Prospective, Randomized, Open-Label Trial Comparing the Safety, Efficacy, and Tolerability of an Acne Treatment Regimen with and without a Probiotic Supplement and Minocycline in Subjects with Mild to Moderate Acne

Background: Systemic antibiotics are an effective treatment for acne vulgaris. However, intolerable side effects may invariably occur. Objective: To determine whether probiotics reduce the side effects imparted by systemic antibiotics while working synergistically with the latter in treating inflammatory acne. Methods: Forty-five 18- to 35-year-old females were randomly assigned to one of three arms in this prospective, open-label study. Group A received probiotic supplementation, whereas group B received only minocycline. Group C was treated with both probiotic and minocycline. Clinical and subjective assessments were completed at baseline and during the 2-, 4-, 8-, and 12-week follow-up visits. Results: All patients demonstrated a significant improvement in total lesion count 4 weeks after treatment initiation ( p < .001), with continued improvement seen with each subsequent follow-up visit ( p < .01). At the 8- and 12-week follow-up visits, group C had a significant decrease in total lesion count versus groups A ( p < .001) and B ( p < .01). Two patients (13%) from group B failed to complete the study secondary to vaginal candidiasis. Conclusion: Probiotics may be considered a therapeutic option or adjunct for acne vulgaris by providing a synergistic antiinflammatory effect with systemic antibiotics while also reducing potential adverse events secondary to chronic antibiotic use.