{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T07:41:20Z","timestamp":1790667680648,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Cosmetic Dermatology"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acne vulgaris is one of the most prevalent disorders affecting 9%\u201310% 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\u2010inflammatory, 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\u2010analysis evaluate the efficacy of Lactobacillus\u2010based probiotics compared to placebo and benzoyl peroxide in reducing inflammatory lesions, non\u2010inflammatory lesions, and total acne lesion counts. The findings aim to clarify their therapeutic role and provide evidence on their effectiveness and safety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This systematic review and meta\u2010analysis investigated the effectiveness of oral and topical Lactobacillus\u2010based probiotics or postbiotics, compared with placebo or benzoyl peroxide, in patients with acne vulgaris.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A systematic review and meta\u2010analysis of randomized controlled trials (RCTs) was conducted, including studies evaluating oral or topical Lactobacillus\u2010based probiotic or postbiotic interventions in patients with acne vulgaris. Primary outcomes were changes in inflammatory lesion counts, while secondary outcomes included non\u2010inflammatory and total lesion counts, skin hydration, and sebum concentration. All analyses were performed using random\u2010effects models with 95% confidence intervals (CI), and heterogeneity was quantified using the I\n                      <jats:sup>2<\/jats:sup>\n                      statistic.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of five RCTs involving 332 participants were included. The pooled mean difference for non\u2010inflammatory lesions was \u22121.39 (95% CI \u22125.10 to 2.32,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.46), for inflammatory lesions was \u22120.08 (95% CI \u22121.28 to 1.11,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.89), and for total lesion counts was \u22129.07 (95% CI \u221220.71 to 2.57,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.13). These results concluded that there was no significant reduction in lesion counts with Lactobacillus\u2010based probiotics as compared to placebo or benzoyl peroxide. Heterogeneity was moderate to low across studies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This meta\u2010analysis indicates that Lactobacillus\u2010based probiotics do not provide significant clinical benefits in reducing inflammatory lesions, non\u2010inflammatory lesions, and total acne lesion counts in Acne vulgaris patients compared to placebo or benzoyl peroxide.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jocd.70792","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T08:55:31Z","timestamp":1773910531000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Lactobacillus\u2010Based Microbiome Therapy for Acne Vulgaris: A\n                    <scp>GRADE<\/scp>\n                    Systematic Review and Meta\u2010Analysis of Randomized Controlled Trials"],"prefix":"10.1111","volume":"25","author":[{"given":"Zain Ul","family":"Abedin","sequence":"first","affiliation":[{"name":"King Edward Medical University  Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asim","family":"Shah","sequence":"additional","affiliation":[{"name":"Khyber Medical College  Peshawar Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Safa","family":"Mazhar","sequence":"additional","affiliation":[{"name":"Jinnah Sindh Medical University  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6023-5835","authenticated-orcid":false,"given":"Saim Mahmood","family":"Khan","sequence":"additional","affiliation":[{"name":"Karachi Medical and Dental College  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad Bin","family":"Aamir","sequence":"additional","affiliation":[{"name":"Punjab Medical College Faisalabad Medical University  Faisalabad Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3072-162X","authenticated-orcid":false,"given":"Sheeza","family":"Yousaf","sequence":"additional","affiliation":[{"name":"King Edward Medical University  Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deeksha","family":"Fnu","sequence":"additional","affiliation":[{"name":"Post Graduate Institute of Medical Education and Research  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5685-7118","authenticated-orcid":false,"given":"Raghabendra Kumar","family":"Mahato","sequence":"additional","affiliation":[{"name":"Gandaki Medical College Teaching Hospital and Research Centre  Pokhara Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asma","family":"Ansari","sequence":"additional","affiliation":[{"name":"Dow University of 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