Skin Microbiome and Acne: Microbial Imbalances and Impact – Interview with Three Key Opinion Leaders

Acne vulgaris, commonly known as acne, is a multifactorial, chronic inflammatory skin condition involving the pilosebaceous unit, and is one of the most common skin diseases globally. Acne significantly impacts the quality of life and wellbeing of patients, and can be associated with anxiety, depression, and low self-esteem. This skin condition is also associated with substantial healthcare costs and economic burden for society. The treatment of acne is complex and challenging. For this article, EMJ conducted an interview in September 2024 with key opinion leaders Marco Rocha from Federal University of São Paulo, and Brazilian Society of Dermatology, Brazil; Thomas Dirschka from CentroDerm Clinic, Wuppertal, and University of Witten-Herdecke, Germany; and Alison Layton from the Skin Research Centre, Hull York Medical School, University of York, and Harrogate and District NHS Foundation Trust, UK. The key opinion leaders, who have a wealth of experience and expertise in the clinical management of acne, were asked about the current landscape for the management of acne, and the potential role of the skin microbiome in the development and treatment of this chronic inflammatory skin disease. The experts provided valuable insights into some of the many unmet needs in acne management, particularly the overuse of antibiotics and the lack of effective alternative therapies for this condition. The experts discussed the contribution of the skin microbiome and the potential role of microbial imbalances in the development of acne, and the potential of prebiotics and probiotics in restoring skin health. The concept of integrating microbiome-modulating strategies into conventional acne treatment, and whether there is a connection between the skin microbiome and psychological conditions such as depression, were also considered. A further topic covered was educating patients and parents about acne. Finally, the experts outlined what the future landscape of acne management might look like.