Acne: role of Cutibacterium acnes and possibilities of using bacteriophages

Abstract

BACKGROUND: The role of Cutibacterium acnes in the pathogenesis of acne vulgaris and its adverse effect on follicular hyperkeratosis, inflammation and the skin microbiome have now been established. Their excessive colonization contributes to the loss of microbial diversity of the skin, activates the innate immune system, leads to the appearance of skin rash elements and chronic inflammation. Bacteriophages are considered as a new promising direction in the treatment of patients with acne, as they have an antimicrobial effect against C. acnes; contribute to the preservation of the skin microbiome; have an indirect effect on the innate and adaptive immune response. AIM: To evaluate the effectiveness and safety of topical therapy with cosmetic gel with bacteriophages Fagoderm in the complex treatment of patients with moderate to severe acne. MATERIALS AND METHODS: In the design of a simple open prospective study in parallel groups, the effect of cosmetic gel with bacteriophages on the number of comedones, pupules and pustules was assessed in 35 adult patients with moderate acne. During therapy, possible adverse events were simultaneously recorded. RESULTS: During therapy, similar dynamics were noted in the form of a decrease in non-inflammatory elements of acne both in the group of people receiving a combination of adapalene and phagoderm, and in the comparison group, where monotherapy with adapalene was carried out. The number of inflammatory elements of acne decreased in both groups, but in the main group this happened at an earlier time. Compared to the initial data, already in the 2nd week the number of inflammatory elements decreased by 50% (in comparison ― by 32%); by the end of the 4th ― by 95% (respectively in the comparison group ― by 74%). CONCLUSION: Cosmetic gel with bacteriophages with bacteriophages helps reduce the inflammatory manifestations of moderate acne.