Assessment of Cutibacterium acnes: Acne Biofilm, Comedones, and Future Treatments for Acne

Cutibacterium acnes (C.acnes) is a skin commensal organism that controls the growth of Staphylococcus aureus and Streptococcus pyogenes. Additionally, the organism can become an opportunistic pathogen, causing acne and post-surgical prosthetic infections. The outcome of acne depends on Cutibacterium subtypes, virulence factors, and microbial equilibrium. This organism makes a biological glue that is essential for biofilm formation, but its overabundance makes its way into the sebum. This sebum slowly reaches the upper layer of the hair unit along with dead cells from the keratinocyte layer, causing comedones. Treatments in the pipeline include tumor necrosis factors (biologics), various agents attacking biofilm viability, phage therapy, and vaccinations against virulence factors produced by C. acnes.