Journal of Clinical & Experimental Dermatology Research
Open Access

Abstract

The Role of an Aloe Vera and Antimicrobial Peptide-Based Skin Cleanser on Microbiome Balance in Acne Vulgaris: A Prospective, Proof of Concept, Open Label Trial

Francesca Colombo and Massimo Milani*

Introduction: The microbiome represents one of the different factors involved in the pathogenesis of acne. Negative effects on skin microbiome were described after the use of specific acne treatments (like isotreinoin and benzoyl peroxide) or aggressive cleansers. Considering that skin cleansing protocols represent an important step in acne care, the use of a cleanser that preserve or restore the microbiome balance represents a key strategy in the treatment of acne. In this context, a prospective, proof of concept, open label trial was conducted to evaluate the effect of a cleanser containing Aloe Vera and Biopep15 (an oligopeptide with antibacterial and anti-inflammatory activities) on skin microbiome in subjects with acne-prone skin.

Materials and methods: Fifteen subjects (11 women and 4 men, mean age 23 ± 3 years), with acne-prone skin, were enrolled in the study. The cleanser was applicated on the face twice a day (morning and evening) for 28 consecutive days. The skin acceptability (clinical signs and sensations of discomfort) and the effect on skin microbiome (by means of skin DNA sequencing) were evaluated after 28 days of product used.

Results: The cleanser showed very good skin acceptability: No clinical signs or sensations of discomfort were observed during the treatment. No alteration in microbial richness and in microbial diversity (evaluated by OTUs, Chao and Shannon Indexes) was observed after 28 days of treatment, although a slight not significant increase in microbial diversity was observed. In the present study a decrease in Actinobacteria (-0.38 ± 23.04%) and Firmicutes (-7.14 ± 17.06%), and an increase in Proteobacteria (5.48 ± 17.75%) and Bacteroidetes (2.41 ± 4.72%, p<0.05), although generally not statistically significant, was observed at the end of the treatment. According to the literature, Actinobacteria and Firmicutes are generally increased in acne patients while Proteobacteria are usually under-represented in the acne skin patients. At genus level a statistical decrease of Corynebacterium (-1.86 ± 3.15%, p<0.05) and a decrease of Staphylococcus and Streptococcus (-1.50 ± 15.89% and -2.93 ± 11.10%, respectively), both generally abundant on acne skin, were observed.

Conclusion: The cleanser evaluated in this study was well tolerated with preserving and restoring effects on microbiome balance in acne patients. Therefore, it could be used as adjuvant product for effective acne treatments like benzoyl peroxide and oral isotretinoin which could have negative effects on skin microbiome.

Published Date: 2023-03-31; Received Date: 2023-02-27