Probiotic Lotion vs Benzoyl Peroxide for Acne

face lotion cream
Woman applying skin face cream.
The efficacy and safety of a probiotic lotion vs a topical benzoyl peroxide for the treatment of acne is compared.

A probiotic lotion had comparable results to 2.5% benzoyl peroxide treatment for acne vulgaris in a randomized controlled trial, study findings of which were published in the Journal of Cosmetic Dermatology.

Investigators enrolled patients from 18 to 35 years of age with mild to moderate acne and randomly assigned them 1:1 to receive either topical 2.5% benzoyl peroxide or a probiotic-derived lotion, formulated from cell-free supernatant of Lactobacillus paracasei MSMC 39-1. Patients using topical benzoyl peroxide applied it twice daily for about 15 minutes on the entire face and then washed it off; patients using the L paracasei lotion applied it twice daily to the entire face where it remained. All patients used the same gentle cleanser and moisturizer. Investigators assessed the outcome with acne lesion counts at baseline, week 2, and week 4. They also used a DSM III Colorimeter to evaluate erythema index for acne redness at weeks 2 and 4. Adverse effects such as erythema, scaling, stinging, and itching were recorded at each visit.

Investigators used an independent student t-test to compare the average mean of continuous data between the groups and Pearson’s Chi-square test to compare the categorical data. They used ANOVA to compare the mean change from baseline at different visits.

There were 104 patients enrolled in the study and divided into 2 groups of 52 patients each. Most patients (80%) in both groups were women, and the mean age was 22 years. The baseline values of noninflammatory lesions, inflammatory lesions, total lesions, and erythema index were not significantly different between groups.

After 4 weeks of treatment, the inflammatory acne counts reduced significantly in both groups (P <.001) without any statistically significant difference when comparing the groups (P =.23). Noninflammatory acne counts did not reduce in either group by weeks 2 or 4 and were not significantly different when compared between groups.

The erythema index decreased significantly in both groups, but there was no significant difference in erythema index decrease between the groups (P =.15).

In the L paracasei-treated group, 7.69% of patients reported adverse events compared with 26.92% of patients in the 2.5% benzoyl peroxide-treated group. The most common adverse effect for both the probiotic lotion and benzoyl peroxide was erythema.

The study was limited by its short treatment duration and unidentified components of the L paracasei supernatant, the researchers acknowledged.

The study authors wrote that L paracasei lotion “could be an alternative for treatment in patients who cannot tolerate benzoyl peroxide due to its irritation.”


Sathikulpakdee S, Kanokrungsee S, Vitheejongjaroen P, Kamanamool N, Udompataikul M, Taweechotipatr M. Efficacy of probiotic-derived lotion from Lactobacillus paracasei MSMC 39-1 in mild to moderate acne vulgaris, randomized controlled trial. J Cosmet Dermatol. Published online April 5, 2022. doi:10.1111/jocd.14971