One prospective trial has looked at the use of oral probiotics (a combination of Lactobacillus acidophilus, Lactobacillus delbrueckii and Bifidobacterium bifidum) to treat acne in which patients, either alone or in combination with antibiotics, and the combination reduced the lesion numbers significantly.3
“Future studies should elucidate if probiotics should be utilized in concert with antibiotics to provide better disease control,” Drs. Rebecca Knackstedt and Thomas Knackstedt told Dermatology Times. “When used for their anti-inflammatory properties in dermatological conditions, it is advisable to use sub-antimicrobial drug dosing. These lower dosages achieve anti-inflammatory efficacy while minimizing disruption of intestinal flora.”
Patients with acne treated with topical probiotics including L plantarum and cell‐free supernatant from Enterococcus faecalis have also been found to experience a reduction in lesion concentration, erythema and pathogenic bacteria load with an improvement in the skin barrier.
“…as acne is associated with an overgrowth of pathogenic bacteria, and the mainstays of therapy are often antibiotics, topical probiotics could restore a more desired microflora to decrease acne lesions without systemic side effects,” Drs. Rebecca Knackstedt and Thomas Knackstedt write.
Probiotics, including the commensal bacteria Streptococcus thermophiles, Vitreoscilla filiformis, Staphylococcus hominis, Staphylococcus epidermidies and Lactobacillus johnsonii, have also been shown to have an impact in the treatment of atopic dermatitis. According to the review, atopic dermatitis is associated with alterations in the skin microflora, such as an abundance of S aureus. And S aureus has been linked to T‐cell dysfunction, reduced antimicrobial peptides, more severe allergic reactions and disruptions in the skin barrier.
1. Knackstedt R, Knackstedt T, Gatherwright J. The role of topical probiotics on skin conditions: A systematic review of animal and human studies and implications for future therapies. Exp Dermatol. 2019;
2. Fitz-gibbon S, Tomida S, Chiu BH, et al. Propionibacterium acnes strain populations in the human skin microbiome associated with acne. J Invest Dermatol. 2013;133(9):2152-60.
3. Baquerizo nole KL, Yim E, Keri JE. Probiotics and prebiotics in dermatology. J Am Acad Dermatol. 2014;71(4):814-21.