Microbial dynamics in acne pathogenesis: Exploring the impact of skin and intestinal microbiota

The skin microbiota is a consortium of microorganisms residing on human skin, which undergoes alterations due to external and internal influences, fostering interindividual variability and microbiota dysbiosis. This study aims to elucidate the impact and role of both skin and intestinal microbiota on acne development. The PubMed and Google Scholar databases were used to write the study, searching for articles from 2013 to 2024 and analyzing them in terms of the topic of the review. Acne vulgaris is a persistent skin ailment marked by various manifestations like comedones, pustules, papules, and cysts, predominantly afflicts teenagers, but is not confined to any specific age group. Its intricate etiopathogenesis involves factors such as heightened sebum production and the proliferation of specific Cutibacterium acnes ( C. acnes ) strains. It is a dominant bacterium in hair follicles in both healthy and affected individuals, with select phylotypes influencing disease progression. Beyond C. acnes , other microorganisms like Malassezia and Staphylococcus epidermidis ( S. epidermidis ) may contribute to acne development. The intestinal microflora, less diverse in acne patients, actively participates in pathogenesis, potentially exacerbating inflammation and disease course. The microbiotas of the skin and intestines play a significant role in the pathogenesis of acne through multiple mechanisms, and imbalance of the microbiotas may exacerbate acne.