Related Articles Japanese Dermatological Association Guidelines: Guidelines for the treatment of acne vulgaris 2017. J Dermatol. 2018 May 21;: Authors: Hayashi N, Akamatsu H, Iwatsuki K, Shimada-Omori R, Kaminaka C, Kurokawa I, Kono T, Kobayashi M, Tanioka M, Furukawa F, Furumura M, Yamasaki O, Yamasaki K, Yamamoto Y, Miyachi Y, Kawashima M Abstract
The Guidelines for the Treatment of Acne Vulgaris of the Japanese Dermatological Association was first published in Japanese in 2008 and revised in 2016 and 2017. These guidelines (GL) indicate the standard acne treatments in Japan and address pharmaceutical drugs and treatments applicable or in use in Japan. In these GL, the strength of the recommendation is based on clinical evidences as well as availability in Japanese medical institutions. In the 2016 and 2017 GL, some of the clinical questions were revised, and other questions were added in accordance with approval of topical medicines containing benzoyl peroxide (BPO). Rather than monotherapies of antibiotics, the 2017 GL more strongly recommend combination therapies, especially fixed-dose combination gels including BPO in the aspects of pharmacological actions and compliance in the acute inflammatory phase to achieve earlier and better improvements. The 2017 GL also indicate to limit the antimicrobial treatments for the acute inflammatory phase up to approximately 3 months and recommend BPO, adapalene, and a fixed-dose combination gel of 0.1% adapalene and 2.5% BPO for the maintenance phase to avoid the emergence of antimicrobial-resistant Propionibacterium acnes. The 2017 GL also discuss rosacea, which requires discrimination from acne and a different treatment plan.
PMID: 29782039 [PubMed - as supplied by publisher] {url} = URL to article

Very very true. It is what you can read in the most recent book called The Beauty of Dirty Skin: The Surprising Science of Looking and Feeling Radiant from the Inside Out  – by doctor Whitney Bowe( one of our MAC). A must read book for Rosaceans. The book can be bought from https://www.amazon.com/Beauty-Dirty-Skin-Surprising-Science/dp/0316509825. Enjoy, learn and apply. A list wit the best Skin-Care Products Infused With Probiotics here https://www.allure.com/gallery/probiotics-skin-care-products.

Abstract
In dermatology probiotic microorganisms have primarily been used orally for the prophylaxis and treatment of atopic disorders. In contrast to the successes achieved for gastrointestinal disorders, positive effects for atopic dermatitis only have been found in a few studies. New insights could now fundamentally change the impact of probiotics on dermatology. Probiotics are - like microflora of the skin - non-pathogenic microbes, which do not induce inflammatory responses in the skin. Common pathways for probiotics, non-pathogenic microbes, and microflora are characterized, in order to facilitate their more effective therapeutic use. These microbes display a majority of their effects directly at the site of application and thereby induce natural defense mechanisms. However, promotion of immunological tolerance is just as important in producing positive effects. Tolerance of the resident flora on surface organs developed during evolution and the mechanisms of action are multifaceted. Therefore, the topical application of probiotics and non-pathogenic microbes for prophylaxis and therapy of overwhelming cutaneous pro-inflammatory immune reactions is very promising. Results of recent clinical trials already have demonstrated the efficacy of this new therapeutic concept. Hautarzt. 2009 Oct;60(10):795-801. doi: 10.1007/s00105-009-1755-8.
Outside-in. Probiotic topical agents.
Volz T, Biedermann T.