Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2025 Jan;24(1):e16614.
doi: 10.1111/jocd.16614. Epub 2024 Oct 16.

Evaluating the Effectiveness of Probiotic Supplementation in Combination With Doxycycline for the Treatment of Moderate Acne: A Randomized Double-Blind Controlled Clinical Trial

Najmolsadat Atefi  1 , Masoumeh Mohammadi  1 , Mohammad Bodaghabadi  2 , Marjan Mehrali  3 , Elham Behrangi  1 , Mohammadreza Ghassemi  1 , Alireza Jafarzadeh  1 , Azadeh Goodarzi  1
Affiliations
Randomized Controlled Trial

Evaluating the Effectiveness of Probiotic Supplementation in Combination With Doxycycline for the Treatment of Moderate Acne: A Randomized Double-Blind Controlled Clinical Trial

Najmolsadat Atefi et al. J Cosmet Dermatol. 2025 Jan.

Abstract

Background: Acne is a chronic inflammatory skin disease that negatively affects patients' quality of life. Increasing antibiotic resistance is making acne less responsive to treatment. Probiotics are live microorganisms that can provide health benefits by fighting pathogens and maintaining intestinal homeostasis and skin microbiome balance. This study investigates the effects of probiotics in the treatment of acne vulgaris.

Methods: In this randomized controlled clinical trial, 80 patients with moderate acne were divided into two groups of 40. All patients received the same topical treatment, which consisted of a daily antibacterial face wash and Adapalene gel every other night. The control group received one capsule of doxycycline (100 mg) daily, whereas the intervention group received one probiotic capsule daily in addition to doxycycline. Patients underwent photography of facial acne lesions, and treatment response was assessed using the global acne grading system (GAGS) and acne grading method at baseline, as well as during follow-up visits at 1, 2, and 3 months.

Results: The global acne grading system indicated that both groups showed improvement. However, analyses revealed that outcomes were significantly better in the doxycycline plus probiotics group for the forehead (p = 0.018), chin (p = 0.021), and nose (p = 0.021). No significant differences were observed for the left and right cheeks, back, and chest areas, with the mean GAGS score reduction between the two groups differing by only 2%. Treatment with probiotics significantly reduced the severity of lesions compared to the control group (p < 0.001). The acne grading method also indicated that the intervention group had a significantly better treatment response than the control group (p < 0.001). Furthermore, treatment with probiotics did not result in any side effects.

Conclusion: Probiotics can serve as an effective and safe treatment option, enhancing the outcomes of routine acne treatments, particularly for patients with acne on the forehead, chin, and nose.

Keywords: RCT; acne; acne vulgaris; doxycycline; efficacy; lactobacillus; microbial supplement; microbiome; probiotic; safety.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Flow diagram of the phases of the study.
FIGURE 2
FIGURE 2
Charts represent mean and standard error of mean (SEM) GAGS score in forehead (A), left cheek (B), chin (C), and total body (D); *p‐value < 0.05.
See this image and copyright information in PMC

References

    1. Perkins A. C., Maglione J., Hillebrand G. G., Miyamoto K., and Kimball A. B., “Acne Vulgaris in Women: Prevalence Across the Life Span,” Journal of Women's Health 21, no. 2 (2012): 223–230. - PubMed
    1. Patel M., Bowe W. P., Heughebaert C., and Shalita A. R., “The Development of Antimicrobial Resistance Due to the Antibiotic Treatment of Acne Vulgaris: A Review,” Journal of Drugs in Dermatology 9, no. 6 (2010): 655–664. - PubMed
    1. Cooper A. J., “Systematic Review of Propionibacterium Acnes Resistance to Systemic Antibiotics,” Medical Journal of Australia 169, no. 5 (1998): 259–261. - PubMed
    1. Hay R. J., Johns N. E., Williams H. C., et al., “The Global Burden of Skin Disease in 2010: An Analysis of the Prevalence and Impact of Skin Conditions,” Journal of Investigative Dermatology 134, no. 6 (2014): 1527–1534. - PubMed
    1. Silverberg J. I. and Silverberg N., “Epidemiology and Extracutaneous Comorbidities of Severe Acne in Adolescence: A US Population‐Based Study,” British Journal of Dermatology 170, no. 5 (2014): 1136–1142. - PubMed

Publication types

MeSH terms

LinkOut - more resources