Acne, which is a very common skin disease during adolescence, is caused by hormonal changes associated with imbalance in the cutaneous microbiota, to the benefit of a bacteria: Propionibacterium acnes.

Created 16 October 2020
Updated 04 August 2023

About this article

Created 16 October 2020
Updated 04 August 2023

Although they affect the face in 95% of cases, acne lesions can be observed on the back, neck, and the front of the thorax. A quarter of adults are affected, particularly women.

Diverse lesions

Acne is a disease of the hair follicles, combining the hair with a sebum-producing gland. This cutaneous condition is characterized by various kinds of lesions, depending on the stage: blackheads and whiteheads are the first stage of acne, then papules and pustules correspond to the inflammatory stage.

The role of the cutaneous microbiota

Genetics, hormones, hygiene…. There are many causes of acne but they all have one thing in common: the involvement of the bacteria Propionibacterium acnes in its development. This germ, naturally present on the skin, multiplies under the effect of excess sebum and leads to an imbalance in the cutaneous microbiota. The skin reacts to this local dysbiosis, creating inflammation.
It is now well-known that chronic skin diseases are often associated with other problems. This is the case for acne, where there is a serious prevalence of stress, anxiety, and depression associated with functional gastrointestinal disorders in people affected. The current hypothesis singles out altered interactions in the “gut-brain-skin” axis, which may cause local and systemic dysbioses and inflammation.

A tailor-made treatment

Acne treatment depends on its severity and its psychological impact. Topical and/or oral treatments (antibiotics or isotretinoin) associated with good hygiene generally give good results. However, with the emergence of antibiotic resistance, the search for a safe and effective alternative has become necessary. For several years, probiotics (local or oral) have been studied for therapeutic purposes. Some have notably shown the benefits of lactobacilli (Lactobacillus acidophilus and Lactobacillus paracasei) on the cutaneous barrier, skin sensitivity, hydration, and the functions of the epidermis.