Probiotics, which are helpful bacteria that protect the body from harmful bacteria, are literally everywhere. Strolling through the aisles of any grocery store, we can find yogurts, milks, juices, and other consumables that contain naturally-occurring probiotics such as lactobacillus or bifidobacterium, or foodstuffs that are artificially teeming with these celebrated organisms. Upon further probing we even encounter “prebiotics,” or nondigestible food ingredients (such as cellulose) that promote the growth of beneficial microorganisms in the intestines—i.e., sustenance for our symbionts.
In light of increasing antibiotic resistance due to over- and misuse, coupled with patients’ preferences for more holistic, natural approaches to healing, are we entering an era of anti-antibiotics and pro-probiotics? Replacing the drugs with the bugs, if you will? There is, in fact, interesting literature on the various applications of probiotics in skin health, and for integrative practitioners striving to combine the best of allopathy with nature’s bounty, several of these studies are here mentioned.
In 2014, Bowe et al reviewed a theory from 1930 known as the “gut-brain-skin axis”—essentially, the idea that disturbed emotional states such as stress, anxiety and depression can reciprocally contribute to altered gut flora (SIBO: small intestinal bacterial overgrowth) and GI leakage, which in turn recruits a systemic inflammatory response with skin manifestations such as acne.1 While this theory has not been directly studied with respect to acne, Parodi and colleagues showed in 2008 that patients with rosacea had a ten-fold greater incidence of SIBO as compared to healthy controls.2 Additionally, studies examining the therapeutic benefit of oral and topical probiotic administration in mild acne patients within the last decade have been promising, with mechanistic theories including decreased release of inflammatory mediators as well as increased production of ceramide and skin barrier restoration.3,4