The preadolescent acne microbiome: A prospective, randomized, pilot study investigating characterization and effects of acne therapy

Coughlin, Carrie C.; Swink, Shane M; Horwinski, Joseph; Sfyroera, Georgia; Bugayev, Julia; Grice, Elizabeth A.; Yan, Albert C.

doi:10.1111/pde.13261

Cited by 28 publications

(44 citation statements)

References 17 publications

(38 reference statements)

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“…In another study evaluating the preadolescent acne microbiome, Streptococcus genus had the highest abundance in control participants, whereas Cutibacterium (Propionibacterium) and Staphylococcus genera predominated in participants with acne. This study was limited by its sample size (n = 8 controls, 8 participants with acne) and thus may overestimate treatment effect . Although we did not directly evaluate our participants’ Tanner stages, our observations may coincide with conclusions of current literature that support that progressing pubertal maturation is correlated with microbiome shifts.…”

Section: Discussionmentioning

confidence: 69%

The microbiome in preadolescent acne: Assessment and prospective analysis of the influence of benzoyl peroxide

Ahluwalia

Borok

Haddock

et al. 2019

Pediatric Dermatology

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Background/Objectives The pathogenesis of preadolescent acne has not been well studied, and it is uncertain if Cutibacterium acnes is a predominant organism in the microbiome in this age group. The aim of this study was to analyze the microbiome of preadolescent females and to assess whether benzoyl peroxide impacts the microbiome. Methods The study enrolled girls, aged 7‐12 years, with evidence of at least six acne lesions who had not been previously treated. Participants’ skin surface of forehead, cheeks, nose, chin, left retroauricular crease, and extruded contents of a comedonal lesion were sampled at baseline. Participants used benzoyl peroxide 4% wash for 6‐8 weeks and returned for skin surface sampling and extraction collection. Microbiome analysis was performed using 16S ribosomal RNA gene amplicon sequencing on all swab and lesional extraction samples. Results Fifty‐one participants were enrolled with a median IGA score of 2 (mild). Changes in microbiome diversity were associated with increasing age and number of acne lesions (P = 0.001). C. acnes had higher abundances on forehead and nose, as opposed to cheeks and chin (P = 0.009). Bacterial diversity (alpha diversity) of the skin microbiome was comparable between preadolescent at baseline and after treatment with benzoyl peroxide. Conclusion This is the first large assessment characterizing female acne microbiome in early and late preadolescence. Results show that preadolescent acne can vary in its microbial profile, reflecting surrounding changes associated with the onset of puberty. Although benzoyl peroxide use was associated with decreased acne counts, its effect on microbial diversity was not demonstrated in our study.

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Section: Discussionmentioning

confidence: 69%

The microbiome in preadolescent acne: Assessment and prospective analysis of the influence of benzoyl peroxide

Ahluwalia

Borok

Haddock

et al. 2019

Pediatric Dermatology

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“…Whether or not the relative abundance of C acnes is greater in acne patients compared to healthy controls, or whether the levels correlate with disease severity, is unclear. Nonetheless, all studies to date support C acnes as a factor in acne pathogenesis . A small pilot study with 8 pre‐adolescent acne patients demonstrated that in addition to C acnes , both Streptococcus and Staphylococcus spp.…”

Section: Acnementioning

confidence: 99%

“…A small pilot study with 8 pre‐adolescent acne patients demonstrated that in addition to C acnes , both Streptococcus and Staphylococcus spp. are highly abundant compared to age‐matched control subjects , suggesting these species may also contribute to acne pathogenesis in this age group . With next‐generation sequencing, an understanding of how C acnes contributes to acne pathogenesis is beginning to take shape.…”

Section: Acnementioning

confidence: 99%

“…Few studies demonstrate the direct effects of acne treatments on the skin microbiome. In general, benzoyl peroxide, lymecycline, topical clindamycin, isotretinoin, and oral minocycline all decrease the bacterial load on the skin, including C acnes , and increase bacterial diversity on the skin by the end of treatment . These treatments are not specific to C acnes , but instead trigger global diversity changes within the skin microbiome community, changes that may persist well beyond the treatment end date.…”

Section: Acnementioning

confidence: 99%

“…Nonetheless, all studies to date support C acnes as a factor in acne pathogenesis. [67][68][69][70][71][72][73] A small pilot study with 8 preadolescent acne patients demonstrated that in addition to C acnes, both Streptococcus and Staphylococcus spp. are highly abundant compared to age-matched control subjects, suggesting these species may also contribute to acne pathogenesis in this age group.…”

Section: Acnementioning

confidence: 99%

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Skin microbiota: Friend or foe in pediatric skin health and skin disease

Schneider

Nelson

2019

Pediatric Dermatology

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The human integument and gastrointestinal tract host unique microbial ecosystems. Within the last decade, research has focused on understanding the contributions of the microbiota to human health and disease. The majority of skin microbiome studies involve adults. This review focuses on key studies conducted within the pediatric population and provides a framework for future skin microbiome work in this ever‐expanding field. This article begins by exploring the skin microbiome at birth and reviews the impact of delivery mode on infant skin colonization. How skin microbial colonization evolves from infancy to adulthood and normal development impacts the abundance of skin commensals such as Streptococcus, Staphylococcus, and Cutibacterium is also highlighted. Finally, several skin microbiome research studies in common pediatric skin conditions are reviewed, including body odor, atopic dermatitis (AD), and acne. The bacteria involved in metabolizing sweat, the impact on body odor, and how this process evolves from childhood to adulthood is outlined. In AD, different bacteria genera that predominate in children and adults and the impact of current AD therapies on skin microbiota are explored. Finally, in acne, the understanding of how Cutibacterium acnes contributes to acne pathogenesis and how acne therapies impact the skin microbial communities is reviewed.

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Topical benzoyl peroxide for acne

Yang

Zhang

Mosler

et al. 2020

Cochrane Database of Systematic Reviews

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The preadolescent acne microbiome: A prospective, randomized, pilot study investigating characterization and effects of acne therapy

Abstract: The predominant bacteria in microbiome studies of adult acne is Propionibacterium, whereas in this pediatric population we saw a lot of Streptococcus bacteria. After treatment, the microbiomes of intervention group participants more closely resembled those of control group participants.

Cited by 28 publications

References 17 publications

The microbiome in preadolescent acne: Assessment and prospective analysis of the influence of benzoyl peroxide

The microbiome in preadolescent acne: Assessment and prospective analysis of the influence of benzoyl peroxide

Skin microbiota: Friend or foe in pediatric skin health and skin disease

Topical benzoyl peroxide for acne

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