Acne vulgaris is characterized by a systemic pattern of microbial dysbiosis with marked alterations in the gut microbiome alongside concurrent, albeit less pronounced, changes in the skin microbiome, supporting a role for the gut-skin axis in acne pathophysiology.
Key Findings
Results
Acne patients exhibited significantly reduced gut microbial alpha diversity compared to healthy controls.
Alpha diversity was significantly reduced in acne patients (p < 0.001 across indices)
Study included 17 patients with moderate-to-severe acne vulgaris and 14 healthy controls
Microbial DNA was extracted and V3-V4 regions of the bacterial 16S rRNA gene were sequenced on the Illumina MiSeq platform
The reduction in diversity was described as 'pronounced' relative to the skin microbiome differences
Results
Decreased diversity was also observed in the skin microbiome of acne patients, though changes were less pronounced than in the gut.
Skin microbial diversity was reduced in acne patients compared to controls
The skin microbiome changes were described as 'less pronounced' relative to gut microbiome changes
Paired facial skin swabs and stool samples were collected from all participants
Skin microbial composition showed 'more subtle differences' between groups compared to gut communities
Results
Beta diversity analyses revealed distinct gut microbial community structures between acne patients and healthy controls, whereas skin microbial composition differences were more subtle.
Beta diversity analyses were used to compare overall community composition between groups
Gut microbial communities showed distinct separation between acne and control groups
Skin microbial community differences between groups were characterized as 'more subtle'
Both gut and skin samples were analyzed from the same 31 participants (17 AV patients, 14 controls)
Results
Taxonomic profiling identified pronounced alterations in gut microbiota in acne patients, contrasting with relatively modest shifts in skin communities.
Gut microbiota showed 'pronounced alterations' in taxonomic composition in acne patients
Skin community taxonomic shifts were described as 'relatively modest'
The study used 16S rRNA gene sequencing targeting V3-V4 regions for taxonomic profiling
This was described as a pilot study with a combined sample of 31 participants
Results
The study identified a systemic pattern of microbial dysbiosis in acne vulgaris affecting both gut and skin compartments simultaneously.
Both gut and skin microbiomes were altered in acne patients relative to healthy controls
The pattern was characterized as 'systemic,' suggesting the dysbiosis is not confined to the skin
Paired sampling design allowed direct comparison of gut and skin microbiomes within the same individuals
Results were interpreted as supporting 'a role for the gut-skin axis in acne pathophysiology'
What This Means
This research suggests that acne vulgaris, a common inflammatory skin condition, is associated with disruptions in the microbial communities (microbiomes) of both the gut and the skin at the same time. The researchers collected skin swabs from the face and stool samples from 17 people with moderate-to-severe acne and 14 healthy individuals, then used genetic sequencing to analyze the bacteria present in each sample. They found that acne patients had significantly less diverse gut bacterial communities compared to healthy controls, and also showed reduced diversity in their skin microbiomes, though the skin changes were less dramatic than those in the gut.
The finding that the gut microbiome showed more substantial changes than the skin microbiome in an inflammatory skin disease is notable. It suggests that what is happening in the digestive system may be linked to what is happening on the skin — a concept sometimes called the 'gut-skin axis.' The types of bacteria present in the guts of acne patients were markedly different from those in healthy individuals, while the skin bacterial communities showed comparatively smaller but still measurable differences.
This research suggests that acne may not be purely a skin condition, but could involve broader disruptions to the body's microbial ecosystem. As a pilot study with a small sample of 31 participants, these findings are preliminary, but they point toward the potential value of examining gut health alongside skin health when studying and potentially treating inflammatory skin diseases like acne. The authors call for larger studies that take an integrated, whole-body approach to understanding how microbiomes interact with human health.
Lesiak A, Krawczyk A, Piasta J, Spałek J, Szajkowska J, Papros E, et al.. (2026). Gut and skin dysbiosis in acne vulgaris: a comparative microbiome analysis.. Frontiers in cellular and infection microbiology. https://doi.org/10.3389/fcimb.2026.1904271