The Role of the Skin Microbiome and Curibacterium Acnes in the Pathogenesis of Acne Vulgaris
DOI:
https://doi.org/10.55927/ajha.v5i1.16546Keywords:
Acne Vulgaris, Skin Microbiome, Cutibacterium Acnes, InflammationAbstract
Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit commonly affecting adolescents and young adults. Recent studies suggested that acne is associated not only with the abundance of C. acnes but also with dysbiosis of the skin microbiome and the predominance of more proinflammatory bacterial strains. The study aimed to discuss both the role of the skin microbiome and C. acnes in the pathogenesis of acne vulgaris. A literature review using the PubMed database using keywords such as “skin microbiome”, “inflammation”, and “Cutibacterium acnes”. Studies published within the last five years were included. Studies were reviewed based on titles, abstracts, and full text. Data from four studies were analyzed, obtained, and categorized based on the normal microbiome composition, dysbiosis, strain differences, inflammatory mechanism, and therapeutic implications. The findings indicated that acne vulgaris is associated with skin microbiome dysbiosis due to reduced microbial diversity and the predominance of specific C. acnes strains, including RT4, RT5, RT8, and RT10. These strains demonstrated the ability to form biofilms, produce virulence factors, and activate inflammatory pathways by increasing proinflammatory cytokines. Conventional therapies have not fully targeted microbiome balance, leading to the emergence of new approaches. In conclusion, the pathogenesis of acne vulgaris is influenced by the presence of C. acnes, imbalance of the skin microbiome, and the predominance of more virulent strains.
Downloads
References
Brüggemann, H., Salar-Vidal, L., Gollnick, H. P. M., & Lood, R. (2021). A Janus-faced bacterium: host-beneficial and-detrimental roles of Cutibacterium acnes. Frontiers in Microbiology, 12, 673845.
Cavallo, I., Sivori, F., Truglio, M., De Maio, F., Lucantoni, F., Cardinali, G., Pontone, M., Bernardi, T., Sanguinetti, M., & Capitanio, B. (2022). Skin dysbiosis and Cutibacterium acnes biofilm in inflammatory acne lesions of adolescents. Scientific Reports, 12(1), 21104.
Chen, Q., Liu, C., Tao, J., Zeng, W., Zhu, Z., Yao, C., Shang, Y., Tang, J., & Jin, T. (2025). Insights into microbial dysbiosis and Cutibacterium acnes CAMP factor interactions in acne vulgaris. Microbial Genomics, 11(7), 1449.
Cheung, C. T., Lancien, U., Corvec, S., Mengeaud, V., Mias, C., Véziers, J., Khammari, A., & Dréno, B. (2024). Pro-inflammatory activity of Cutibacterium acnes phylotype IA1 and extracellular vesicles: An in vitro study. Experimental Dermatology, 33(8). https://doi.org/10.1111/exd.15150
Claesen, J., Spagnolo, J. B., Ramos, S. F., Kurita, K. L., Byrd, A. L., Aksenov, A. A., Melnik, A. V, Wong, W. R., Wang, S., & Hernandez, R. D. (2020). A Cutibacterium acnes antibiotic modulates human skin microbiota composition in hair follicles. Science Translational Medicine, 12(570), eaay5445.
Coenye, T., Spittaels, K.-J., & Achermann, Y. (2022). The role of biofilm formation in the pathogenesis and antimicrobial susceptibility of Cutibacterium acnes. Biofilm, 4, 100063.
Cros, M. P., Mir-Pedrol, J., Toloza, L., Knödlseder, N., Maruotti, J., Zouboulis, C. C., Güell, M., & Fábrega, M.-J. (2023). New insights into the role of Cutibacterium acnes-derived extracellular vesicles in inflammatory skin disorders. Scientific Reports, 13(1), 16058.
Del Rosso, J. Q., & Kircik, L. (2024). The primary role of sebum in the pathophysiology of acne vulgaris and its therapeutic relevance in acne management. Journal of Dermatological Treatment, 35(1), 2296855.
Dessinioti, C., & Katsambas, A. (2024). The microbiome and acne: perspectives for treatment. Dermatology and Therapy, 14(1), 31–44.
Di Francesco, A. M., Pasciuto, G., Verrecchia, E., Sicignano, L. L., Gerardino, L., Rigante, D., & Manna, R. (2025). The role of Cutibacterium acnes in the etiopathogenesis of sarcoidosis: current insights and future study directions. International Journal of Molecular Sciences, 26(14), 6652.
Dréno, B., Dagnelie, M. A., Khammari, A., & Corvec, S. (2020a). The Skin Microbiome: A New Actor in Inflammatory Acne: B. Dréno et al. American Journal of Clinical Dermatology, 21(Suppl 1), 18–24.
Hamann, T., Brüggemann, H., Feidenhansl, C., Rruci, E., Gallinger, J., Gallinat, S., & Hüpeden, J. (2025). Distinct intraspecies variation of Cutibacterium acnes and Staphylococcus epidermidis in acne vulgaris and healthy skin. Microorganisms, 13(2), 299.
Jin, Z., Song, Y., & He, L. (2023). A review of skin immune processes in acne. Frontiers in Immunology, 14, 1324930.
Josse, G., Mias, C., Le Digabel, J., Filiol, J., Ipinazar, C., Villaret, A., Gomiero, C., Bevilacqua, M., Redoules, D., & Nocera, T. (2020). High bacterial colonization and lipase activity in microcomedones. Experimental Dermatology, 29(2), 168–176.
Khormi, G., Aldubayyan, N., Hakami, M., Daghriri, S., & Aqeel, S. (2024). Impact of Lifestyle and Dietary Habits on the Prevalence of Acne Vulgaris: A Cross-Sectional Study From Saudi Arabia. Cureus.
Lee, H., Kang, W., Ha, Y., Jung, Y., Bin, Y., & Park, T. (2025). Phenylacetaldehyde attenuates Cutibacterium acnes-induced inflammation in keratinocytes and monocytes. International Immunopharmacology, 158, 114885.
Li, J., Wang, F., Liu, D., Yang, W., Sun, H., Gao, M., Chen, D., & Xu, H. (2025). Transcriptomic Profiling of Cutibacterium acnes IA1—Infected Keratinocytes Reveal Hub Genes and CLR Pathway in Acne Pathogenesis. Current Issues in Molecular Biology, 48(1), 34.
Li, X., & Jin, J. (2025). The Mechanism and Research Progress of Skin Microbiota in Pathogenesis of Acne. Dermatology Research and Practice, 2025(1), 9910076.
Li, Z., Zhang, J., Zhang, Y., Chen, H., & Bao, Y. (2025). Skin Microbiome in Health and Disease: Mechanisms and Emerging Therapeutic Strategies. Clinical, Cosmetic and Investigational Dermatology, 3443–3455.
Mayslich, C., Grange, P. A., & Dupin, N. (2021). Cutibacterium acnes as an opportunistic pathogen: An update of its virulence-associated factors. Microorganisms, 9(2), 1–21.
Mias, C., Mengeaud, V., Bessou‐Touya, S., & Duplan, H. (2023). Recent advances in understanding inflammatory acne: Deciphering the relationship between Cutibacterium acnes and Th17 inflammatory pathway. Journal of the European Academy of Dermatology and Venereology, 37, 3–11.
Mohammadi, M. (2024). Cutibacterium acnes bacteriophage therapy: exploring a new frontier in acne vulgaris treatment. Archives of Dermatological Research, 317(1), 84.
Nakase, K., Momose, M., Yukawa, T., & Nakaminami, H. (2022). Development of skin sebum medium and inhibition of lipase activity in Cutibacterium acnes by oleic acid. Access Microbiology, 4(10), 397.
Nguyen, A. T., & Kim, K. Y. (2020). Inhibition of Proinflammatory Cytokines in Cutibacterium acnes-Induced Inflammation in HaCaT Cells by Using Buddleja davidii Aqueous Extract. International Journal of Inflammation, 2020.
Niedźwiedzka, A., Micallef, M. P., Biazzo, M., & Podrini, C. (2024). The role of the skin microbiome in acne: challenges and future therapeutic opportunities. International Journal of Molecular Sciences, 25(21), 11422.
Park, S.-Y., Kim, H. S., Lee, S. H., & Kim, S. (2020). Characterization and analysis of the skin microbiota in acne: impact of systemic antibiotics. Journal of Clinical Medicine, 9(1), 168.
Podwojniak, A., Tan, I. J., Sauer, J., Neubauer, Z., Rothenberg, H., Ghani, H., Parikh, A. K., & Cohen, B. (2025). Acne and the cutaneous microbiome: A systematic review of mechanisms and implications for treatments. Journal of the European Academy of Dermatology and Venereology, 39(4), 793–805.
Rozas, M., de Ruijter, A. H., Fabrega, M. J., Zorgani, A., Guell, M., Paetzold, B., & Brillet, F. (2021). From dysbiosis to healthy skin: Major contributions of cutibacterium acnes to skin homeostasis. Microorganisms, 9(3), 1–18.
Rozas, M., Hart de Ruijter, A., Fabrega, M. J., Zorgani, A., Guell, M., Paetzold, B., & Brillet, F. (2021). From dysbiosis to healthy skin: major contributions of Cutibacterium acnes to skin homeostasis. Microorganisms, 9(3), 628.
Ruchiatan, K., Rizqandaru, T., Satjamanggala, P. R., Tache, N., Cahyadi, A. I., Rezano, A., Gunawan, H., Sutedja, E. K., Dwiyana, R. F., & Hidayah, R. M. N. (2023). Characteristics of biofilm-forming ability and antibiotic resistance of Cutibacterium acnes and Staphylococcus epidermidis from acne vulgaris patients. Clinical, Cosmetic and Investigational Dermatology, 2457–2465.
Schommer N. N., & Gallo R. L.: (2013). Structure and function of the human skin microbiome. Trends in Microbiology, 21, 660–668.
Searle, T., Al-Niaimi, F., & Ali, F. R. (2025). Modulation of the microbiome: a paradigm shift in the treatment of acne. Clinical and Experimental Dermatology, 50(12), 2357–2364.
Sfriso, R., Egert, M., Gempeler, M., Voegeli, R., & Campiche, R. (2020). Revealing the secret life of skin - with the microbiome you never walk alone. International Journal of Cosmetic Science, 42(2), 116–126.
Sitohang, I. B. S., Legiawati, L., Widaty, S., Nilasari, H., Agustin, T., Chairunnisa, S., & Manurung, T. H. P. (2026). Comparative Profile of Microbiome in Normal Skin and Acne Vulgaris Skin Patients. Clinical, Cosmetic and Investigational Dermatology, 1–7.
Spittaels, K.-J., Ongena, R., Zouboulis, C. C., Crabbé, A., & Coenye, T. (2020). Cutibacterium acnes phylotype I and II strains interact differently with human skin cells. Frontiers in Cellular and Infection Microbiology, 10, 575164.
Zhang, N., Yuan, R., Xin, K. Z., Lu, Z., & Ma, Y. (2019). Antimicrobial susceptibility, biotypes and phylotypes of clinical cutibacterium (formerly propionibacterium) acnes strains isolated from acne patients: an observational study. Dermatology and Therapy, 9(4), 735–746.
Zhu, C., Wei, B., Li, Y., & Wang, C. (2025). Antibiotic resistance rates in Cutibacterium acnes isolated from patients with acne vulgaris: a systematic review and meta-analysis. Frontiers in Microbiology, 16, 1565111.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Putri Novian Zahra

This work is licensed under a Creative Commons Attribution 4.0 International License.




























