The plain-language read
Acne vulgaris is one of the most prevalent disorders affecting 9%-10% of the global population, representing as papules, pustules, and comedones, with a pathogenesis involving increased sebum production, C. This research aim to clarify their therapeutic role and provide evidence on their effectiveness and safety. OBJECTIVES: This systematic review and meta-analysis investigated the effectiveness of oral and topical Lactobacillus-based probiotics or postbiotics, compared with placebo or benzoyl peroxide, in patients with acne vulgaris.
- BACKGROUND: Acne vulgaris is one of the most prevalent disorders affecting 9%-10% of the global population, representing as papules, pustules, and comedones, with a pathogenesis involving increased sebum production, C. acnes colonization, and inflammation.
- The pooled mean difference for non-inflammatory lesions was -1.39 (95% CI -5.10 to 2.32, p = 0.46), for inflammatory lesions was -0.08 (95% CI -1.28 to 1.11, p = 0.89), and for total lesion counts was -9.07 (95% CI -20.71 to 2.57, p = 0.13).
- The findings aim to clarify their therapeutic role and provide evidence on their effectiveness and safety.
- OBJECTIVES: This systematic review and meta-analysis investigated the effectiveness of oral and topical Lactobacillus-based probiotics or postbiotics, compared with placebo or benzoyl peroxide, in patients with acne vulgaris.
Relevant if you're working with retinol, glycolic acid, benzoyl peroxide for acne and aging.
What this means for your routine
If you're targeting acne, this research supports adding retinol to your PM routine. Effective concentration range: 9% based on this study.
If you're targeting acne, this research supports adding glycolic_acid to your AM/PM routine. Effective concentration range: 9% based on this study.
Translated from this study's findings, not a personal prescription. Pair with your existing protocol and your practitioner's guidance.
Technical Summary, For Professional Reference
Clinical context
1. J Cosmet Dermatol. 2026 Mar;25(3):e70792. doi: 10.1111/jocd.70792. Lactobacillus-Based Microbiome Therapy for Acne Vulgaris: A GRADE Systematic Review and Meta-Analysis of Randomized Controlled Trials. Abedin ZU(1), Shah A(2), Mazhar S(3), Khan SM(4), Aamir AB(5), Yousaf S(1), Fnu D(6), Mahato RK(7), Ansari A(8).
Full abstract→
1. J Cosmet Dermatol. 2026 Mar;25(3):e70792. doi: 10.1111/jocd.70792. Lactobacillus-Based Microbiome Therapy for Acne Vulgaris: A GRADE Systematic Review and Meta-Analysis of Randomized Controlled Trials. Abedin ZU(1), Shah A(2), Mazhar S(3), Khan SM(4), Aamir AB(5), Yousaf S(1), Fnu D(6), Mahato RK(7), Ansari A(8). Author information: (1)King Edward Medical University, Lahore, Pakistan. (2)Khyber Medical College, Peshawar, Pakistan. (3)Jinnah Sindh Medical University, Karachi, Pakistan. (4)Karachi Medical and Dental College, Karachi, Pakistan. (5)Punjab Medical College, Faisalabad Medical University, Faisalabad, Pakistan. (6)Post Graduate Institute of Medical Education and Research, Chandigarh, India. (7)Gandaki Medical College Teaching Hospital and Research Centre, Pokhara, Nepal. (8)Dow University of Health Sciences, Karachi, Sindh, Pakistan. BACKGROUND: Acne vulgaris is one of the most prevalent disorders affecting 9%-10% of the global population, representing as papules, pustules, and comedones, with a pathogenesis involving increased sebum production, C. acnes colonization, and inflammation. Conventional treatments like retinoids and antibiotics often cause side effects, thus diverting attention toward probiotics as an alternative therapy. Lactobacillus probiotics, having their immunomodulatory, anti-inflammatory, and antimicrobial properties, are useful in managing acne by reducing inflammation and oxidative stress with proved safety profile and the potential to reduce antibiotic reliance. This systematic review and meta-analysis evaluate the efficacy of Lactobacillus-based probiotics compared to placebo and benzoyl peroxide in reducing inflammatory lesions, non-inflammatory lesions, and total acne lesion counts. The findings aim to clarify their therapeutic role and provide evidence on their effectiveness and safety. OBJECTIVES: This systematic review and meta-analysis investigated the effectiveness of oral and topical Lactobacillus-based probiotics or postbiotics, compared with placebo or benzoyl peroxide, in patients with acne vulgaris. METHODS: A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted, including studies evaluating oral or topical Lactobacillus-based probiotic or postbiotic interventions in patients with acne vulgaris. Primary outcomes were changes in inflammatory lesion counts, while secondary outcomes included non-inflammatory and total lesion counts, skin hydration, and sebum concentration. All analyses were performed using random-effects models with 95% confidence intervals (CI), and heterogeneity was quantified using the I2 statistic. RESULTS: A total of five RCTs involving 332 participants were included. The pooled mean difference for non-inflammatory lesions was -1.39 (95% CI -5.10 to 2.32, p = 0.46), for inflammatory lesions was -0.08 (95% CI -1.28 to 1.11, p = 0.89), and for total lesion counts was -9.07 (95% CI -20.71 to 2.57, p = 0.13). These results concluded that there was no significant reduction in lesion counts with Lactobacillus-based probiotics as compared to placebo or benzoyl peroxide. Heterogeneity was moderate to low across studies. CONCLUSION: This meta-analysis indicates that Lactobacillus-based probiotics do not provide significant clinical benefits in reducing inflammatory lesions, non-inflammatory lesions, and total acne lesion counts in Acne vulgaris patients compared to placebo or benzoyl peroxide. © 2026 The Author(s). Journal of Cosmetic Dermatology published by Wiley Periodicals LLC. DOI: 10.1111/jocd.70792 PMCID: PMC13000680 PMID: 41853869 [Indexed for MEDLINE] Conflict of interest statement: The authors declare no conflicts of interest.
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