by Dr. Ky Lo, BA, BSc, ND, LAc

We know probiotics can ease the symptoms of gastrointestinal (GI) discomfort. We are also familiar with probiotics for our immune health and even for addressing mental health through the gut-brain axis. But did you know that probiotics can improve skin health as well? Now, we can better understand the gut-brain-skin axis and the benefits of probiotics for our skin.

The skin’s primary functions are to serve as a barrier to the entry of microbes and viruses in the body. Other important functions of skin are homeostatic control of body temperature, sensory reception, water balance (the skin prevents the loss of water and extracellular fluid), synthesis of vitamins and hormones, and absorption of topical materials. The gut microflora appears to play a key role in the development of many inflammatory disorders of the skin. Intestinal dysbiosis or leaky gut has the potential to negatively impact the skin microbiome and its basic function.

This can contribute to common skin disorders such as acne, psoriasis, atopic dermatitis (eczema), and rosacea.[1]

There are three ways to use probiotics for skin care:

1. Topical (skin application)

2. Oral intake of probiotic supplements

3. Eating probiotic foods

Skin-care products containing probiotics for topical application are not an entirely new idea—we have all heard of yogurt mask. What is new is that cosmetic companies are beginning to bottle probiotic-containing products. Some challenges with topical probiotic skin-care are storage requiring refrigeration, as they are sensitive to heat, light, and humidity; a short shelf life of six months or less. In order for a probiotic to be effective, it must be alive. For this reason, most topical skin-care formulas do not contain live probiotics; instead, they contain prebiotic (nondigestible fibre to feed the good bacteria) such as xylitol, fructooligosaccharides (FOS), glucomannan, and inulin or a postbiotic (byproduct from natural bacterial function) such as Aqua Posae Filiformis, a postbiotic ideal for dry skin, or Lactococcus ferment lysate for skin wrinkle and rejuvenation.[2][3]

Even though topical probiotics have shown efficacy in several clinical trials—particularly those involving the treatment of acne, atopic dermatitis, and rosacea [4]—a great deal of research still needs to be carried out to demonstrate large-scale effectiveness. With safety concerns, cosmetic products are expected to have a low content of microorganisms—below 500 colony-forming units (CFU) per gram for eye-area products, and 1,000 CFU/g for the rest of the face.[5]

Alternately, the most reliable and safe way to get enough probiotics is to ingest them. Fermented foods like yogurt, kimchi, kombucha, sauerkraut, and natto may provide a good nutritional alterative. Even though these foods provide a natural source of prebiotic and postbiotic nutrients, the number and strain of probiotics in the food may not actually survive passage through stomach acid. For moderate to inflammatory skin conditions, a much higher dose than that available in fermented foods is needed; thus, an oral probiotic supplement is the most reliable way to get the desired dose.

In particular, multistrain, enteric-coated probiotics will ensure survivability through the stomach acid into the large intestine, where we need them.

Probiotic strains are now being categorized for different functions for antiaging skin-care. Below is a list of probiotics (topical and oral) and their corresponding effects.

Oral probiotics:

Lactobacillus plantarum: Wrinkles, elasticity, and improved hydration in the skin. Also for photoaging, particularly relevant for the summer, as it might help to serve as an additional form of protection for your skin against damaging ultraviolet rays.[6] 

Lactobacillus rhamnosus GG: Reduce eczema in newborns when mothers take it for more than 10 weeks during pregnancy. Protective of ultraviolet (UV) damage in skin.[7]

Lactobacillus paracasei: Anti-inflammatory properties and helps strengthen the skin barrier to prevent moisture loss.[8]

Lactobacillus johnsonii: Protect skin from UV damage.[9]

Lactobacillus fermentum KBL375: Antioxidant properties for protecting the skin from free-radical damage, which can lead to skin cancer, brown spots, melasma, and wrinkles. Hydration for severely dry skin.[10]

Lactococcus lactis: Helps with wound healing, skin hydration, and elasticity.[11]

Bacillus coagulans (topical and oral): A free-radical scavenger that helps with oxidative stress (lentigos/brown spots, acne, and fine lines). Increases the skin’s synthesis of moisturizing ceramides to reduce wrinkles. Beneficial for inflammatory skin conditions such as eczema.[12]

Topical probiotics:

Lactobacillus plantarum: Decreases the number and size of acne lesions as well as redness; may also help with rosacea flares.[13]

Lactobacillus paracasei: Inhibits Substance P (a pain-promoting neuropeptide) to regulate inflammation and oil production. Potential role in acne and rosacea patients.[14]

Bifidobacterium longum: Helps with sensitive skin or skin that easily reacts with stinging or burning.[15]

Enterococcus faecalis SL-⁠5: Acne reduction.[16]

Lactococcus sp. HY 449: Excretes antimicrobial agent to control the growth of Propionibacterium acnes and prevent inflammation and acne breakouts.[17]

Staphylococcus hominis and epidermis: Suppresses the growth of Staphylococcus aureus, an infectious bacterial strain that drives the symptoms of eczema and skin inflammation.[18]

Streptococcus salivarius or thermophilus: They secrete a bacteriocin-like inhibitory substance (BLIS) that reigns in the acne-causing bacteria, P. acnes. They also augment ceramides in the skin to counter moisture loss and irritation, with benefit for eczema and sensitive dry skin.[19]

References

  1. Bowe, W.P., and A.C. Logan. “Acne vulgaris, probiotics and the gut-brain-skin axis—Back to the future?” Gut Pathogens, Vol. 3, No. 1 (2011): 1.
  2. Mahe, Y.F., M.J. Perez, C. Tacheau, C. Fanchon, R. Martin, F. Rousset, and S. Seite. “A new Vitreoscilla filiformis extract grown on spa water-enriched medium activates endogenous cutaneous antioxidant and antimicrobial defenses through a potential Toll-like receptor 2/protein kinase C, zeta transduction pathway.” Clinical, Cosmetic and Investigational Dermatology, Vol. 6 (2013): 191–196.
  3. Puebla-Barragan, S., and G. Reid. “Probiotics in cosmetic and personal care products: Trends and challenges.” Molecules, Vol. 26, No. 5 (2021): 1249.
  4. Griffin, R.L., M. Maarouf, A.J. Hendricks, D.E. Lee, and V.Y. Shi. “Topical probiotics: The unknowns behind their rising popularity.” Dermatology Online Journal, Vol. 25, No. 5 (2019): 13030/qt2v83r5wk.
  5. Huang, J., A.D. Hitchins, T.T. Tran, and J.E. McCarron. “Microbiological methods for cosmetics.” Chapter 23 in Bacteriological Analytical Manual (BAM). https://www.fda.gov/food/laboratory-methods-food/bacteriological-analytical-manual-bam · Accessed 2021-⁠02-⁠19.
  6. Lee, D.E., C.-⁠S. Huh, J. Ra, I.-⁠D. Choi, J.-⁠W. Jeong, S.-⁠H. Kim, J.H. Ryu, et al. “Clinical evidence of effects of Lactobacillus plantarum HY7714 on skin aging: A randomized, double blind, placebo-controlled study.” Journal of Microbiology and Biotechnology, Vol. 25, No. 12 (2015): 2160–2168.
  7. Jung, Y.-⁠O., H. Jeong, Y. Cho, E.-⁠O. Lee, H.-⁠W. Jang, J. Kim, K. Nam, and K.M. Lim. “Lysates of a probiotic, Lactobacillus rhamnosus, can improve skin barrier function in a reconstructed human epidermis model.” International Journal of Molecular Sciences, Vol. 20, No. 17 (2019): 4289.
  8. Philippe, D., S. Blum, and J. Benyacoub. “Oral Lactobacillus paracasei improves skin barrier function recovery and reduces local skin inflammation.” European Journal of Dermatology, Vol. 21, No. 2 (2011): 279–280.
  9. Guéniche, A., D. Philippe, P. Bastien, S. Blum, E. Buyukpamukcu, and I. Castiel-⁠Higounenc. “Probiotics for photoprotection.” Dermato-⁠Endocrinology, Vol. 1, No. 5 (2009): 275–279.
  10. Kim, W.-⁠K., Y.J. Jang, D.H. Han, B. Seo, S. Park, C.H. Lee, and G Ko. “Administration of Lactobacillus fermentum KBL375 causes taxonomic and functional changes in gut microbiota leading to improvement of atopic dermatitis.” Frontiers in Molecular Biosciences, Vol. 6 (2019): 92.
  11. Kober, M.-⁠M., and W.P. Bowe. “The effect of probiotics on immune regulation, acne, and photoaging.” International Journal of Women’s Dermatology, Vol. 1, No. 2 (2015): 85–89.
  12. Kaci, G., D. Goudercourt, V. Dennin, B. Pot, J. Doré, S.D. Ehrlich, P. Renault, H.M. Blottière, C. Daniel, and C. Delorme. “Anti-inflammatory properties of Streptococcus salivarius, a commensal bacterium of the oral cavity and digestive tract.” Applied and Environmental Microbiology, Vol. 80, No. 3 (2014): 928–934.
  13. Lee et al. “Clinical evidence of effects of Lactobacillus plantarum HY7714 on skin aging.”
  14. Philippe, Blum, and Benyacoub. “Oral Lactobacillus paracasei improves skin barrier function recovery.”
  15. Guéniche, A., P. Bastien, J.M. Ovigne, M. Kermici, G. Courchay, V. Chevalier, L. Breton, and I. Castiel-⁠Higounenc. “Bifidobacterium longum lysate, a new ingredient for reactive skin.” Experimental Dermatology, Vol. 19, No. 8 (2010): e1–e8.
  16. Oh, S., S.-⁠H. Kim, Y. Ko, J.-⁠H. Sim, K.S. Kim, S.-⁠H. Lee, S. Park, and Y.J. Kim. “Effect of bacteriocin produced by Lactococcus sp. HY 449 on skin-inflammatory bacteria.” Food and Chemical Toxicology, Vol. 44, No. 8 (2006): 1184–1190.
  17. Kang, B.S., J.-⁠G. Seo, G.-⁠S. Lee, J.-⁠H. Kim, S.Y. Kim, Y.W. Han, H. Kang, et al. “Antimicrobial activity of enterocins from Enterococcus faecalis SL-⁠5 against Propionibacterium acnes, the causative agent in acne vulgaris, and its therapeutic effect.” Journal of Microbiology, Vol. 47, No. 1 (2009): 101–109.
  18. Brown, M.M., and A.R. Horswill. “Staphylococcus epidermidis—Skin friend or foe?” PLoS Pathogens, Vol. 16, No. 11 (2020): e1009026.
  19. Kaci et al. “Anti-inflammatory properties of Streptococcus salivarius.”