Efficacy of probiotic‐derived lotion from Lactobacillus paracasei MSMC 39‐1 in mild to moderate acne vulgaris, randomized controlled trial

Abstract Background Probiotics provide benefits for reducing acne. Previous studies showed an anti‐inflammatory effect of Lactobacillus paracasei . However, the clinical evidence of topical probiotic lotion and acne treatment is still lacking. Objective To evaluate the efficacy and safety of probiotic‐derived lotion compared with 2.5% benzoyl peroxide in the treatment of mild‐to‐moderate acne vulgaris. Methods Topical probiotic‐derived lotion was formulated from cell‐free supernatant of L . paracasei MSMC 39‐1. In vitro study showed the ability of the supernatant to inhibit both antibiotic‐resistance and‐susceptibility strains of C. acnes and inhibit tumor necrosis factor‐α. The patients with mild‐to‐moderate acne vulgaris on the face were randomized to receive topical probiotic‐derived lotion or 2.5% benzoyl peroxide. Acne lesion counts, erythema index, and side effects were assessed after 2 and 4 weeks of treatment. Results One hundred and four acne vulgaris patients were enrolled. After four weeks of treatment, the inflammatory acne lesion counts and erythema index significantly decreased compared with the baseline in both the probiotic‐derived lotion group and 2.5% benzoyl peroxide group ( p < 0.001 in both groups) without statistically significant difference between the two groups ( p > 0.05). However, the comedones were not affected in both groups. Four patients (7.69%) treated with probiotic‐derived lotion and 14 patients (26.92%) treated with 2.5% benzoyl peroxide reported treatment‐associated side effects. Conclusion Probiotic‐derived lotion is safe and effective for treating mild to moderate acne vulgaris, a comparable outcome with 2.5% benzoyl peroxide. It could be an alternative treatment of acne with more minor side effects.