The influence of benzoyl peroxide on skin microbiota and the epidermal barrier for acne vulgaris
Benzoyl peroxide (BPO) has been advocated as a means for lowering the Cutibacterium load on the skin of patients having shoulder arthroplasty.
These authors sought to determine the effect of BPO treatment on the skin microbiome and on the epidermal barrier in 33 patients with acne vulgaris and 19 healthy controls.
All subjects received topical treatment with BPO 5% gel for 12 weeks.
After receiving treatment with BPO, subjects had significant improvement in their Global Acne Grading System (GAGS) score, porphyrin, and red areas.
However, the epidermal barrier indices of stratum corneum hydration (SCH), and transepidermal water loss (TEWL) worsened.
When compared with baseline, microbial diversity was significantly reduced after treatment. The prevalence of the Cutibacterium was significantly reduced after treatment while the prevalence of Staphylococcus tended to increase.
The authors concluded that BPO treatment may reduce microbial diversity and damage the epidermal barrier.
They suggested that the decline of sebum level by BPO treatment may damage the stratum corneum,
which is known to be covered with a sebum membrane and primarily composed of keratinocytes and lipids to act in the homeostatic control of water. Consequently, increased transepidermal water loss and decreased stratum corneum hydration were observed and skin irritability and dryness occurred.
The impaired skin barrier function could promote altered microbial colonization. Their study found that the relative abundance of Staphylococcus increased after treatment alongside a decline in SCH, deterioration of TEWL, and loss of microbial diversity.
Comment: While BPO treatment can lessen the average load of Cutibacterium on the skin, it can also have adverse effects such as skin irritability, dryness, and cause disturbance of the microbiome (dysbiosis see Cutibacterium - friend or foe?).
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