Comparative efficacy of essential oils against Cutibacterium acnes: Effect upon strains from phylotypes with different virulence patterns

Objectives: Despite being a commensal of human skin, Cutibacterium acnes plays an important role in the pathogenesis of Acne vulgaris, with the loss of bacterial phylotype diversity being related to disease progression. This study evaluated differences in the virulence profile of C. acnes strains from different phylotypes and investigated the possible phylotype-selective efficacy of essential oils (EOs) from Thymus x citriodorus (TC), Thymus mastichina, and Cistus ladanifer compared to Melaleuca alternifolia (tea tree), focusing on both planktonic and biofilm growth forms, the latter being related with pathogenesis and treatment resistance.

Methods: One collection strain and seven clinical isolates were classified into phylotypes using multiplex-touchdown PCR. Virulence trait differences across phylotypes were evaluated by studying antibiotic resistance, biofilm formation, porphyrin production, and lipase activity. EOs were tested for minimum inhibitory/bactericidal concentrations (MIC/MBC) and effects on biofilm biomass and metabolic activity.

Results: Strains from phylotype IA₁ were higher biofilm and lipase producers than phylotype II strains. Regarding EO's efficacy, TC EO presented lower planktonic MIC values for all strains compared to the other EOs, presenting a smaller difference in MIC values across phylotypes. TC EO was able to similarly reduce biofilm biomass and metabolic activity in phylotype IA₁ clinical strains, being effective at lower concentrations compared with the remaining EOs.

Conclusions: Not all virulence traits were phylotype-related, highlighting the multifactorial nature of the disease. TC EO showed a relevant anti-acne potential, outperforming tea tree EO (a species with a commercial claim for Acne vulgaris) against both planktonic and biofilm growth forms of C. acnes.