Study Finds Gender-Based Differences in Gut Microbiota, Metabolites in People With Acne

Male and female patients with acne vulgaris have been found to have significantly different dysbiosis of gut microbiota and associated metabolites.

Male and female patients with acne vulgaris have significantly different dysbiosis, or reduced microbial diversity, of gut microbiota and associated metabolites, according to a study published in Annals of Dermatology.

The study authors said these findings support the potential role of gender in the pathogenesis of acne vulgaris but do not show a causal relationship between gut microbiota and acne.

Although gender differences in the pathogenesis of acne vulgaris have been assumed, there have been no specific studies on potential gender-related discrepancies in gut microbiota and microbial metabolism in acne.

A research team in China collected and analyzed fecal samples from 43 patients with acne and 43 patients without acne, matched for age and gender. All participants were middle school or college students. Acne severity was defined as mild, moderate, severe, or very severe based on the number of open and closed comedones, papules, pustules, cysts, and nodules on half of the face, and participants were further sorted into groups based on gender. The men in this study generally had more severe acne compared with women.

“The participants had not used antibiotics, glucocorticoids, immunosuppressive drugs, or herbal medicines within the past 6 months and did not present with other dermatoses, obesity, infections, tumors, mental diseases, immunodeficiency, or any other systemic disorders,” the authors explained. “Fresh fecal samples were collected in a sterile container and frozen within 30 minutes at –80℃ until they were processed.”

Researchers analyzed the gut microbiota by sequencing the V3-V4 region of 16SrDNA gene. Microbial metabolites were quantitatively detected using gas chromatography time-of-flight mass spectrometry.

“Compared with healthy controls, the men had a lower abundance of 18 microbes such as Butyricicoccus, Clostridium sensu stricto, Faecalibaculum, Bacillus, Lactococcus, Blautia, Clostridiales, Lachnospiracea incertae sedis, [and] Ruminococcus at genus level,” the authors found. “However, the female patients only showed increased Clostridium sensu stricto and declined Oscillibacter and Odoribacterin.”

Further, a disordered metabolism of fatty acids was identified in male patients and the dysbiosis of amino acid metabolism was identified in female patients, but there was no significant difference in bacterial diversity and structures among patient subgroups with different acne severity.

“In this study, the decreased diversity of gut microbiota was only found in the men acne samples but not in women, which also occurs in other inflammatory skin diseases,” the authors said. “It was shown in previous studies that people with low microbial diversity are characterized by a more pronounced inflammatory phenotype.”

When comparing the control group participants to the participants with acne, the authors found that, in men with acne, the metabolites of linoleic acid, alpha-Linolenic acid, oxoglutaric acid, phenylacetic acid, stearic acid, and succinic acid were negatively associated with microbes such as Lachnospiracea, Blautia, Ruminococcus, Gemmiger, Fusicatenibacter, and Butyricicoccus.

For women with acne, the metabolites of 2-phenylglycine, 4-hydroxyphenylpyruvic acid, glycine, and L-alanine were positively related to Clostridium sensu stricto. Additionally, 2-phenylglycine, Lleucine, L-methionine, L-serine, and L-valine was negatively correlated with declined Oscillibacter.

The authors noted the small sample size and generally young participant age as limitations, as well as the detection of 145 gut microbiome metabolites that were not analyzed.


Huang Y, Liu L, Chen L, Zhou L, Xiong X, Deng Y. Gender-specific dfferences in gut microbiota composition associated with microbial metabolites for patients with acne vulgaris. Ann Dermatol. Published online November 4, 2021. doi:10.5021/ad.2021.33.6.531