Minocycline and Its Impact on Microbial Dysbiosis in the Skin and Gastrointestinal Tract of Acne Patients.

BACKGROUND

Associations between acne and gastrointestinal comorbidities suggest that microbial dysbiosis and intestinal permeability may promote inflammatory acne, a condition often managed with oral antibiotics.

OBJECTIVE

We performed a case-control study to investigate the skin and gut microbiota in 8 acne patients before and after receiving oral minocycline compared to controls matched by age ±5 years, sex, and race.

METHODS

DNA was extracted from stool samples and facial skin swabs. Sequencing of the V3V4 region of the bacterial 16S rRNA gene was performed using Illumina MiSeq and analyzed using QIIME/MetaStats 2.0 software.

RESULTS

Acne patients included 7 female and 1 male, ages 20~32. Shannon diversity was not significantly different between the skin (=0.153) or gut (<0.999) microbiota of acne patients before and after antibiotics. The gut microbiota in pre-antibiotic acne patients compared to acne-free controls was depleted in probiotics (=0.001), (=0.001), and (=0.026). After antibiotics, the gut microbiota of acne patients was depleted in (=0.001), (=0.002), (=0.010), and (=0.042), while the skin microbiota was enriched in probiotics (=0.028) and (=0.029) and depleted in (=0.009) and (=0.028). At the phylum level, significant enrichment of Bacteroidetes in stool of acne patients following antibiotic treatment (=0.033) led to a decreased Firmicutes to Bacteroidetes ratio.

CONCLUSION

Minocycline produces significant derangements in the microbiota of the skin and gut, including many probiotic species, highlighting the potential for more targeted antimicrobial treatments for acne.