Isotretinoin: antimicrobial activity

Im just going to go here on a couple quick studies. You see some of this is separate from a 5ar inhibition effect.

Isotretinoin’s Mechanism of Action Explored
Isotretinoin appears to derive its effectiveness from increased production of the antimicrobial protein neutrophil-gelatinase associated lipocalin in the skin, reducing sebum levels, and in turn reducing levels of Propionibacterium acnes , according to new data.

now this is just from broad spectrum antibiotics, but we know Accutane is more effective then that.
So you knock down p.acnes what might go along with it?
Looking at so called probiotics bifido is from the same phylum as p.acnes (Actinobacteria) and you also see lactobacillus here getting knocked down even more so then P.acnes or now known as c. acnes.

Treating Acne with Systemic Antibiotics Alters Skin Microbiota

After 4 weeks of treatment, researchers identified a 1.4-fold reduction in the level of Cutibacterium acnes across all 4 participants, with recovery after minocycline was discontinued. They also reported a transient 5.6-fold increase in the relative abundance of Pseudomonas species immediately following antibiotic treatment.

Eight weeks after antibiotic cessation, researchers found a persistent 1.7-fold increase in the relative abundance of Streptococcus species as well as a 4.7-fold decrease in the relative abundance of Lactobacillus species.

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Interesting stuff. I spent A LOT of time on tetracycline antibiotics to treat acne between the ages of 17-19 (took fin at 23). It definitely f*cked up my gut big time. Still struggle with SIBO to this day.