Live lactobacilli in skin cream modulate microbiome and reduce acne symptoms

The skin is home to an important part of our commensal microbiota, despite it being a cool, acidic and desiccated environment. Tailored microbiome modulation approaches with for example probiotics are nevertheless highly challenging for this body site. Here we show by next-generating sequencing that Lactobacillus taxa (especially taxa known to be dominant in the human vagina) are underestimated members of the skin microbiota. Specific strains were selected in the lab and formulated in a viable form in an oil in water-based topical cream. Facial application by patients with mild-to-moderate acne symptoms was able to reduce inflammatory lesions and comedone formation. This was associated with a temporary modulation of the skin microbiome, including a reduction in relative abundance of staphylococci and increase in -viable- lactobacilli. Skin microbiome modulation by addition of carefully formulated lactobacilli to enrich keystone microbes thus forms a viable option to reduce antibiotic use for common acne symptoms.