You’ve probably heard about probiotics and how good they are for your digestive health. Could it be that probiotics are also good for the health of our skin? As the body’s largest organ, and the first line of attack, the skin is the barrier against pathogens, allergens, and parasites. From a medical perspective, protecting against physical, chemical, bacterial, and fungal exposures is important. Our skin is also the first thing people see when they look at you, so from a cosmetic perspective, having a clear, smooth, and healthy complexion is also important.
What are Probiotics?
Probiotics are live microorganisms, bacteria and yeast, similar to the “friendly bacteria” found in our digestive tract. Our body is host to both good and bad bacteria and the balance is what keeps our digestive and immune systems healthy and functioning well.
Prebiotics are the counterpart to probiotics. They are nondigestible food ingredients that help to nourish the friendly bacteria and fungi already found in your gut. Think of them like fertilizer that selectively stimulates the growth and survival of beneficial microorganisms in the intestine.
Probiotics have the ability to improve gut flora in the digestive tract, which in turn, boosts the immune system. Just like your gut, your skin barrier is home to a diverse network of microorganisms, so it too can benefit from prebiotics and probiotics. While probiotics are well known in the food and supplements industries, applying probiotics topically within skincare is still new.
Where to Find Probiotics?
Probiotics are found naturally in fermented foods such as pickles, kimchi, kefir, miso, some cheeses, and sourdough bread. Kombucha is probably the most marketed fermented product today. Another good source of probiotics is live culture yogurt. Generally, naturally occurring probiotics are preferable, but there are also multitudes of over-the-counter probiotic supplements that come in the form of capsules, tablets, and skin creams.
Probiotics most commonly contain the lactobacillus and bifidobacterium acidophilus families, which are already prevalent in our digestive systems.
What is the Microbiome?
Before discussing probiotic skincare, it is important to understand the microbiome. Both on and inside, the body is home to trillions of microorganisms including bacteria, fungi, and viruses. The skin has about 1 billion microbes per square centimeter! That naturally beneficial bacteria helps support the immune system, providing nutrients for cells and preventing the invasion of harmful pathogens and viruses. Just like the bacteria found in the gut, the microbes on the skin are essential for fighting infections and protecting the body from environmental damages. Microbes can even be the cause of clear, healthy skin. Diversity is critical for the health of the microbiome and the more variety of beneficial microbes, the healthier the skin barrier will be.
Probiotics for Skin Health
While we know that our overall immune health begins in our gut and that probiotics help our gut health, you might be hesitant to put microbes on your skin. Can probiotics cause the skin to be itchy or break out? Probiotics ingested or topical are not linked to skin reactions or rashes. In fact, probiotics are good for our skin health. We can get probiotic benefits from both taking them internally and applying them topically.
The use of naturally probiotic-containing foods, such as yogurt, clay, and dirt, have long been a part of natural approaches to skincare, including for bathing and topical application. Recent research has indicated that the microbiome has a significant impact on overall human health, including skin health. Skin conditions like rosacea, acne, atopic dermatitis, and psoriasis can impair the skin’s barrier function that protects against bad bacteria. Applying probiotics directly on the skin forms a protective shield preventing skin cells from being in contact with bad bacteria and parasites. This prevents inflammation, redness, acne, rosacea, and other symptoms. Differences in the colonization of microbes in the gut and on the skin have been found in those with chronic skin conditions, such as acne, atopic dermatitis, and psoriasis.
Acne occurs when hair follicles become clogged with oil and dead skin cells. These clogged follicles can become inflamed if left untreated, which results in the large red bumps we all know as acne. Acne predominantly occurs in adolescence but can occur well into adulthood. The original lesions along with the resulting pigmentation and scarring result in significant cosmetic damage that has been linked to depression, anxiety, and other mental health challenges.
Oral probiotics have been linked to improved acne for decades. Topical probiotics have also been shown to be promising in reducing inflammation and redness of acne. The anti-inflammatory action of probiotics may inhibit the growth and colonization of pathogenic microbes that cause acne. The evidence is growing for the use of oral and topical probiotics in the treatment of acne.
Atopic dermatitis, better known as eczema, is a chronic inflammatory disease caused by a combination of genetic, environmental, and immunological factors. Severity varies in individuals and not everyone responds to treatments the same. Atopic dermatitis may also lead to skin infections and predisposes children to food allergies. While often considered a childhood ailment, eczema can affect adults. Typical treatment consists of a skincare regimen to keep broken skin clean and topical steroids for inflammation.
Gut microbiome manipulation has been shown beneficial for the prevention of eczema and reducing symptoms. Individuals with atopic dermatitis have reduced skin bacteria diversity and an increase of fungal diversity. Pregnant women who took probiotics during pregnancy and while breastfeeding, or added to infant formula, reduced the risk of eczema in their children until at least the age of 2. Some adults with atopic dermatitis have gained benefit from adding probiotics to their diet. Topical probiotic application has shown to be effective against flare-ups associated with Atopic dermatitis.
While believed to be an immune disease, psoriasis is difficult to treat and poorly understood. It is characterized by patches of dry, itchy, and red skin often found on the elbows, knees, and upper body, including the scalp. People with psoriasis have a different composition of bacteria dominant on the affected skin. In addition, psoriasis is often accompanied by gastrointestinal conditions such as inflammatory bowel disease. Probiotics are potentially beneficial for treating inflammatory bowel disease. A study showed an inverse trend between probiotic use and the occurrence of skin lesions. As the role of the gut-skin axis is becoming more apparent, it may be possible that probiotics can alleviate psoriasis symptoms.
How Do Probiotics Work?
What happens in your gut affects your skin and vice versa. Taking probiotics orally has been shown to decrease systemic inflammation and benefit the skin. While it is clear that there is an important connection between the skin and gut and our overall well-being, more research is needed on how probiotics can efficiently treat chronic skin conditions. The best probiotic strains and doses as well as what form, oral or topical, are still unknown. There may also be some worry that probiotic use may promote antibiotic resistance and risk of allergic reactions, though one does not need to worry about low-risk skin care interventions, such as yogurt face masks (though there is a potential for allergic reactions). While there still is no defined optimal gut or skin microbiome, including food sources containing prebiotics and probiotics may help shift gut microbiota towards a more healthy profile.
Chronic inflammation, stress, changes in skin pH, and diet can all influence the balance of the microbes in your gut and on your skin. When the microbiome is imbalanced, it can result in infections or skin conditions. Growing research is showing skincare products with prebiotics and probiotics help get healthy microbes back into balance and that balance may help reduce eczema, acne, dry skin, and even wrinkles and aid in skin cancer risks. Probiotics are hydrating, which may slow the signs of aging skin, protect against sun damage, and generally make wrinkles less visible.
Your skin is teeming with good bacteria that support immune and barrier function but unfortunately many factors can reduce the healthy microbes and increase the risk of acne, rosacea, eczema, psoriasis, and even wrinkles. Increasingly, studies are showing that skincare products with prebiotics and probiotics can boost your skin’s microbiome for clearer, healthier skin. As our understanding of the microbiome grows, we will learn more to apply to probiotic dermatological uses. In the meantime, the rapid increase in the medical use of probiotics confirms their excellent safety profile. They can be used by most healthy adults without side effects. If you have underlying health issues, consult your physician before consuming or applying probiotics.