Skin barrier and microbiome in acne



Acne is an immune-mediated chronic inflammatory disease. Although several factors are involved in its pathophysiology, this process is not completely understood. Androgen hormone activity increases sebum production inside the pilosebaceous follicle, adjusting the environment for the development of Propionibacterium acnes which triggers inflammation. Knowing how others factors such as the skin barrier and microbiome are involved in acne, can help in understanding more about the disease and may help to conduct a better treatment.


Acne Skin barrier Microbiome Microbiota 


Compliance with ethical standards

Conflict of interest

Authors declare that they have no conflicts of interest.




  1. 1.
    Baroni A, Buommino E, De Gregorio V et al (2012) Structure and function of epidermis related to barrier properties. Clin Dermatol 30:257–262CrossRefPubMedGoogle Scholar
  2. 2.
    Belkaid Y, Segre JA (2014) Dialogue between skin microbiota and immunity. Science 346:954–959CrossRefPubMedGoogle Scholar
  3. 3.
    Brüggemann H, Henne A, Hoster F et al (2004) The complete genome sequence of Propionibacterium acnes, a commensal of human skin. Science 305:671–673CrossRefPubMedGoogle Scholar
  4. 4.
    Brüggemann H (2005) Insights in the pathogenic potential of Propionibacterium acnes from its complete genome. Semin Cutan Med Surg 24:67–72CrossRefPubMedGoogle Scholar
  5. 5.
    Burton JL, Cunliffe WJ, Stafford L (1971) The prevalence of acne vulgaris in adolescence. Br J Dermatol 85:119–26CrossRefPubMedGoogle Scholar
  6. 6.
    Choi CW, Choi JW, Park KC, Youn SW (2013) Facial sebum affects the development of acne, especially the distribution of inflammatory acne. J Eur Acad Dermatol Venereol 27:301–306CrossRefPubMedGoogle Scholar
  7. 7.
    Cogen AL, Nizet V, Gallo RL (2008) Skin microbiota: a source of disease or defense? Br J Dermatol 158:442–455CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Collier CN, Harper JC, Cafardi JA, Wang W, Foster KW (2008) The prevalence of acne in adults 20 years and older. J Am Acad Dermatol 58:56–9CrossRefPubMedGoogle Scholar
  9. 9.
    Decker A, Graber EM (2012) Over-the-counter acne treatments: a review. J Clin Aesthet Dermatol 5(5):32–40PubMedPubMedCentralGoogle Scholar
  10. 10.
    Del Rosso JQ (2009) Moisturizers: functions, formulation, and clinical applications. In: Draelos ZD (ed) Cosmeceuticals. Saunders Elsevier, Philadelphia, pp 97–102Google Scholar
  11. 11.
    Del Rosso JQ, Levin J (2011) The clinical relevance of maintaining the functional integrity of the stratum corneum in both healthy and disease-affected skin. J Clin Aesthet Dermatol 4(9):22–42PubMedPubMedCentralGoogle Scholar
  12. 12.
    Del Rosso JQ (2011) Topical antibiotics. In: Shalita AR, Del Rosso JQ, Webster GF (eds) Acne vulgaris. Informa Healthcare, London 95–104CrossRefGoogle Scholar
  13. 13.
    Del Rosso JQ (2013) Clinical relevance of skin barrier changes associated with the use of oral isotretinoin: the importance of barrier repair therapy in patient management. J Drugs Dermatol 12:626–631PubMedGoogle Scholar
  14. 14.
    Dominguez-Bello MG, Costello EK, Contreras M, Magris M, Hidalgo G, Fierer N, Knight R (2010) Delivery mode shapes the acquisition and structure of the initial microbiota across multiple body habitats in newborns. Proc Natl Acad Sci USA 107(26):11971–11975CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Downing D, Stewart M, Wertz P, Strauss J (1986) Essential fatty acids and acne. J Am Acad Dermatol 14:221–225CrossRefPubMedGoogle Scholar
  16. 16.
    Draelos ZD, Ertel KD, Berge CE (2006) Facilitating facial retinization through barrier improvement. Cutis 78:275–281PubMedGoogle Scholar
  17. 17.
    Elias PM (1986) Epidermal effects of retinoids: supramolecular observations and clinical implications. J Am Acad Dermatol 15(4 Pt 2):797–809CrossRefPubMedGoogle Scholar
  18. 18.
    Farrah G, Tan E (2016) The use of oral antibiotics in treating acne vulgaris: a new approach. Dermatol Ther 29(5):377–384CrossRefPubMedGoogle Scholar
  19. 19.
    Findley K, Grice EA (2014) The skin microbiome: a focus on pathogens and their association with skin disease. PLoS Pathog 10(10):e1004436CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Fitz-Gibbon S, Tomida S, Chiu BH et al (2013) Propionibacterium acnes strain populations in the human skin microbiome associated with acne. J Invest Dermatol 133:2152–2160CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Gollnick H, Cunliffe W, Berson D et al (2003) Management of acne: a report from the global alliance to improve outcomes in acne. J Am Acad Dermatol 49(Suppl 1):S1–S38CrossRefPubMedGoogle Scholar
  22. 22.
    Grice EA, Kong HH, Renaud G et al (2008) A diversity profile of the human skin microbiota. Genome Res 18:1043–1050CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Grice EA, Segre JA (2011) The skin microbiome. Nat Rev Microbiol 9:244–253CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Haustein UF, Tegetmeyer L, Ziegler V (1985) Allergic and irritant potential of benzoyl peroxide. Contact Dermat 13(4):252–257CrossRefGoogle Scholar
  25. 25.
    Heughebaert C, Shalita A. Comedogenesis (2011) In: Shalita AR, Del Rosso JQ, Webster GF (eds) Acne vulgaris. Informa Healthcare, New York, pp 28–42CrossRefGoogle Scholar
  26. 26.
    Hsieh M, Chen C (2011) Delivery of pharmaceutical agents to treat acne vulgaris: current status and perspectives. J Med Biol Eng 32(4):215–224CrossRefGoogle Scholar
  27. 27.
    Hui A, Shalita A (2011) Topical retinoids. In: Shalita AR, Del Rosso JQ, Webster GF (eds) Acne vulgaris. Informa Healthcare, London, pp 86–94CrossRefGoogle Scholar
  28. 28.
    Jarrousse V, Castex-Rizzi N, Khammari A et al (2007) Modulation of integrins and filaggrin expression by Propionibacterium acnes extracts on keratinocytes. Arch Dermatol Res 299:441–447CrossRefPubMedGoogle Scholar
  29. 29.
    Jasson F, Nagy I, Knol AC, Zuliani T, Khammari A, Dréno B (2013) Different strains of Propionibacterium acnes modulate differently the cutaneous innate immunity. Exp Dermatol 22:587–592CrossRefPubMedGoogle Scholar
  30. 30.
    Kong HH (2011) Skin microbiome: genomics-based insights into the diversity and role of skin microbes. Trend Mol Med 17:320–328CrossRefGoogle Scholar
  31. 31.
    Krishna S, Kim C, Kim J (2011) Innate immunity in the pathogenesis of acne vulgaris. In: Shalita AR, Del Rosso JQ, Webster GF (eds) Acne vulgaris. Informa Healthcare, London, pp 12–27Google Scholar
  32. 32.
    Kumar B, Pathak R, Mary PB et al (2016) New insights into acne pathogenesis: exploring the role of acne-associated microbial populations. Dermatol Sin 34(2):67–73CrossRefGoogle Scholar
  33. 33.
    Kurokawa I, Mayer-da-Silva A, Gollnick H et al (1988) Monoclonal antibody labeling for cytokeratins and filaggrin in the human pilosebaceous unit of normal, seborrhoeic and acne skin. J Invest Dermatol 91:566–571CrossRefPubMedGoogle Scholar
  34. 34.
    Marples RR, Downing DT, Kligman AM (1971) Control of free fatty acids in human surface lipids by Corynebacterium acnes. J Invest Dermatol 56:127–131CrossRefPubMedGoogle Scholar
  35. 35.
    Mueller NT, Bakacs E, Combellick J, Grigoryan Z, Dominguez-Bello MG (2015) The infant microbiome development: mom matters. Trend Mol Med 21(2):109–17CrossRefGoogle Scholar
  36. 36.
    Muszer M, Noszczyńska M, Kasperkiewicz K, Skurnik M (2015) Human microbiome: when a friend becomes an enemy. Arch Immunol Ther Exp (Warsz) 63(4):287–98CrossRefGoogle Scholar
  37. 37.
    Naik S, Bouladoux N, Wilhelm C et al (2012) Compartmentalized control of skin immunity by resident commensals. Science 337:1115–1119CrossRefPubMedPubMedCentralGoogle Scholar
  38. 38.
    Nakamura M, Kametani IS, Higaki S, Yamagishi T (2003) Identification of Propionibacterium acnes by polymerase chain reaction for amplification of 16S ribosomal RNA and lipase genes. Anaerobe 9(1):5–10CrossRefPubMedGoogle Scholar
  39. 39.
    Ottaviani M, Alestas T, Flori E, Mastrofrancesco A, Zouboulis CC, Picardo M (2006) Peroxidated squalene induces the production of inflammatory mediators in HaCaT keratinocytes: a possible role in acne vulgaris. J Invest Dermatol 126:2430–2437CrossRefPubMedGoogle Scholar
  40. 40.
    Pappas A, Fantasia J, Chen T (2013) Age and ethnic variations in sebaceous lipids. Dermato-endocrinology 5:319–324CrossRefPubMedPubMedCentralGoogle Scholar
  41. 41.
    Pappas A, Johnsen S, Liu JC et al (2009) Sebum analysis of individuals with and without acne. Dermato-endocrinology 1(3):157–161CrossRefPubMedPubMedCentralGoogle Scholar
  42. 42.
    Pathak R, Kasama N, Kumar R, Gautman HK (2013) Staphylococcus epidermidis in human skin microbiome associated with acne: a cause of disease or defence? Res J Biotech 8(12):78–82Google Scholar
  43. 43.
    Plewig G, Kligman AM (2000) Sebaceous glands. In: Plewig G, Kligman AM (eds) Acne and rosacea, vol 70, 3rd edn. Springer, BerlinCrossRefGoogle Scholar
  44. 44.
    Ritvo E, Del Rosso J, Stillman MA et al (2011) Psychosocial judgments and perceptions of adolescents with acne vulgaris: a blinded, controlled comparison of adult and peer evaluations. Biopsychosoc Med 5:11–26CrossRefPubMedPubMedCentralGoogle Scholar
  45. 45.
    Rosenthal M, Goldberg D’Aiello A et al (2011) Skin microbiota: microbial community structure and its potential association with health and disease. Infect Genet Evol 11:839–848CrossRefPubMedPubMedCentralGoogle Scholar
  46. 46.
    Sender R, Fuchs S, Milo R (2016) Revised estimates for the number of human and bacteria cells in the body. PLoS Biol 14(8):e1002533CrossRefPubMedPubMedCentralGoogle Scholar
  47. 47.
    Smith RN, Braue A, Varigos GA, Mann NJ (2008) The effect of a low glycemic load diet on acne vulgaris and the fatty acid composition of skin surface triglycerides. J Dermatol Sci 50:41–52CrossRefPubMedGoogle Scholar
  48. 48.
    Solomon BA, Shalita AR (1996) Effect of detergents on acne. Clin Dermatol 14:95–9CrossRefPubMedGoogle Scholar
  49. 49.
    Subramanyan K (2004) Role of mild cleansing in management of patient skin. Dermatol Ther 17:26–34CrossRefPubMedGoogle Scholar
  50. 50.
    Tagami H (2008) Location-related differences in structure and function of the stratum corneum with special emphasis on facial skin. Int J Cosmet Sci 30:413–434CrossRefPubMedGoogle Scholar
  51. 51.
    Tanghetti EA, Popp KF (2009) A current review of topical benzoyl peroxide: new perspectives on formulation and utilization. Dermatol Clin 27:17–24CrossRefPubMedGoogle Scholar
  52. 52.
    Tanghetti E, Dhawan S, Green L et al (2010) Randomized comparison of the safety and efficacy of tazarotene 0.1% cream and adapalene 0.3% gel in the treatment of patients with at least moderate facial acne vulgaris. J Drugs Dermatol 9(5):549–58PubMedGoogle Scholar
  53. 53.
    Thiboutot D, Del Rosso JQ (2013) Acne vulgaris and the epidermal barrier. Is acne vulgaris associated with inherent epidermal abnormalities that cause impairment of barrier functions? Do any topical acne therapies alter the structural and/or functional integrity of the epidermal barrier? J Clin Aesthet Dermatol 6(1):18–24PubMedPubMedCentralGoogle Scholar
  54. 54.
    Thiboutot D, Gilliland K, Light J (1999) Androgen metabolism in sebaceous glands from subjects with and without acne. Arch Dermatol 135:1041–1045PubMedGoogle Scholar
  55. 55.
    Toyoda M, Morohashi M (2001) Pathogenesis of acne. Med Electron Microsc 34(1):29–40CrossRefPubMedGoogle Scholar
  56. 56.
    Weber SU, Thiele JJ, Han N et al (2003) Topical tocotrienol supplementation inhibits lipid peroxidation but fails to mitigate increased transepidermal water loss after benzoyl peroxide treatment of human skin. Free Radic Biol Med 34:170–176CrossRefPubMedGoogle Scholar
  57. 57.
    Webster GF, Kim J (2008) Immunology of acne. In: Gaspari AA, Tyring SK (eds) Clinical and basic immunodermatology. Springer, London, pp 217–222CrossRefGoogle Scholar
  58. 58.
    Wolf JE Jr (2002) Potential anti-inflammatory effects of topical retinoids and retinoid analogues. Adv Ther 19(3):109–118CrossRefPubMedGoogle Scholar
  59. 59.
    Yamamoto A, Takenouchi K, Ito M (1995) Impaired water barrier function in acne vulgaris. Arch Dermatol Res 287(2):214–218CrossRefPubMedGoogle Scholar
  60. 60.
    Yazici K, Baz K, Yazici A (2004) Disease-specificquality of life is associated with anxiety and depression in patients with acne. J Eur Acad Dermatol Venereol 18:435–439CrossRefPubMedGoogle Scholar
  61. 61.
    Zhang YQ, Ren SX, Li HL et al (2003) Genome-based analysis of virulence genes in a non-biofilm-forming Staphylococcus epidermidis strain (ATCC 12228). Mol Microbiol 49:1577–1593CrossRefPubMedGoogle Scholar
  62. 62.
    Zouboulis CC (2004) Acne and sebaceous gland function. Clin Dermatol 22:360–366CrossRefPubMedGoogle Scholar
  63. 63.
    Zouboulis CC, Schagen S, Alestas T (2008) The sebocyte culture: a model to study the pathophysiology of the sebaceous gland in sebostasis, seborrhoea and acne. Arch Dermatol Res 300:397–413CrossRefPubMedGoogle Scholar

Related articles recently published in Archives of Dermatological Research (selected by the journal’s editorial staff):

  1. 64.
    Kong F, Galzote C, Duan Y (2017) Change in skin properties over the first 10 years of life: a cross-sectional study. Arch Dermatol Res. PubMedPubMedCentralGoogle Scholar
  2. 65.
    Li WH, Zhang Q, Flach CR, Mendelsohn R, Southall MD, Parsa R (2017) In vitro modeling of unsaturated free fatty acid-mediated tissue impairments seen in acne lesions. Arch Dermatol Res. PubMedCentralGoogle Scholar
  3. 66.
    Maguire M, Maguire G (2017) The role of microbiota, and probiotics and prebiotics in skin health. Arch Dermatol Res 309:411–421CrossRefPubMedGoogle Scholar
  4. 67.
    Patwardhan SV, Richter C, Vogt A, Blume-Peytavi U, Canfield D, Kottner J (2017) Measuring acne using Coproporphyrin III, Protoporphyrin IX, and lesion-specific inflammation: an exploratory study. Arch Dermatol Res 309:159–167CrossRefPubMedPubMedCentralGoogle Scholar
  5. 68.
    Younis S, Blumenberg M, Javed Q (2016) Resistin gene polymorphisms are associated with acne and serum lipid levels, providing a potential nexus between lipid metabolism and inflammation. Arch Dermatol Res 308:229–237CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2017

Authors and Affiliations

  1. 1.Federal University of São Paulo (Escola Paulista de Medicina—Universidade Federal de São Paulo)São PauloBrazil

Personalised recommendations