Daily application for 8 weeks is associated with an in vivo temporary modulation of the microbiome, including a reduction in relative abundance of staphylococci and Cutibacterium acnes, and an increase in lactobacilli. The selected lactobacilli are able to reduce inflammatory lesions in a pilot and placebo-controlled study. The strains are formulated as microcapsules for topical formulations and tested in patients with mild-to-moderate acne. We select specific strains of nomadic lactobacilli for their functional applicability on the skin and capacity to inhibit growth and inflammation by skin pathobionts. Here, we show that lactobacilli are underestimated members of the skin microbiota. Tailored skin microbiome modulation approaches with probiotics are highly challenging.
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