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Can oral probiotics treat skin diseases? What does science say about it?

The use of probiotics, prebiotics and postbiotics for skin care has grown immensely in the last years. The cosmetic market took advantage of this new trend and developed new products with claims such as “microbiome friendly”, “microbiome restoring” or “microbiome optimizing”. We could define microbiome as the set of microorganisms that inhabit a specific place or the entire human body. Most of the topic products developed contain prebiotics, which could be defined in a simple way as “food” for the good bacteria of the skin, or contain postbiotics, which are metabolites or “extracts” of dead “good microbes”.

Probiotics and skin, what are the benefits?

On the other hand, the use of oral supplements containing “real” probiotics, which are defined as viable microorganisms that, when administered in adequate amounts, confer health benefits to the host, is not something that new. A lot of research has been done on how the intestinal microbiota can influence other sites of the body, ether in a good or bad way. For example, changes in the intestinal microbiota, called dysbiosis, can lead to the development of inflammatory or autoimmune diseases in organs distant from the intestine, such as the skin.

Common inflammatory and infection dermatological diseases, such as acne vulgaris, atopic dermatitis, rosacea, psoriasis and even melasma could be caused or aggravated by intestinal dysbiosis. Recent research and hypotheses have suggested that the main mechanism by which the skin and the intestine microbiota can affect each other is through modulation of the endocrine and immune system, controlling the inflammation in the tissue.

The use of oral probiotics to manipulate the intestinal microbiota and thus obtain a positive effect is a rather old practice, but what does science say about the benefits of that practice on skin health?

Different clinical trials have been performed to analyze the use of probiotics as a single treatment, or in combination with standard medicine. A considerate number of publications has shown beneficial effect of the use of oral probiotics on the treatment of acne, rosacea, atopic dermatitis, psoriasis, photoaging, melasma and also rejuvenation.

Can oral probiotics improve skin diseases treatment?

Although it is seen mainly as a complementary therapy in clinical practice, the use of probiotics alone can present a positive result. Studies evaluating the usage of isolate probiotic strains, such as Lactobacillus rhamnosus SP1 for acne or Lactobacillus plantarum HY7714 as antiaging, and with defined doses, showed significative results on the skin of the patients. After three to six months in average of use, reduction of acne symptoms and transepidermal water loss was seen, in comparison to control.

Also, when combined with conventional therapy, it could improve the clinical outcome of the treatment further. Also, its use reduces the adverse events of more aggressive therapies, such as systemic antibiotics, used for acne or rosacea for example.

Some of the flaws of most of the studies is not evaluating the probiotic supplementation as an isolate strain of the microorganism. Many of the clinical studies utilize more than one species or a combination of supplements, reducing the evidence of positive effect of the probiotic itself and making it difficult the standardization of strains or doses.

Even though there are still gaps in knowledge and information that need to be better understood, science has been showing that oral probiotics can represent a good ally in the peruse of a healthier skin!

If you got interested in this topic, don't hesitate to contact me!

Artur Stramari de Vargas

Pharmacist - Master student - EMOTION

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1. Kalil C, Chaves C, Vargas A, Campos V. Use of probiotics in Dermatology - Review. Surg Cosmet Dermatol. 2020;12(2020).

2. Szántó M, Dózsa A, Antal D, Szabó K, Kemény L, Bai P. Targeting the gut-skin axis-Probiotics as new tools for skin disorder management? Exp Dermatol. 2019;28(11):1210-8.

3. Fabbrocini G, Bertona M, Picazo Ó, Pareja-Galeano H, Monfrecola G, Emanuele E. Supplementation with Lactobacillus rhamnosus SP1 normalises skin expression of genes implicated in insulin signalling and improves adult acne. Benef Microbes. 2016;7(5):625-30.

4. Lee DE, Huh CS, Ra J, Choi ID, Jeong JW, Kim SH, et al. Clinical Evidence of Effects of Lactobacillus plantarum HY7714 on Skin Aging: A Randomized, Double Blind, Placebo-Controlled Study. J Microbiol Biotechnol. 2015;25(12):2160-8.

5. Jung GW, Tse JE, Guiha I, Rao J. Prospective, randomized, open-label trial comparing the safety, efficacy, and tolerability of an acne treatment regimen with and without a probiotic supplement and minocycline in subjects with mild to moderate acne. J Cutan Med Surg. 2013;17(2):114-22.

6. Yu Y, Dunaway S, Champer J, Kim J, Alikhan A. Changing our microbiome: probiotics in dermatology. Br J Dermatol. 2020;182(1):39-46.

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