Bacteriophage therapeutics in dermatology: A clinical review

Antimicrobial resistance represents an escalating global health crisis that increasingly impacts dermatologic practice. Chronic wounds, inflammatory dermatoses, and barrier disruption predispose patients to recurrent and drug-resistant infections. Bacteriophages are viruses that specifically infect bacteria; they are a promising alternative or adjunct to conventional antibiotics due to their high specificity, ability to penetrate biofilms, and capacity to co-evolve with pathogens. This clinical review summarizes the current evidence supporting bacteriophage-based therapies, with emphasis on therapeutic mechanisms, practical clinical applications, limitations of existing data, and considerations for patient selection. We review current evidence supporting phage-based interventions for acne vulgaris, resistant Staphylococcus aureus skin infections, chronic wounds, and multidrug-resistant gram-negative infections in burn care. This review further explores advances in Clustered Regularly Interspaced Short Palindromic Repeats–Cas engineered phages. These engineered phages have potential to overcome bacterial resistance and enable programmable antimicrobials. In addition, we address key translational challenges which include host specificity, manufacturing standardization, regulatory barriers, and safety considerations. Finally, we propose a practical framework for how dermatologists may begin to evaluate and incorporate phage-based therapeutics as antimicrobial resistance continues to expand.