? DESCRIPTION (provided by applicant): Acne is a nearly universal condition, affecting 80% of all people at some point in their lives. In the US alone, acne affects about 50 million people and causes physical and psychological scars. Acne is a $6.5 billion market and each year there are 40 million prescriptions to treat acne, including 10 million prescriptions for topical antibiotics alone. Antibiotic treatment is frequently ineffective or has poor longterm outcomes. Decades of treating acne with antibiotics has also led to more than 60% of acne causing P. acnes bacteria acquiring drug resistance, which is a major public health concern. As an alternative to antibiotic therapy we are developing a precise microbiome editing platform to treat acne and other skin disorders with topical treatments comprising probiotic microorganisms. Our approach is to selectively replace the pathogenic acne causing P. acnes with probiotic bacteria sourced from healthy skin, restoring the balance of the microbiome to a healthy state. Our live biotherapeutic product would have three characteristics. First, it would be inherently safe for use on human skin. Second, based on the efficacy of a similar approach in treating skin infections, our product is expected to have superior longterm outcomes. Third, it would replace topical antibiotics that have caused an overwhelming rise in drug resistant skin bacteria, and reduce the problem of antibiotic resistance. The probiotic therapy developed as a result of this work can be applied to recalibrate the microbiota in other skin disorders of bacterial etiology, such as rosacea and atopic dermatitis.