Acne in Athletes: Associated Factors, Clinical Characteristics, and Preventive Measures

Presenter: Ouissal Hormi

Acne in athletes may be aggravated by training-related friction, sweating, occlusive clothing, dietary supplements and skincare habits. This descriptive cross-sectional study assessed acne prevalence, clinical characteristics, and potential behavioral risk factors among 180 athletes recruited through an online questionnaire and fitness centers. Participants had a mean age of 27.1 ± 6.4 years (range: 18–45 years), and 72% were amateur, 18% semi-professional, and 10% professional athletes.Most participants (68%) had engaged in regular physical activity for more than two years, while 61% reported training three to five times per week. Acne was reported by 80% (n = 144), with 42% of affected individuals reporting onset after 20 years of age, highlighting the considerable prevalence of adult-onset acne.

Lesions were primarily distributed across seborrheic areas, with the face being the most commonly affected site (79%), followed by the back (52%) and chest (28%). Moderate acne with mixed comedonal and inflammatory lesions predominated. Unfavorable practices included delayed showering after training (62%), failure to cleanse the face before exercise (63%), and use of tight or occlusive clothing. Exposure to potential aggravating factors was also frequent. Protein supplements or anabolic substances were reported by 30% of participants, of whom 38% perceived worsening acne. Furthermore, 33% of participants reported regular use of body oils, many of which may be comedogenic. Notably, 90% of athletes did not clean shared sports equipment, indicating substantial exposure to potential environmental contaminants and microbial colonisation.Moderate-to-inflammatory acne was more frequently associated with these behavioral factors, although no inferential statistical tests were performed. The findings suggest that acne is common among athletes and may be associated with modifiable hygiene, clothing, and supplement-related practices. Comparative analysis revealed that athletes with moderate-to-inflammatory acne more frequently reported delayed post-exercise cleansing, wearing occlusive clothing, and supplement consumption than those with mild acne. Preventive education on appropriate skincare, breathable clothing, equipment hygiene, and potentially aggravating products may support acne management without compromising athletic performance.

Acne in Dark Phototypes: A Study of 146 Patients

Presenter: Ouissal Laadime

Acne in darker skin phototypes (Fitzpatrick IV–VI) is frequently accompanied by post-inflammatory hyperpigmentation (PIH), which may contribute substantially to the disease burden. This four-year retrospective observational comparative study (2022–2026) analysed clinical features, treatment outcomes, scarring, and quality of life in 146 patients with acne, comparing light phototypes (I–III) with dark phototypes (IV–VI).The mean age was 24 years (range 9–48), and 72.6% were female. Phototype III was the most prevalent (69.9%), followed by phototypes IV (19.2%) and V–II (5.5%); no patients with phototypes I or VI were recorded. Inflammatory acne predominated (50.7%), while 72.5% had moderate-to-severe disease (Global Evaluation of Acne [GEA] grades 3–5) before treatment. Among patients with darker phototypes, inflammatory acne (48.6%) and mixed inflammatory forms (32.4%) were predominant. Severe variants, including acne keloidalis (5.4%), fulminans (2.7%), and conglobata (2.7%), were more frequently observed than in patients with lighter phototypes. Facial involvement was predominant (96%), particularly on the cheeks (82.9%) and forehead (74%), while trunk involvement was reported in 38.4%. Before treatment, 72.5% of patients had moderate-to-severe acne (GEA 3–5); following therapy, 73.8% achieved clear or almost clear skin (GEA 0–1). PIH affected 62.3% overall and was significantly more frequent in dark than light phototypes (75.7% vs 58.7%). Scarring occurred in 83.3% of patients, with keloid scars more frequent in dark phototypes (5.4% vs 1.8%). Following treatment, 73.8% achieved GEA grades 0–1. Treatment approaches included topical retinoids and benzoyl peroxide (60.3%), oral antibiotics (56.2%), isotretinoin (27.4%), hormonal therapy (19%), and procedural interventions (7%). Quality of life was substantially affected at baseline, with a mean DLQI score of 15.13 and body image disturbance reported by 78.8% of patients. Following treatment, the mean DLQI score decreased to 7.6, indicating a significant improvement in quality of life. These findings indicate a greater burden of pigmentary sequelae in darker phototypes, supporting early, individualized acne management that considers skin phototype.

Acne in Elite Athletes: Clinical Patterns and Management Considerations

Presenter: Vania Azizi

Acne in elite athletes may be aggravated by repeated sweating, heat, friction, occlusive sports equipment, tight clothing, intensive training, and performance-related supplement use, requiring management tailored to sporting demands. This narrative literature review examined clinical patterns, potential triggers, and treatment considerations using a PubMed search covering publications from 1 January 2000 to 31 December 2025. Acne commonly affected the face, chest, shoulders, and back, with lesions also occurring at pressure, occlusion  and friction sites beneath helmet straps, shoulder pads, tight uniforms and compression garments. Differential diagnoses included folliculitis, steroid acne, and hidradenitis suppurativa. A detailed history of training practices, equipment use, supplement intake, and drug exposure is therefore crucial. Preventive measures included prompt post-exercise cleansing, early removal of occlusive equipment, breathable clothing, equipment hygiene, and avoiding oil-based products under occlusive gear. Topical retinoids, benzoyl peroxide and fixed-combination preparations remained central to mild-to-moderate acne management, - Oral antibiotics should be prescribed judiciously and, where appropriate, used in combination with benzoyl peroxide to minimise the risk of antimicrobial resistance. Isotretinoin was discussed for severe, scarring, or refractory disease, with specific counselling regarding to dryness, photosensitivity, musculoskeletal symptoms, and possible creatine kinase elevation during intense exercise, with advice on hydration, symptom reporting and temporary training modification when needed. Anabolic-androgenic steroid misuse remains a significant contributor to severe truncal acne, warranting sensitive screening and comprehensive counselling on its broader health implications.

 Hormonal treatments and anabolic-androgenic steroid exposure also required consideration of anti-doping regulations and associated health concerns. Acne in elite athletes should be approached as more than a cosmetic concern, with management extending beyond standard treatment algorithms. The review emphasizes individualized, practical management involving dermatologists, sports physicians, and nutrition professionals. However, limited athlete-specific trials, particularly on supplement use and treatment safety during high-intensity training, constrain the evidence base and support further prospective research.

Acne in Male Patients: A Comparative Study of Acne in Both Sexes

Presenter: Manal Kettam

Acne may differ between men and women in lesion characteristics, associated factors, scarring patterns, and psychological burden. This retrospective, descriptive, and analytical study compared clinical presentation and treatment approaches among 146 patients with acne treated at a diagnostic center between January 2022 and December 2025.The cohort comprised 106 women (72.6%) and 40 men (27.4%). Patients aged under 20 years accounted for 46.2% of women and 65% of men. Inflammatory acne was the predominant presentation in both groups, affecting 51.9% of women and 47.5% of men. Acne fulminans and acne conglobata were reported in 5% and 2.5% of men, respectively. Post-inflammatory hyperpigmentation was more frequent in women than men (68.9% vs 45%), whereas ice-pick atrophic scars predominated in men (73.5%). The duration of disease progression before seeking consultation was generally more than one year, with no notable difference between sexes. Stress and a diet high in fats and sugars were commonly reported triggering factors in both sexes, although these were more prevalent among women (11.3% vs 7.5%). In contrast, a family history of acne was more frequently reported among men (10% vs 5.6%).Topical treatments were used in approximately 64% of both groups. Among women, cyclines were used in 58.4% and isotretinoin in 18.8%; among men, each accounted for 50%. Overall therapeutic response was favorable in most patients. However, recurrence was higher in men (35% vs 24.5%), as was the reported psychological impact (87.5% vs 75.5%).These findings demonstrate sex-related differences in clinical presentation, acne-associated scarring, systemic treatment patterns, recurrence, and psychological burden, supporting individualized management that addresses both clinical presentation and psychosocial needs.

Adult Female Acne: Clinical, Hormonal and Metabolic Patterns in A Retrospective–Prospective Study

Presenter: Hanae lammini

Adult acne vulgaris is a distinct clinical entity, frequently associated with endocrine and metabolic abnormalities. Its varied clinical presentation and underlying pathophysiological mechanisms necessitate a comprehensive evaluation. This study aimed to characterize the clinical, hormonal, and metabolic profiles of adult female patients with acne and identify associated etiological patterns. This retrospective–prospective descriptive study characterized clinical manifestations and hormonal and metabolic profiles in 130 women aged ≥25 years presenting with acne, including persistent acne (continuing or recurring beyond age 25) and late-onset acne (beginning after age 25). Clinical evaluation included assessment of age at onset, lesion morphology, distribution, and severity using the Adult Female Acne Scoring Tool (AFAST) and the Global Evaluation Acne (GEA) scale. Clinical features of hyperandrogenism, including hyperseborrhea, hirsutism, menstrual irregularities, and androgenetic alopecia, were documented. Hormonal evaluation comprised measurements of total and free testosterone, dehydroepiandrosterone sulfate, and 17-hydroxyprogesterone. Pelvic ultrasonography was performed when indicated to assess for polycystic ovary syndrome (PCOS) based on the Rotterdam criteria. Metabolic evaluation included body mass index, clinical indicators of insulin resistance, fasting glucose, lipid profile, and the HOMA index when metabolic syndrome was suspected. The mean age was 26.85 years, and persistent acne accounted for 79.2% of cases and late-onset acne represented 20.8%. Moderate acne (Global Evaluation of Acne [GEA] grade 3) predominated (71%), while clinical hyperandrogenism was identified in 73%. Hyperseborrhea affected 84%, hirsutism 57%, and menstrual irregularities 30.7%. Mandibular involvement was reported in 68.6%, and post-inflammatory hyperpigmentation in 92.9%. Elevated testosterone, 17-hydroxyprogesterone, and dehydroepiandrosterone sulfate were observed in 43%, 35%, and 27%, respectively. Polycystic ovary syndrome (PCOS) was identified in 32%, while idiopathic acne accounted for 46%. Overweight and obesity affected 35.4% and 14.7%, respectively.These findings demonstrate the clinical and etiological heterogeneity of adult female acne, supporting comprehensive endocrine and metabolic assessment and multidisciplinary management.

Assessing Maternofetal Risk Associated with Isotretinoin Use Preceding Pregnancy: A Retrospective Cohort Study

Presenter: Saakshi Khattri

Isotretinoin is teratogenic during pregnancy, but evidence regarding maternal and fetal outcomes following discontinuation before conception remains limited. This retrospective cohort study used the TriNetX Global Collaborative Network to compare pregnant patients with isotretinoin exposure at least 1 month before conception against pregnant patients with acne who had never received isotretinoin. Sensitivity analyses used doxycycline- and spironolactone-exposed comparator cohorts. Patients were matched in a 1:1 ratio using propensity scores based on demographic variables and several baseline clinical characteristics .Eight maternal-fetal outcomes were evaluated assessed over 21 months across pregnancy and 1-year postpartum, with associations estimated using Cox hazard ratios (95% CIs) and Bonferroni-adjusted significance testing (α=0.00625).  No outcome differed significantly between the isotretinoin and non-isotretinoin cohorts after adjustment. Spontaneous abortion showed nominal significance (hazard ratio [HR] 1.42, 95% confidence interval [CI] 1.01–2.00, p=0.045),but did not meet the adjusted threshold. In the doxycycline comparison, spontaneous abortion (HR 1.52, 95% CI 1.07–2.16, p=0.019) and abnormal ultrasound findings (HR 0.68, 95% CI 0.48–0.95, p=0.024) were also nominally significant but not after correction. No outcome was significant in the spironolactone comparison. The findings suggest no statistically significant increase in the assessed maternal–fetal outcomes following preconception isotretinoin exposure. Our findings indicate that isotretinoin exposure at least one month before conception is not associated with an increased risk of a broad range of maternal and fetal outcomes, supporting the pharmacokinetic rationale underlying the recommended 30-day washout period. However, residual confounding and reliance on diagnosis codes limit interpretation, and prospective studies are needed to clarify the potential spontaneous abortion signal.

Assessing The Role of Baseline Creatine Kinase Measurement Before initiating oral Isotretinoin in Acne Vulgaris Patients: Insights from A Retrospective Cohort of 1,256 individuals

Presenter: Saadet Miray Ayyildiz

Creatine kinase (CK) elevations during oral isotretinoin treatment may reflect musculoskeletal effects, although routine monitoring is not recommended in asymptomatic patients. This retrospective observational study assessed CK trajectories in 1,256 patients treated with oral isotretinoin for acne vulgaris between January 2022 and July 2024. Data were obtained from medical records and included demographic characteristics, cumulative isotretinoin dose, and laboratory parameters (CK, AST, and ALT) measured at baseline and at months 1, 2, 4, and 6 of therapy.The mean age was 19.69 ± 3.9 years, and 75.1% were female. Median baseline CK was 73 U/L (range: 15–5505), with 6.5% (n=82) recording levels ≥ 200 U/L before treatment. At month 6, among 452 patients, mean cumulative isotretinoin dose was 4,928 ± 324.2 mg and median CK was 70 U/L (range: 15–4,267) . Although 26 patients experienced CK ≥ 200 U/L with increases ≥5-fold from baseline, follow-up CK levels did not differ significantly overall. CK changes correlated moderately across time points and weakly to moderately with alanine aminotransferase (ALT) and aspartate aminotransferase (AST) changes. Although isotretinoin was not associated with a significant overall increase in CK levels, considerable interindividual variability and occasional elevations were noted. Baseline CK measurement may help contextualise subsequent changes, particularly in patients presenting with muscle-related symptoms. Moderate correlations between CK and AST indicate a potential muscular contribution to some transaminase elevations. These findings support symptom-guided, individualized CK assessment rather than routine monitoring, with baseline values helping contextualize subsequent elevations. Prospective studies are needed to refine monitoring strategies.

Beyond C. Acnes: The Emerging Role of The Follicular Mycobiome in Truncal Acne Revealed by Scanning Electron Microscopy

Presenter: Angeline Tay

Acne vulgaris is commonly associated with Cutibacterium acnes (C. acnes. However, emerging evidence from microbiome research underscores the role of the follicular mycobiome as an important contributor to pilosebaceous dysbiosis. This observational study used scanning electron microscopy (SEM) to examine microbial localisation and biofilm architecture in truncal acne. The cohort included 77 women aged 18–25 years with moderate facial and truncal acne (Investigator’s Global Assessment [IGA] grade 3) and matched healthy controls. Dorsal skin biopsies were obtained from healthy participants and lesional and non-lesional sites in the acne group; 34 representative samples underwent high-resolution SEM.C. acnes predominated in the deep follicular infundibulum, with dense, deeply embedded biofilms in over 50% of acne lesions. Malassezia species were observed on the stratum corneum in half of acne lesions and within follicles in 20%. Staphylococcus biofilms appeared frequently on the skin surface across sample types but were absent from deep lesional cross-sections, indicating distinct microbial niches. These findings provide anatomical evidence of bacterial–fungal coexistence in truncal acne within an Indian demographic and highlight the potential contribution of Malassezia alongside deep follicular C. acnes biofilms. These findings challenge the conventional bacteria-centric model, suggesting that antibacterial approaches alone may be insufficient for managing refractory or pruritic truncal acne. Accordingly, our results highlight the clinical importance of targeting both deep-seated bacterial biofilms and the follicular mycobiome to optimise dermatological outcomes.

Beyond The Surface: Decoding The Gut-Skin-Brain Axis in Adult Female Acne

Presenter: Farhat Khan

In managing adult female acne, the conventional emphasis on oral and topical medications is increasingly being challenged by patients seeking a more holistic understanding of their condition. Emerging evidence suggests that acne is not simply a localized cutaneous disorder but may reflect broader systemic interactions mediated by the gut–skin–brain axis. A 12-month phenotypic and lifestyle audit was conducted to evaluate factors beyond lesion counts in 30 distinct cases of persistent adult female acne. The cases were classified into three clinical ecosystems: the stress-reactive cluster, focusing on the effects of elevated cortisol levels on intestinal barrier integrity; the dietary-metabolic cluster, examining the influence of high-glycaemic-index diets and dairy consumption on insulin-like growth factor 1 (IGF-1); and the microbiome cluster, assessing the association between digestive symptoms, including bloating and irregular bowel habits, and the severity of inflammatory acne flare-ups.The audit identified a distinct internal-to-external pathway in the clinical presentation of acne. Stress-related flares: 70% of patients reported significant stress-induced exacerbations. Psychological stress was observed to correlate with increased intestinal permeability, potentially facilitating the entry of pro-inflammatory markers into the bloodstream and contributing to cystic acne. Impact of Western diet: 65% of the cohort followed diets high in processed sugars. This dietary pattern was associated with a distinct metabolic phenotype characterised by increased sebum production and more resistant inflammatory nodules. Microbiome connection: More than half of the patients reported concurrent gastrointestinal symptoms. Disruption of the gut microbiome was associated with more frequent acne recurrence following discontinuation of conventional antibiotics, suggesting a potential link between gut health and sustained skin improvement. Adult female acne represents a complex, multifactorial condition with potential systemic associations. The findings suggest that cutaneous manifestations may be influenced by underlying gut and psychological factors. A lifestyle modification approach, incorporating stress management and gut-supportive nutrition, should therefore be considered alongside conventional topical therapy. Addressing the gut–skin–brain axis may offer a more sustainable and integrated approach to acne management, aligning with patients' preference for a holistic approach to dermatological health.

Combination of Low-Dose Isotretinoin and 1450 Nm Non-Ablative Laser in Moderate Acne: A Synergistic Approach with Reduced Systemic Burden

Presenter: Jelena Krstic Eric

Combining oral isotretinoin with sebaceous gland-targeting laser therapy may offer an approach to  enhance efficacy while limiting systemic drug exposure. This case series assessed the efficacy and tolerability of the combination in 30 patients with moderate acne (24 females, 6 males). Participants received oral isotretinoin 10 mg daily for 5–6 months alongside a 1450 nm Er: Glass non-ablative laser. The protocol comprised four laser sessions at two-week intervals, followed by monthly sessions during isotretinoin treatment. Laser settings included a fluence of approximately 2500 mJ, a pulse repetition rate of 1 Hz, a 7×7 pixel tip, and two passes with stacking. Inflammatory lesions decreased by 65%–95%, while sebum production fell by 70%–90%. Treatment was generally well tolerated, with cheilitis the most commonly reported adverse effect and no other significant side effects observed. During 9 months of follow-up, 3 patients experienced relapse, with milder manifestations. Improvements in skin texture and early acne scarring were also noted.The combination of low-dose isotretinoin and 1450 nm non-ablative laser therapy demonstrated a synergistic effect in the management of moderate acne. This treatment protocol was associated with significant clinical improvement, reduced systemic treatment burden, and favourable tolerability, while also contributing to early scar modulation. These findings suggest that this combination may represent a promising strategy for optimising acne management.

Concomitant Therapy of oral Isotretinoin with Multiplex Pulsed Dye Laser and Nd: Yag Laser for Acne

Presenter: Jennifer Tran

Concerns about impaired wound healing and scarring have contributed to caution around laser procedures during or after oral isotretinoin treatment. This retrospective chart review assessed the safety, effectiveness, and patient satisfaction associated with concomitant isotretinoin and non-ablative laser (NAL) therapy at a single outpatient dermatology clinic. Records from January 1, 2009, to August 17, 2017, were reviewed for 187 patients (85 males, 45.5%; 102 females, 54.5%), with a mean age of 21.4 years. The laser system sequentially delivered 585 nm pulsed dye laser (PDL) and 1064 nm neodymium-doped yttrium aluminium garnet (Nd: YAG) laser. Side effects were reported by 31.6% (n=59) of patients, most commonly eczema (n=14), erythema (n=11), significant dryness of the skin, lips, or eyes (n=8), flushing (n=6), and bruising (n=6). At treatment completion, 99.2% achieved clear or almost-clear skin. Patients received a mean of 3.8 NAL treatments during isotretinoin therapy, 1.5 afterward, and 5.3 in total, with standard deviations of 2.4, 2.5, and 3.6, respectively. Among those expressing satisfaction, 65.2% (n=122) reported being satisfied; the remaining patients reported neither satisfaction nor dissatisfaction. The combination therapy demonstrated favourable efficacy and patient satisfaction, with excellent cosmetic outcomes. The use of isotretinoin in conjunction with multiplex Nd:YAG and pulsed dye laser (PDL) therapy delivered through a single device may be considered a treatment alternative to other topical and systemic therapies, given its favourable safety profile, clinical effectiveness, and high patient satisfaction.

Cumulative Isotretinoin Dosing (120 Vs 150 Mg/Kg) and 12-Month Relapse in Acne Vulgaris: A Randomized Controlled Trial

Presenter: Ruggero Cascio Ingurgio

The optimal cumulative isotretinoin dose for sustained acne remission remains uncertain, particularly regarding whether increasing exposure beyond 120 mg/kg improves long-term outcomes. This single-centre, randomized, assessor-blinded controlled trial compared cumulative doses of 120 mg/kg and 150 mg/kg in patients with moderate-to-severe acne vulgaris. Primary outcomes were changes in total lesion count and acne severity at treatment completion; secondary outcomes included scarring and relapse over 12 months, defined by the need for further topical or systemic treatment. Of 91 randomized patients, 74 completed treatment and 64 had complete 12-month follow-up. Both groups experienced substantial, comparable improvements in lesion counts and acne severity, without significant between-group differences. Scar counts remained stable or decreased slightly in both groups. At 12 months, relapse occurred in 26.7% of the 120 mg/kg group and 32.3% of the 150 mg/kg group (p=0.619). When relapse was restricted to systemic retreatment, rates were 16.7% and 20.6%, respectively (p=0.688). Univariable analyses showed that cumulative dose, baseline acne severity grade, baseline lesion count, and baseline scar count were not significantly associated with relapse.Higher baseline lesion burden and male sex showed non-significant trends toward increased and reduced relapse risk, respectively. Increasing the cumulative dose from 120 to 150 mg/kg did not significantly improve clinical response, scarring, or 12-month relapse outcomes. Increasing the cumulative isotretinoin dose from 120 mg/kg to 150 mg/kg did not result in greater reductions in lesions or scarring, nor did it improve 12-month relapse outcomes. These findings suggest that dose escalation within this range offers no meaningful additional long-term benefit and support a cumulative dose of 120 mg/kg as an effective target for most patients with moderate-to-severe acne vulgaris.

Effectiveness of Secukinumab in Patients with Moderate to Severe Hidradenitis Suppurativa in A Real-World Setting: interim Results from The Anima Study in Germany

Presenter: Thomas Volz

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease associated with substantial quality-of-life impairment. The prospective, multicentre ANIMA study is assessing secukinumab effectiveness in adults with active moderate-to-severe HS in routine German clinical practice. This ongoing, observational, open-label, single-cohort study follows patients for 24 months across 81 sites. Effectiveness measures include the International Hidradenitis Suppurativa Severity Score System (IHS4) and the Patient’s Global Assessment of Skin Pain using an 11-point numerical rating scale (Pain NRS-11). This interim analysis included available data from patients who completed their 12-month visit by 31 March 2026, with data cut-off on 27 May 2026. By the recruitment end date of 31 March 2025, 437 patients had been documented, and approximately 260 were included in the interim analysis. At baseline, approximately 96% had moderate or severe active inflammatory disease according to IHS4. Preliminary findings indicated that secukinumab was associated with reduced HS severity and improved quality of life in routine practice. However, detailed quantitative results for IHS4, lesion counts, and Pain NRS-11 were not yet available. These interim observations provide early real-world evidence on secukinumab use in moderate-to-severe HS. Further analyses are needed to quantify clinical improvements and establish longer-term outcomes.

Effects of oral Omega-3 Fatty Acids on Isotretinoin tolerability in Acne Vulgaris: A Systematic Review and Meta-Analysis

Presenter: Jia Qi Adam Bai

Mucocutaneous adverse effects and dyslipidaemia can compromise tolerability during oral isotretinoin treatment for moderate-to-severe acne vulgaris. This systematic review and meta-analysis examined whether adjunctive oral omega-3 fatty acids reduce these effects. MEDLINE, Embase, and CENTRAL were searched through 12 March 2026 for randomized controlled trials. Five trials involving 303 patients were included (mean age 21.3 years; 53.5% male), of whom 155 (51.2%) received omega-3 supplementation and 148 (48.8%) received control therapy alongside isotretinoin. Mean treatment duration was 14.7 weeks (range: 8.0–24.0), with mean follow-up of 3.7 months (range: 2.0–6.0). Compared with control therapy, omega-3 supplementation reduced triglyceride levels (mean difference [MD] −0.12 mmol/L, 95% confidence interval [CI] −0.20 to −0.03; I²=0%). Differences in high-density lipoprotein cholesterol (MD 0.05 mmol/L, CI −0.11 to 0.20; I²=0%) and total cholesterol (MD −0.08 mmol/L, CI −0.47 to 0.32; I²=56%) were not significant. At 12 weeks, supplementation reduced the risks of dry skin (risk ratio [RR] 0.42, CI 0.26–0.68; I²=0%) and dry lips (RR 0.57, CI 0.40–0.82; I²=0%). Individual trials also reported lower rates of dry nose, dry eyes, and cheilitis with supplementation. No omega-3-related adverse events were reported. These findings suggest that omega-3 supplementation may improve isotretinoin tolerability by reducing mucocutaneous adverse effects and modestly reduce triglyceride levels. Larger, longer-term randomized trials with standardized dosing and outcome reporting are needed to confirm these effects and establish optimal supplementation strategies.

Microbiome and Mycobiome Profiling on Different Anatomical Sites Reveal Difference Between Facial and Truncal Acne

Presenter: Delphine Kerob

Differences in sebum production, follicular density, ventilation, and mechanical occlusion may contribute to distinct microbial environments across acne-affected body sites. This exploratory clinical study compared bacterial and fungal communities on the cheeks and upper back in 63 subjects with mild-to-moderate facial and truncal acne in Brazil. Samples from lesional and adjacent non-lesional skin were analysed using quantitative polymerase chain reaction (qPCR) and amplicon sequencing. Of the 63 participants, 51 completed the study (mean age 24 ± 1 years; 62% female). All had facial acne, while 34 also had truncal acne. Bacterial alpha and beta diversity differed significantly between the cheeks and upper back, with a higher Shannon diversity index on the cheeks at both lesional and non-lesional sites. Quantification also showed significantly higher cheek abundance of Cutibacterium acnes and Staphylococcus epidermidis at both site types, alongside higher lesional Malassezia spp. loads. In contrast, fungal diversity was significantly higher on the back, with distinct fungal community composition between sites. Malassezia restricta predominated on the face, whereas Malassezia globosa dominated the truncal mycobiome. These findings demonstrate anatomical variation in bacterial and fungal communities associated with acne. The distinct fungal profiles highlight the potential contribution of the mycobiome to site-specific acne characteristics, warranting further investigation into its role in disease mechanisms and targeted treatment strategies.

EADV Congress 2026, 30 SEP - 03 OCT 26, Vienna