IDDF2024-ABS-0350 Untangling gut dysbiosis in acne vulgaris: insights and potential interventions

<h3>Background</h3> Acne, a chronic inflammatory disease, is a widespread dermatological condition impacting diverse demographics. The ramifications transcend beyond altering physical appearance, influencing the psychological well-being of those affected, subsequently diminishing quality of life. Research on gut-skin axis suggests interplay of gut dysbiosis and the exacerbation of acne. Therefore, this scoping review aims to investigate gut dysbiosis in acne and potential interventions that act on gut to improve acne outcomes. <h3>Methods</h3> The search was conducted across five databases: Embase, Ovid MEDLINE, Pubmed, Scopus, and Web of Science, using the terms ‘‘gut microbio* OR dysbiosis’ AND ‘acne OR acne vulgaris’’ following PRISMA guidelines. English original articles reporting on gut dysbiosis in acne and studies on interventions to improve gut dysbiosis or acne symptoms were included. Publications were identified, screened, and assessed for inclusion. <h3>Results</h3> IDDF2024-ABS-0350-Figure 1 shows the PRISMA flow diagram and the effect of gut dysbiosis on acne alongside its reported effective mitigations. 11 studies focused on gut dysbiosis in acne, 9 studies explored interventions in acne. Causal relationship studies utilizing microbiome databases frequently linked the abundance of <i>Allisonella</i> and <i>Bacteroidaceae</i> to acne development. Conversely, <i>Bifidobacteriaceae</i>, <i>Lactobacillaceae</i>, and <i>Ruminocococcacea</i> exhibited protective effects against acne. Acne patients often present with decreased <i>Firmicutes</i> and <i>Actinobacteria</i>, but increased <i>Bacteroidetes</i> and <i>Proteobacteria</i>. Interestingly, gender disparities were found in gut dysbiosis, with fatty acid metabolism disorder in males and females experiencing amino acid metabolism disruption. As for interventions, probiotics promoted the growth of beneficial bacteria, restored microbial diversity, and reduced inflammation. Prebiotic supplementation of fructo-oligosaccharides and galacto-oligosaccharides controlled high glycemic diets to reduce acne exacerbation. Furthermore, omega-3 fatty acids alleviated inflammation via gut microbiota modulation while metformin restored gut dysbiosis by increasing <i>Firmicutes</i> abundance in acne. Moreover, a Mediterranean diet lowered IGF-1 levels, eliciting a protective role against inflammation in the pathogenesis of acne. Lastly, a very low-calorie ketogenic diet improved acne symptoms, attributed to its antioxidant and anti-inflammatory effects. <h3>Conclusions</h3> Identifying gut dysbiosis and specific microbial species enables targeted supplementation to restore balance. Combining therapeutic and dietary interventions can significantly enhance acne management, leading to a good improvement in quality of life.