The relationship between beneficial and pathogenic skin bacteria and their mediators is complex and not fully understood. The skin microbiome is individualized, changes frequently in response to a variety of factors, and as a result not all probiotics will work for all patients, Drs. Rebecca Knackstedt and Thomas Knackstedt conclude.
“The optimal dosing and strain for various skin conditions has yet to be determined,” they write. “The most efficacious treatment strategy may include a combination of topical and oral therapy. Additionally, some have proposed utilizing oral and/or topical probiotics and antibiotics in concert to allow for targeting of pathogenic bacteria while providing support for commensal and beneficial bacteria.”
“There is a paucity of well-done studies investigating the role that probiotics, topical or oral, may have on the evolution of acne. However, the studies that have been done in acne and other inflammatory and infectious conditions indicate that probiotics could positively impact these disease states,” Dr and Dr Knackstedt told Dermatology Times. “More well-done studies are required to help determine the role that probiotics could have in mitigating acne and other dermatologic conditions.”
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.