The 2026 paper by Lestari et al. is a plan for a future acne trial, not a report of results. BMJ Open labels it a Protocol for a double-blind, randomised controlled trial in the protocol published in BMJ Open.
That label means methods come before patient outcomes. A trial protocol states who will enroll, what care each group will receive and how benefit will be measured. An MDPI review describes topical secretome as cell-free conditioned medium from mesenchymal stem cells. The practical point is timing: this paper sets up the test, so buying decisions should wait for results.
Medical information disclaimer: This article is for general educational purposes only and does not provide medical advice, diagnosis, or treatment. Always consult a physician or other qualified health professional about symptoms, medications, tests, or treatment decisions.
Table of Contents
- What the paper actually publishes
- Who will be studied and what each group receives
- How doctors will count improvement
- What to do while results are pending
What the paper actually publishes
PubMed indexes the same paper under the title "Oral probiotics and topical secretome to enhance clinical outcomes and microbiome restoration in acne vulgaris," according to the PubMed record from the U.S. National Library of Medicine. That record carries the same DOI family as the BMJ Open protocol.
It points readers to a design paper, not an efficacy claim. A protocol paper locks in the question and measurements before treatment starts. It lets other clinics, reviewers and registries check later whether the team did what it planned. For readers, it answers "what will be tested" rather than "what works.".
Who will be studied and what each group receives
BMJ Open states the planned trial will enroll 64 patients with mild-to-moderate acne vulgaris. Participants will be randomized with permuted blocks into four parallel arms. That structure keeps group sizes balanced while testing two add-on treatments.
The arms compare oral probiotics versus placebo and topical secretome versus placebo. Each add-on goes with the same base care: structured skincare plus nightly clindamycin-tretinoin on affected areas for 8 weeks. Keeping base care constant helps isolate any extra effect from probiotics or secretome.
How doctors will count improvement
BMJ Open names reduction in comedones and inflammatory lesions as the prespecified primary outcome. Staff will assess counts with the Yolov8 lesion-count method at baseline and after therapy. A prespecified measure makes selective reporting harder when results arrive.
Secretome itself is not live stem cells. An MDPI review defines it as conditioned medium containing secreted proteins, lipids, nucleic acids and extracellular vesicles studied for tissue repair and skin disease in the MDPI review of secretome biology. In acne, the stated interest is microbiome restoration alongside fewer lesions, but that idea remains to be tested in this trial.
What to do while results are pending
Because outcomes use future wording such as "will be allocated" and "will be measured," the paper gives no proof that probiotics plus secretome improves acne or microbiome. BMJ Open presents the design and planned analyses only.
Readers should await completed results and registry follow-up before changing care. Until then, keep decisions tied to current prescriptions and clinician advice: Bring the protocol reference to your next dermatology visit and ask how any future result would apply to your acne type.
- Continue prescribed skincare and nightly clindamycin-tretinoin exactly as directed.
- Ask a dermatologist before adding an oral probiotic or stem-cell-derived skin product.
- Watch for the finished trial results, not the protocol date, before judging benefit.