THE ROLE OF PROBIOTICS AND GUT MICROBIOTA MODULATION IN THE PATHOGENESIS AND MANAGEMENT OF ACNE VULGARIS: A SYSTEMATIC REVIEW

Agnieszka Jóźwicka; Ewa  Bąkowska; Wojciech Janikowski; Aleksandra Stępka; Lena Jaworowicz; Weronika Plichtowicz-Kordowska; Karina Lewandowska; Maria Wieczorek

doi:10.31435/ijitss.2(50).2026.5454

Authors

Agnieszka Jóźwicka Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland https://orcid.org/0009-0008-1130-1518
Ewa Bąkowska Medical University of Lublin, Aleje Racławickie 1, 20-059 Lublin, Poland https://orcid.org/0009-0007-4135-9748
Wojciech Janikowski Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland https://orcid.org/0009-0008-4078-9698
Aleksandra Stępka Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland https://orcid.org/0009-0007-5034-0037
Lena Jaworowicz Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland https://orcid.org/0009-0008-4210-7216
Weronika Plichtowicz-Kordowska Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland https://orcid.org/0009-0009-7713-8597
Karina Lewandowska Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland https://orcid.org/0009-0004-5298-1426
Maria Wieczorek Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland https://orcid.org/0009-0000-9951-7509

DOI:

https://doi.org/10.31435/ijitss.2(50).2026.5454

Keywords:

Acne Vulgaris, Gut Microbiome, Gut-Skin Axis, Probiotics, Microbiota, Dysbiosis, Lactobacillus, Bifidobacterium

Abstract

Background: Acne vulgaris is a multifactorial inflammatory skin condition. Recent evidence highlights the critical role of the gut-skin axis and gastrointestinal dysbiosis in its pathogenesis, suggesting that systemic inflammation originating in the gut may exacerbate cutaneous symptoms.

Objective: This systematic review aims to evaluate the clinical efficacy, microbiological specificity, and safety profile of probiotic interventions in the management of acne vulgaris.

Methods: A comprehensive literature search was conducted across PubMed and Google Scholar databases to identify relevant experimental and clinical studies investigating the relationship between the gut microbiome, probiotic supplementation, and acne development.

Results: Current data demonstrate that both oral and topical probiotic interventions significantly reduce inflammatory and non-inflammatory acne lesion counts. Oral probiotics primarily modulate the gut-brain-skin axis, lowering systemic inflammation and regulating sebum excretion rates (SER). Topical applications directly restore the cutaneous barrier and competitively inhibit Cutibacterium acnes. Efficacy is highly strain-specific, with Lactobacillus and Bifidobacterium species showing the most significant benefits. Furthermore, probiotics serve as highly effective adjuvant therapies, synergistically improving clinical outcomes while mitigating the adverse effects of conventional treatments such as systemic antibiotics and isotretinoin.

Conclusion: Microbiome-targeted therapies, specifically probiotics, represent a safe, well-tolerated, and promising adjunctive strategy in acne management. Further large-scale, randomized controlled trials are required to establish standardized, strain-specific therapeutic protocols.

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