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Acne VulgarisPhase 2NCT06925386

The Relationship Between Microbioma Balance and Acne Vulgaris as a New Acne Treatment

A Phase 2 study testing Standard therapy, HEXBIO and Secretome in people with Acne Vulgaris, run by Universitas Padjadjaran at 1 site in Indonesia.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

Background: Acne vulgaris is a chronic inflammatory condition primarily caused by Cutibacterium acnes, which disrupts skin homeostasis, thereby triggering immune responses and sebum metabolism. Read more about this study

Who is it for?
Ages 13 to 45 years
Conditions the study is for
Acne Vulgaris
What is being tested?
Standard therapy, HEXBIO and Secretome
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
64 participants
Where
1 siteIndonesia
Study dates
1 May 2025to 1 May 2026
Phase
Phase 2
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 13 to 45 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • individuals aged 13 to 45 years
  • diagnosed with acne vulgaris by a certified dermatologist, presenting with mild to moderate facial acne based on the lesion count criteria by Lehman et al. Mild acne is defined as having fewer than 20 comedones or fewer than 15 papular/pustular lesions, while moderate acne is characterized by 20-100 comedones and 20-50 papular/pustular lesions.
  • must have experienced recurring new acne lesions in the past 6 months
  • must be willing to comply with all protocol requirements
  • must be willing to have standardized facial photograps taken using an imaging system
  • must be able to follow study and adhere to a fixed schedule
  • must have ability to provide inform concent for participation in the study
  • must be generally healthy and in good mental condition.

Who cannot join

  • pregnant patients
  • subjects who have undergone hormonal acne treatment within six months prior to the study
  • subjects who have taken oral isotretinoin within one month prior to the study.
  • simultaneous participation in a different study conducted by an external research institution at the same testing site.
  • inadequate language proficiency (both spoken and written)
  • participation in the study under the influence of alcohol and/or drugs, as well as substance addiction
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  • severe diseases (cardiovascular, hepatic, renal, or pulmonary diseases, severe diabetes mellitus) or chronic infections (Hepatitis, HIV).
  • immunodeficiency.
  • current use of the following topical or systemic medications: corticosteroids, immunosuppressants, and antihistamines.
  • skin conditions such as vitiligo, psoriasis, or atopic dermatitis.
  • any other diseases or medications that may directly interfere with the study or pose a risk to the subject's health

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

apt. Ida Ayu Manik Pharta Sutema, M.Farm., Researcher contact

+6282236350009

idaayumanik85@gmail.com

Indonesia1 site
  • Rumah Sakit Umum Daerah Bali Mandara

    Denpasar, Bali, 80116

    apt. Ida Ayu Manik Partha Sutema, M.Farm., +6282236350009, idaayumanik85@gmail.com

Other trials in Indonesia

About this study

Background: Acne vulgaris is a chronic inflammatory condition primarily caused by Cutibacterium acnes, which disrupts skin homeostasis, thereby triggering immune responses and sebum metabolism. Dysbiosis is an imbalances in the skin and gut microbiota identified as a significant factor contributing to acne progression. Standard therapy often rely on antibiotics, but the long-term use has increased antibiotic resistance, including in Indonesia. Consequently, alternative methods, such as probiotics and mesenchymal stromal cell (MSC) secretomes are gaining attention for immunomodulatory and regenerative properties. These novel therapies have shown promising results in modulating the skin and gut microbiota while reducing inflammation.

Study Design: A phase 2 double-blind randomized controlled trial was adopted using a parallel group design with four arms, namely: (1) standard therapy with oral probiotics and topical secretome (placebo), (2) standard therapy with oral probiotics (placebo) and topical secretome, (3) standard therapy with oral probiotics and topical secretome, and (4) standard therapy with oral probiotics (placebo) and topical secretome (placebo). Sixty-four mild to moderate acne vulgaris patients were randomly allocated to these groups. Interventions were administered over a period of 8 weeks, with outcomes measured at baseline and post-therapy. This study was conducted at Dermatology and Venereology Department of Bali Mandara General Hospital (RSBM). The primary outcome is the reduction of comedones and inflammatory lesions, assessed using the Yolov8 method. Secondary outcomes include gut and skin health parameters, such as tryptophan metabolites, collagen, pH, moisture, sebum levels, and IL-6, to explore the relationship between microbiome balance, skin condition, and inflammation in acne.

Discussion: In the context of increasing antibiotic resistance in Indonesia, where therapies often fail to produce sustainable clinical outcomes, this study showed the potential of combining probiotics and MSC secretomes as adjunctive therapies for acne vulgaris. Probiotics restored gut and skin microbiota balance, while MSC secretomes promoted immune modulation and tissue repair. The results of this study paved the way for innovative, non-antibiotic methods for acne management, addressing the need for sustainable and effective therapies amidst growing concerns over dysbiosis and antibiotic resistance.

Read the detailed description

Acne cases have a very high number of visits to doctors, around 87%, especially in teenagers, which has implications for the psychological impact where long treatment with repeated inflammation for quite a long time can have the effect of reducing self-confidence and increasing stress. The therapy that is often given to Acne vulgaris is in the form of long-term topical antibiotics which can risk increasing the bacteria's resistance to antibiotics. Researchers are considering a new therapeutic approach in improving acne vulgaris by improving the balance of the microbiome through consuming oral probiotics so that it can reduce the development of C. acnes bacteria that cause acne and administering serum containing secretome to reduce inflammation/lesions in acne. As proof of the effect of the addition of this new therapy, research was carried out which required 64 research participants who met the criteria and consent from research participants was indicated by agreeing to take part in the research as outlined in the informed consent and research participants were asked to be involved until the research was completed. In research involving humans (participants) who experience mild to moderate acne as determined through examination by a dermatologist to determine the severity of the acne (seen from the total number of acne lesions or bumps), the patients included in the study had an age range of 13 - 45 years, and additional criteria such as: experiencing new acne lesions or bumps repeatedly in the last 6 months, willing to have flash facial images, and physically and mentally healthy. Research participants were given additional therapy from the therapy that should have been given by a doctor. The additional therapy was in the form of oral probiotics which had BPOM distribution permits and topical secretome in the form of facial serum. Participants will be divided into 4 groups randomly so that respondents are selected fairly and objectively. All drugs/test materials use natural ingredients which tend to be very safe with low side effects, oral probiotics have been reported in a few cases with diarrhea and secretome side effects with a very low possibility of skin redness, but to further increase safety, researchers will carry out a skin redness test first. first on the skin before being given the test material, and if changes occur such as loose stools and repeated bowel movements more than 3 times a day, the researchers have prepared medication as a preventive measure, and if it continues, it will be fully handled by the researchers. The development of new therapies, especially skin diseases, in this case Acne vulgaris, needs to be explored, one of which is through the microbiome approach and new regenerating medicine using stem cells (secretome). In this study, researchers want to prove that natural ingredient-based treatments, namely oral probiotics and topical secretome, can have the potential to improve acne vulgaris through measuring microbiome balance and severity, so in this study a clinical trial will be carried out to compare the effects of standard therapy (usual therapy) with additional oral probiotic therapy and topical secretome on its ability to increase clinical and microbiome improvement in moderate-severe Acne vulgaris patients through a double-blended open label Randomized Control Trial study.

Conditions
Acne Vulgaris
Being tested
Standard therapy, HEXBIO, Secretome
Medical subject headings
Acne Vulgaris

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Standard therapyDrug

    The standard therapy for participants included a structured skincare regimen. A face wash was used once daily before bedtime to cleanse the skin. In the morning, a non-comedogenic sunscreen and a moisturizer were applied to protect and hydrate the skin. Additionally, a night cream containing clindamycin and tretinoin was applied once daily at night, specifically on acne-affected areas, to target inflammation and promote skin renewal.

  • HEXBIODietary supplement

    The oral probiotics given are Hexbio®, an oral probiotic containing multiple beneficial bacterial strains, including Lactobacillus acidophilus BCMC® 12130, Lactobacillus casei BCMC® 12313, Lactobacillus lactis BCMC® 12451, Bifidobacterium bifidum BCMC®02290, Bifidobacterium longum BCMC® 02120, and Bifidobacterium infantis BCMC®02129. This probiotic was administered in granule form and swallowed directly. Participants consumed the probiotic twice daily, after breakfast and dinner, for eight weeks to support gut microbiome balance and potential skin health benefits.

  • SecretomeBiological

    The topical secretome used is a hydrogel-based serum containing secretome components, including cytokines, growth factors, exosomes, microvesicles, and cell differentiation factors. The serum is formulated with a hydrogel base consisting of xanthan gum, sclerotium gum, 1% alginate, 2% glycerin, 1% caprylyl glycol, and 96% aqua. It is applied after cleansing the face with a facial cleanser, twice daily, in the morning and evening, for eight weeks

Study groups in NCT06925386
Study groupRoleWhat they receive
Group 1ExperimentalStandard therapy + oral probiotics + topical secretome (placebo)
Receives: Drug: Standard therapy; Dietary Supplement: HEXBIO
Group 2ExperimentalStandard therapy + oral probiotics (placebo) + topical secretome
Receives: Drug: Standard therapy; Biological: Secretome
Group 3ExperimentalStandard therapy + oral probiotics + topical secretome
Receives: Drug: Standard therapy; Dietary Supplement: HEXBIO; Biological: Secretome
Group 4Placebo comparatorStandard therapy + oral probiotics (placebo) + topical secretome (placebo)
Receives: Drug: Standard therapy

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Reduction of comedones and inflammatory lesions

    The primary outcome measured in this study is the reduction in the number of comedones and/or inflammatory lesions (papules/pustules). This is assessed using the Yolov8 machine learning detection method, which enables accurate and objective quantification of comedones and lesions while also determining the severity of acne

    Measured: From enrollment to the end of treatment at 8 weeks

Secondary outcomes (6)
  1. Tryptophan metabolites

    In the gut, tryptophan metabolites are measured using the ELISA method to assess the abundance of probiotic bacteria, specifically lactic acid bacteria such as Lactobacillus and Bifidobacterium

    Measured: From enrollment to the end of treatment at 8 weeks

  2. Inflammatory Response

    Inflammatory responses are assessed by measuring serum IL-6 levels, which serve as an indicator of systemic inflammation

    Measured: From enrollment to the end of treatment at 8 weeks

  3. Collagen Measurement

    collagen measurement use skin Elastometer

    Measured: From enrollment to the end of treatment at 8 weeks

  4. Moisture content

    Moisture content use skin hydrometer

    Measured: From enrollment to the end of treatment at 8 weeks

  5. Sebum levels

    Sebum levels use sebumeter

    Measured: From enrollment to the end of treatment at 8 weeks

  6. pH levels

    pH levels use pH meter to determine the balance of the skin microbiome

    Measured: From enrollment to the end of treatment at 8 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted13 Apr 2025
  2. Study start1 May 2025 (estimated)
  3. Primary completion31 Dec 2025 (estimated)
  4. Study completion1 May 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
A parallel group design with four arms was used, (1) standard therapy with oral probiotics and topical secretome (placebo), (2) standard therapy with oral probiotics (placebo) and topical secretome, (3) standard therapy with oral probiotics and topical secretome, and (4) standard therapy with oral probiotics (placebo) and topical secretome (placebo). Participants were assigned to groups using a random permuted block sampling method (comprising A, B, C, D). This method is commonly applied in clinical trials including small sample sizes with staggered participants' enrollment. Observation spans 8 weeks. All groups were subjected to pretest and posttest assessments, measuring acne severity, fecal microbiome metabolites, skin condition, and IL-6 before and after intervention.
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
64 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06925386
Sponsor's protocol ID
PHAR-202503.01
Status last verified
Apr 2025
First submitted
20 Mar 2025
Last updated
13 Apr 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Lestari K, Sutema IAMP, Latarissa IR, Oon SF, Tamsir NM, Noor A, Widowati IGAR, Sartika CR, Ciptasari NWE. Oral probiotics and topical secretome to enhance clinical outcomes and microbiome restoration in acne vulgaris: a double-blind, randomised controlled trial protocol. BMJ Open. 2026 Jun 4;16(6):e109586. doi: 10.1136/bmjopen-2025-109586.

    PubMed 42242743

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Standard therapy, HEXBIO and Secretome in people with Acne Vulgaris, run by Universitas Padjadjaran at 1 site in Indonesia.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 13 Apr 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Indonesia. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact apt. Ida Ayu Manik Pharta Sutema, M.Farm., Researcher (+6282236350009, idaayumanik85@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Reduction of comedones and inflammatory lesions (time frame: From enrollment to the end of treatment at 8 weeks). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06925386, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 13 Apr 2025.

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