{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T21:30:13Z","timestamp":1784323813039,"version":"3.55.0"},"reference-count":76,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T00:00:00Z","timestamp":1773360000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"ArrowBiome pte ltd","award":["nil"],"award-info":[{"award-number":["nil"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biomolecules"],"abstract":"<jats:p>This review discusses the microbiology of acne vulgaris, a chronic inflammatory condition of the pilosebaceous unit that affects most adolescents and can persist into adulthood. The current standard of care consists largely of antibacterial interventions, based on the traditional view of Cutibacterium acnes as a pathogen. Alternative treatments are suggested by the \u201ccomedo switch\u201d hypothesis, which attributes acne to aberrant differentiation of LRIG1+ sebaceous progenitor cells. While there is strong evidence to support this idea, it does not explain the efficacy of antibacterial interventions. We propose a unified mechanism wherein C. acnes phylotype IA1 can act as a trigger for the comedo switch. Unlike commensal strains, phylotype IA1 has high lipase activity, hydrolyzing sebum triglycerides into free fatty acids, specifically palmitic acid. This metabolite stimulates LRIG1+ progenitors, inducing inflammation and initial comedo formation. The review discusses C. acnes phylotypes, emphasizing known virulence factors of IA1, such as enhanced biofilm formation. We evaluate the efficacy and limitations of both old and new antibacterials, noting how newer materials that selectively remove C. acnes IA1 can reduce non-inflammatory acne lesions, supporting a key role for this phylotype in the pathogenesis of acne.<\/jats:p>","DOI":"10.3390\/biom16030430","type":"journal-article","created":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T09:26:38Z","timestamp":1773393998000},"page":"430","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The Evolving Microbial Paradigm in Acne"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7507-2442","authenticated-orcid":false,"given":"Maurice A. M.","family":"van Steensel","sequence":"first","affiliation":[{"name":"Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e15719","DOI":"10.1111\/dth.15719","article-title":"Acne Treatment Review and Future Perspectives","volume":"35","author":"Mohsin","year":"2022","journal-title":"Dermatol. Ther."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e1260","DOI":"10.1002\/mbo3.1260","article-title":"Impact of Antibiotics on the Human Microbiome and Consequences for Host Health","volume":"11","author":"Patangia","year":"2022","journal-title":"Microbiologyopen"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.clindermatol.2009.03.012","article-title":"The Role of Propionibacterium acnes in Acne Pathogenesis: Facts and Controversies","volume":"28","author":"Dessinioti","year":"2010","journal-title":"Clin. Dermatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1007\/s00105-021-04856-8","article-title":"Acne","volume":"72","author":"Karoglan","year":"2021","journal-title":"Hautarzt"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1111\/bjd.17981","article-title":"Homeostasis of the Sebaceous Gland and Mechanisms of Acne Pathogenesis","volume":"181","author":"Clayton","year":"2019","journal-title":"Br. J. Dermatol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1111\/ahg.70014","article-title":"The Genetics of Acne","volume":"89","year":"2025","journal-title":"Ann. Hum. Genet."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1159\/000382031","article-title":"Strategic Targets in Acne: The Comedone Switch in Question","volume":"231","author":"Saurat","year":"2015","journal-title":"Dermatology"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2340","DOI":"10.1111\/jdv.15795","article-title":"Cutibacterium acnes Phylotypes Diversity Loss: A Trigger for Skin Inflammatory Process","volume":"33","author":"Dagnelie","year":"2019","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"4422","DOI":"10.1099\/ijsem.0.001367","article-title":"The Natural History of Cutaneous Propionibacteria, and Reclassification of Selected Species within the Genus Propionibacterium to the Proposed Novel Genera Acidipropionibacterium Gen. Nov., Cutibacterium Gen. Nov. and Pseudopropionibacterium Gen. Nov","volume":"66","author":"Scholz","year":"2016","journal-title":"Int. J. Syst. Evol. Microbiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1128\/jb.109.3.1047-1066.1972","article-title":"Cell Wall Composition and Deoxyribonucleic Acid Similarities among the Anaerobic Coryneforms, Classical Propionibacteria, and Strains of Arachnia Propionica","volume":"109","author":"Johnson","year":"1972","journal-title":"J. Bacteriol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1128\/jcm.7.1.84-90.1978","article-title":"Use of Bacteriophage Typing to Distinguish Propionibacterium acne Types I and II","volume":"7","author":"Webster","year":"1978","journal-title":"J. Clin. Microbiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1128\/JCM.43.1.326-334.2005","article-title":"Propionibacterium acnes Types I and II Represent Phylogenetically Distinct Groups","volume":"43","author":"McDowell","year":"2005","journal-title":"J. Clin. Microbiol."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Lomholt, H.B., and Kilian, M. (2010). Population Genetic Analysis of Propionibacterium acnes Identifies a Subpopulation and Epidemic Clones Associated with Acne. PLoS ONE, 5.","DOI":"10.1371\/journal.pone.0012277"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2152","DOI":"10.1038\/jid.2013.21","article-title":"Propionibacterium acnes Strain Populations in the Human Skin Microbiome Associated with Acne","volume":"133","author":"Tomida","year":"2013","journal-title":"J. Investig. Dermatol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1111\/jdv.19540","article-title":"Acne Microbiome: From Phyla to Phylotypes","volume":"38","author":"Dreno","year":"2024","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1007\/s13555-019-00320-7","article-title":"Antimicrobial Susceptibility, Biotypes and Phylotypes of Clinical Cutibacterium (Formerly Propionibacterium) Acnes Strains Isolated from Acne Patients: An Observational Study","volume":"9","author":"Zhang","year":"2019","journal-title":"Dermatol. Ther."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Ponraj, D.S., Lange, J., Falstie-Jensen, T., J\u00f8rgensen, N.P., Ravn, C., Poehlein, A., and Br\u00fcggemann, H. (2022). Amplicon-Based Next-Generation Sequencing as a Diagnostic Tool for the Detection of Phylotypes of Cutibacterium acnes in Orthopedic Implant-Associated Infections. Front. Microbiol., 13.","DOI":"10.3389\/fmicb.2022.866893"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1111\/jdv.16789","article-title":"Is Cutibacterium (Previously Propionibacterium) Acnes a Potential Pathogenic Factor in the Aetiology of the Skin Disease Progressive Macular Hypomelanosis?","volume":"35","author":"McDowell","year":"2021","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Li, C., Ravikrishnan, A., Wijaya, I., Naim, A.N.M., Gounot, J.-S., Wearne, S., On, Y.Y., Ho, E.X.P., Ang, Q.Y., and Chia, M. (2025). Large-Scale Skin Metagenomics Reveals Extensive Prevalence, Coordination, and Functional Adaptation of Skin Microbiome Dermotypes across Body Sites. bioRxiv.","DOI":"10.1101\/2025.04.24.650393"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1369","DOI":"10.1099\/mic.0.27788-0","article-title":"CAMP Factor Homologues in Propionibacterium acnes: A New Protein Family Differentially Expressed by Types I and II","volume":"151","author":"Valanne","year":"2005","journal-title":"Microbiology"},{"key":"ref_21","first-page":"001449","article-title":"Insights into Microbial Dysbiosis and Cutibacterium acnes CAMP Factor Interactions in Acne Vulgaris","volume":"11","author":"Chen","year":"2025","journal-title":"Microb. Genom."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Nazipi, S., St\u00f8dkilde, K., Scavenius, C., and Br\u00fcggemann, H. (2017). The Skin Bacterium Propionibacterium acnes Employs Two Variants of Hyaluronate Lyase with Distinct Properties. Microorganisms, 5.","DOI":"10.3390\/microorganisms5030057"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"8061","DOI":"10.1038\/s41467-023-43833-8","article-title":"Functional Divergence of a Bacterial Enzyme Promotes Healthy or Acneic Skin","volume":"14","author":"Hajam","year":"2023","journal-title":"Nat. Commun."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"107159","DOI":"10.1016\/j.micpath.2024.107159","article-title":"Comparative Efficacy of Essential Oils against Cutibacterium acnes: Effect upon Strains from Phylotypes with Different Virulence Patterns","volume":"199","author":"Oliveira","year":"2025","journal-title":"Microb. Pathog."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1008","DOI":"10.1111\/j.0022-202X.2005.23682.x","article-title":"Unsaturated Fatty Acids Induce Calcium Influx into Keratinocytes and Cause Abnormal Differentiation of Epidermis","volume":"124","author":"Katsuta","year":"2005","journal-title":"J. Investig. Dermatol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1007\/BF00413256","article-title":"Fluorescence from Pilosebaceous Follicles","volume":"279","author":"Johnsson","year":"1987","journal-title":"Arch. Dermatol. Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.jphotobiol.2018.06.005","article-title":"Ultraviolet Radiation-Mediated Development of Cutaneous Melanoma: An Update","volume":"185","author":"Emri","year":"2018","journal-title":"J. Photochem. Photobiol. B"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"25568","DOI":"10.1016\/S0021-9258(19)74429-9","article-title":"Regulation of Interleukin 8 Gene Expression by Oxidant Stress","volume":"268","author":"DeForge","year":"1993","journal-title":"J. Biol. Chem."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1919","DOI":"10.1111\/jocd.15726","article-title":"Sun Exposure, a Relevant Exposome Factor in Acne Patients and How Photoprotection Can Improve Outcomes","volume":"22","author":"Jourdan","year":"2023","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"293ra103","DOI":"10.1126\/scitranslmed.aab2009","article-title":"Vitamin B12 Modulates the Transcriptome of the Skin Microbiota in Acne Pathogenesis","volume":"7","author":"Kang","year":"2015","journal-title":"Sci. Transl. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1080\/08998280.2024.2392472","article-title":"Vitamin B12\u2013Induced Acneiform Eruption","volume":"38","author":"Owen","year":"2025","journal-title":"Bayl. Univ. Med. Cent. Proc."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1006.e1","DOI":"10.1016\/j.jaad.2023.12.017","article-title":"Guidelines of Care for the Management of Acne Vulgaris","volume":"90","author":"Reynolds","year":"2024","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"100063","DOI":"10.1016\/j.bioflm.2021.100063","article-title":"The Role of Biofilm Formation in the Pathogenesis and Antimicrobial Susceptibility of Cutibacteriumacnes","volume":"4","author":"Coenye","year":"2021","journal-title":"Biofilm"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"21104","DOI":"10.1038\/s41598-022-25436-3","article-title":"Skin Dysbiosis and Cutibacterium acnes Biofilm in Inflammatory Acne Lesions of Adolescents","volume":"12","author":"Cavallo","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1016\/j.jaad.2007.05.013","article-title":"Expanding the Microcomedone Theory and Acne Therapeutics: Propionibacterium acnes Biofilm Produces Biological Glue That Holds Corneocytes Together to Form Plug","volume":"57","author":"Burkhart","year":"2007","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1111\/exd.12482","article-title":"Three Dimensional Distribution of Propionibacterium acnes Biofilms in Human Skin","volume":"23","author":"Jahns","year":"2014","journal-title":"Exp. Dermatol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1111\/1523-1747.ep12676804","article-title":"Ultrastructural Observations in Acne Vulgaris: The Normal Sebaceous Follicle and Acne Lesions","volume":"62","author":"Knutson","year":"1974","journal-title":"J. Investig. Dermatol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1038\/nrmicro.2017.157","article-title":"The Human Skin Microbiome","volume":"16","author":"Byrd","year":"2018","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1371","DOI":"10.1016\/j.jid.2018.01.007","article-title":"Propionibacterium acnes-Derived Extracellular Vesicles Promote Acne-Like Phenotypes in Human Epidermis","volume":"138","author":"Choi","year":"2018","journal-title":"J. Investig. Dermatol."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Chudzik, A., Migda\u0142, P., and Pa\u015bciak, M. (2022). Different Cutibacterium acnes Phylotypes Release Distinct Extracellular Vesicles. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23105797"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e15150","DOI":"10.1111\/exd.15150","article-title":"Pro-Inflammatory Activity of Cutibacterium acnes Phylotype IA1 and Extracellular Vesicles: An in Vitro Study","volume":"33","author":"Cheung","year":"2024","journal-title":"Exp. Dermatol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"2603","DOI":"10.1016\/j.jid.2021.11.034","article-title":"Aberrant Wnt Signaling Induces Comedo-Like Changes in the Murine Upper Hair Follicle","volume":"142","author":"Shang","year":"2022","journal-title":"J. Investig. Dermatol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"2603","DOI":"10.1016\/j.celrep.2023.113121","article-title":"Distinct Mechanisms for Sebaceous Gland Self-Renewal and Regeneration Provide Durability in Response to Injury","volume":"42","author":"Veniaminova","year":"2023","journal-title":"Cell Rep."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"4027","DOI":"10.1038\/s41598-023-30411-7","article-title":"Lrig1-Expressing Epidermal Progenitors Require SCD1 to Maintain the Dermal Papilla Niche","volume":"13","author":"Lim","year":"2023","journal-title":"Sci. Rep."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1016\/j.devcel.2022.05.011","article-title":"Embigin Is a Fibronectin Receptor That Affects Sebaceous Gland Differentiation and Metabolism","volume":"57","author":"Rognoni","year":"2022","journal-title":"Dev. Cell"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"792","DOI":"10.12688\/f1000research.25588.1","article-title":"Recent Advances in Understanding and Managing Acne","volume":"9","author":"Kurokawa","year":"2020","journal-title":"F1000Research"},{"key":"ref_47","unstructured":"Sugihira, T., Tamai, M., Takagi, K., Salcman, B., Kobayashi, T., Hobro, A.J., Nakagawa, S., Takeuchi, Y., Ishikawa, E., and Maekawa, M. (2025). A Lipid-Driven, Microbe-Independent Mechanism of Acne via Lrig1+ Follicular Progenitor Cells. bioRxiv."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.1038\/s41431-023-01326-8","article-title":"Genome-Wide Meta-Analysis Identifies Novel Loci Conferring Risk of Acne Vulgaris","volume":"32","author":"Kals","year":"2024","journal-title":"Eur. J. Hum. Genet."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1801","DOI":"10.1080\/14656566.2021.1918100","article-title":"Androgens and Acne: Perspectives on Clascoterone, the First Topical Androgen Receptor Antagonist","volume":"22","author":"Kircik","year":"2021","journal-title":"Expert. Opin. Pharmacother."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"105059","DOI":"10.1016\/j.cmicom.2025.105059","article-title":"Tetracyclines, the Old and the New: A Narrative Review","volume":"2","author":"Pearson","year":"2025","journal-title":"CMI Commun."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Carr, M., Chou, S.R., Sun, J., LaRock, D.L., and LaRock, C.N. (2025). Therapeutic Inhibition of Metalloproteases by Tetracyclines during Infection by Multi-Drug Resistant Pseudomonas. bioRxiv.","DOI":"10.1101\/2025.02.14.638345"},{"key":"ref_52","first-page":"259","article-title":"Evaluation of Tetracycline in the Neutrophil Chemotactic Response","volume":"90","author":"Majeski","year":"1977","journal-title":"J. Lab. Clin. Med."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1016\/j.tibs.2018.06.011","article-title":"How Macrolide Antibiotics Work","volume":"43","author":"Mankin","year":"2018","journal-title":"Trends Biochem. Sci."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Zimmermann, P., Ziesenitz, V.C., Curtis, N., and Ritz, N. (2018). The Immunomodulatory Effects of Macrolides\u2014A Systematic Review of the Underlying Mechanisms. Front. Immunol., 9.","DOI":"10.3389\/fimmu.2018.00302"},{"key":"ref_55","first-page":"429","article-title":"Antibiotics and Antimicrobial Resistance in Acne: Epidemiological Trends and Clinical Practice Considerations","volume":"95","author":"Dessinioti","year":"2022","journal-title":"Yale J. Biol. Med."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"e23","DOI":"10.1016\/S1473-3099(15)00527-7","article-title":"Systematic Review of Antibiotic Resistance in Acne: An Increasing Topical and Oral Threat","volume":"16","author":"Walsh","year":"2016","journal-title":"Lancet Infect. Dis."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"100106","DOI":"10.1016\/j.medmic.2024.100106","article-title":"Antibiotics and the Gut Microbiome: Understanding the Impact on Human Health","volume":"20","author":"Lathakumari","year":"2024","journal-title":"Med. Microecol."},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Dallo, M., Patel, K., and Hebert, A.A. (2023). Topical Antibiotic Treatment in Dermatology. Antibiotics, 12.","DOI":"10.3390\/antibiotics12020188"},{"key":"ref_59","unstructured":"Matin, T., Patel, P., and Goodman, M.B. (2025). Benzoyl Peroxide. StatPearls, StatPearls Publishing."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/S0190-9622(81)70004-5","article-title":"Benzoyl Peroxide: Percutaneous Penetration and Metabolic Disposition","volume":"4","author":"Nacht","year":"1981","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1177\/12034754211037994","article-title":"The Impact of Acne Treatment on Skin Bacterial Microbiota: A Systematic Review","volume":"26","author":"Lam","year":"2022","journal-title":"J. Cutan. Med. Surg."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1016\/S0891-5849(02)01187-5","article-title":"Topical Alpha-Tocotrienol Supplementation Inhibits Lipid Peroxidation but Fails to Mitigate Increased Transepidermal Water Loss after Benzoyl Peroxide Treatment of Human Skin","volume":"34","author":"Weber","year":"2003","journal-title":"Free Radic. Biol. Med."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1007\/s00253-013-5394-8","article-title":"Staphylococcus Epidermidis in the Human Skin Microbiome Mediates Fermentation to Inhibit the Growth of Propionibacterium acnes: Implications of Probiotics in Acne Vulgaris","volume":"98","author":"Wang","year":"2014","journal-title":"Appl. Microbiol. Biotechnol."},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Cui, H., Guo, C., Wang, Q., Feng, C., and Duan, Z. (2022). A Pilot Study on the Efficacy of Topical Lotion Containing Anti-Acne Postbiotic in Subjects with Mild -to -Moderate Acne. Front. Med., 9.","DOI":"10.3389\/fmed.2022.1064460"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"2211","DOI":"10.1038\/jid.2010.123","article-title":"Activation of TLR2 by a Small Molecule Produced by Staphylococcus Epidermidis Increases Antimicrobial Defense against Bacterial Skin Infections","volume":"130","author":"Lai","year":"2010","journal-title":"J. Investig. Dermatol."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Puebla-Barragan, S., and Reid, G. (2021). Probiotics in Cosmetic and Personal Care Products: Trends and Challenges. Molecules, 26.","DOI":"10.3390\/molecules26051249"},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Karn, S.L., Gangwar, M., Kumar, R., Bhartiya, S.K., and Nath, G. (2023). Phage Therapy: A Revolutionary Shift in the Management of Bacterial Infections, Pioneering New Horizons in Clinical Practice, and Reimagining the Arsenal against Microbial Pathogens. Front. Med., 10.","DOI":"10.3389\/fmed.2023.1209782"},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Harper, D.R. (2021). Introduction to Bacteriophages. Bacteriophages, Springer.","DOI":"10.1007\/978-3-319-41986-2"},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Mayorga-Ramos, A., Carrera-Pacheco, S.E., Barba-Ostria, C., and Guam\u00e1n, L.P. (2024). Bacteriophage-Mediated Approaches for Biofilm Control. Front. Cell Infect. Microbiol., 14.","DOI":"10.3389\/fcimb.2024.1428637"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"e93","DOI":"10.1002\/ski2.93","article-title":"Development of a Topical Bacteriophage Gel Targeting Cutibacterium acnes for Acne Prone Skin and Results of a Phase 1 Cosmetic Randomized Clinical Trial","volume":"2","author":"Golembo","year":"2022","journal-title":"Skin. Health Dis."},{"key":"ref_71","first-page":"6","article-title":"inPhocus: Current State and Challenges of Phage Research in Singapore","volume":"3","author":"Verma","year":"2022","journal-title":"Phage"},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"Fukaya-Shiba, A., Ogata, A., Kuribayashi, R., Sakurai, A., Suzuki, K., Takadama, S., Nishimura, J., Uchiyama, J., Ohge, H., and Takeuchi, T. (2025). Regulatory Considerations for Developing Phage Therapy Medicinal Products for the Treatment of Antimicrobial Resistant Bacterial Infections. Front. Pharmacol., 16.","DOI":"10.3389\/fphar.2025.1713471"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"9","DOI":"10.4161\/bbug.1.1.9818","article-title":"Recombinant Bacteriophage Lysins as Antibacterials","volume":"1","author":"Fenton","year":"2010","journal-title":"Bioeng. Bugs"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"2170","DOI":"10.1126\/science.1066869","article-title":"Rapid Killing of Streptococcus Pneumoniae with a Bacteriophage Cell Wall Hydrolase","volume":"294","author":"Loeffler","year":"2001","journal-title":"Science"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"e0116825","DOI":"10.1128\/aem.01168-25","article-title":"Comparative Antibacterial Activity of N-Terminal and C-Terminal Domains of a Recombinant Endolysin against Cutibacterium acnes","volume":"91","author":"Lee","year":"2025","journal-title":"Appl. Environ. Microbiol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"AB217","DOI":"10.1016\/j.jaad.2024.07.861","article-title":"49342 First FASN Inhibitor ASC40 to Treat Acne Vulgaris Patients: Final Results Form a Phase 2 Trial","volume":"91","author":"Xiang","year":"2024","journal-title":"J. Am. Acad. 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