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Treating Acne with Systemic Antibiotics Alters Skin Microbiota

Systemic antibiotic treatment for acne using oral minocycline is associated with changes in the diversity of skin microbiota, according to a study published online in JAMA Dermatology.

“Given the widespread use of systemic antibiotics for treatment of moderate to severe acne, it is important to understand the associations of such antibiotic use with changes not only in Cutibacterium acnes (formerly Propionibacterium acnes),” the researchers wrote, “but also in the complete bacterial community of the skin.”
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 The longitudinal cohort study included 4 women with acne vulgaris and no recent use of systemic or topical acne treatments. The women, ages 25, 25, 29, and 35, were prescribed oral minocycline, 100 mg, twice a day over 4 weeks. Researchers examined skin microbiota on the forehead, cheek, and chin at baseline, at 4 weeks after starting minocycline, and at 1 and 8 weeks after discontinuing minocycline.

After 4 weeks of treatment, researchers identified a 1.4-fold reduction in the level of Cutibacterium acnes across all 4 participants, with recovery after minocycline was discontinued. They also reported a transient 5.6-fold increase in the relative abundance of Pseudomonas species immediately following antibiotic treatment.

Eight weeks after antibiotic cessation, researchers found a persistent 1.7-fold increase in the relative abundance of Streptococcus species as well as a 4.7-fold decrease in the relative abundance of Lactobacillus species.

“Understanding the association between systemic antibiotic use and skin microbiota,” the researchers wrote, “may help clinicians decrease the likelihood of skin comorbidities related to microbial dysbiosis.”

 —Jolynn Tumolo


Chien AL, Tsai J, Leung S, et al. Association of systemic antibiotic treatment of acne with skin microbiota characteristics [published online February 13, 2019]. JAMA Dermatologydoi:10.1001/jamadermatol.2018.5221

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