.53]) compared with the placebo group (-18.31 [-28.21 to -8.41]). In addition, patients with improvement attending the Global Acne Grading System were 7/34 (20.58%) in the placebo group vs 17/40 (42.50%) in the probiotic group (p = 0.02). The number of adverse events was similar in both groups. The probiotic used in this study was effective and well tolerated, and it should be considered for acne vulgaris patients.
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A Randomized Clinical Trial to Evaluate the Efficacy of an Oral Probiotic in Acne Vulgaris
Acta Derm Venereol 2024 May 15;104(xx)adv33206, C Eguren, A Navarro-Blasco, M Corral-Forteza, A Reolid-Pérez, N Setó-Torrent, A García-Navarro, D Prieto-Merino, E Núñez-Delegido, P Sánchez-Pellicer, V Navarro-LópezFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
The connection between gut health and skin in patients with acne has become increasingly apparent through the emerging knowledge about diet and the gut microbiome. As the search for alternatives to oral antibiotics for acne grows, there has been a greater focus on evaluating how oral probiotics may influence acne.
Eguren et al present a clinical study to evaluate the role of oral probiotic supplementation in the treatment of patients with acne. The outcomes of using a probiotic consisting of Lacticaseibacillus rhamnosus (previously known as Lactobacillus rhamnosus) and Arthrospira platensis in a total of 1 billion colony-forming units (CFUs) per dose were studied against an oral placebo over 12 weeks, dosed in a randomized double-blind fashion. A total of 81 male and female patients were enrolled. The primary endpoint was at least a 1-point improvement in the Acne Global Severity Scale, and the proportion of patients meeting the primary endpoint was higher in the probiotic group than in the placebo group (50.0% vs 29.41%; P = .03) at week 12. Non-inflammatory lesion counts significantly improved in the probiotic group compared with the placebo group (−18.60 vs −10.54; P = .01) at 12 weeks. There was no significant difference in the inflammatory lesion counts between the groups. The number of adverse events was comparable between the probiotic group and the placebo group.
The study's strength is that it recruited a mix of both males and females, whereas the previous 12-week study recruited only females.1 The limitations of this study include the relatively low number of CFUs of the two probiotics that were used, as the total is at 1 billion CFUs/dose, which is typically on the lower end of probiotic dosing when considering oral studies. For example, previous studies regarding the use of probiotics in patients with acne have utilized a total of 4 to 30 billion CFUs and showed improvements in both non-inflammatory and inflammatory lesion counts.1,2 This may explain the modest effect size for inflammatory lesion counts. Another limitation is that it is not clear whether the participants had truncal acne, and whether these lesions were counted. The use of the Acne Global Severity Scale with an improvement of at least 1 category is not as stringent as the typical approach of requiring a 2-point improvement in the Investigator Global Assessment of acne severity.
This study adds to the emerging evidence that oral probiotics may be effective in the treatment of patients with acne. The probiotic presented in this study may be useful for non-inflammatory lesions. This study reinforces the need to be specific with probiotic recommendations for acne rather than lumping all "probiotics" together, as differences in probiotic species and the effects prevent grouping studies together. Overall, this study highlights the continued excitement for probiotics and for clinicians to consider incorporating specific probiotics as part of the acne treatment regimen.
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