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Dermatology

Modulating the skin microbiota with oral solutions

Skin health
Dermatology

The existence of a gut-skin axis suggests the possibility of influencing the skin microbiota by modulating the gut microbiota. Pre- and probiotic oral solutions are therefore an option.

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Lactobacillus bacteria, computer illustration.

About this article

Created 22 April 2021
Updated 12 October 2021

In numerous murine models, a Lactobacillus-enriched diet reduces skin sensitivity, rash, inflammation, dermatitis, etc., and improves skin phenotype (increased dermal thickness, enhanced folliculogenesis and increased sebocyte production).23 These beneficial probiotic effects have been confirmed by several interventional studies in humans involving lactobacilli and/or bifidobacteria.23 Managing skin diseases by modulating the gut microbiota will most likely involve probiotics (beneficial live bacteria), prebiotics (bacterial substrates) and symbiotics (combinations of pro- and prebiotics).23

Image
Legend

In mice, a Lactobacillus-enriched diet reduces skin sensitivity and improves skin phenotype.

A lack of adverse effects makes oral probiotics of even greater interest for the management of skin diseases.14

For example, in atopic dermatitis, daily consumption of probiotics (Bifidobacterium) and prebiotics (galacto-oligosaccharides) improves skin hydration in healthy adult women.14 To take another example, oral Lactobacillus supplementation reduces skin sensitivity and strengthens the skin’s barrier function in adults29 and children30. Several clinical trials have shown probiotics to have a positive effect when taken alone or in a cocktail (lactobacilli, bifidobacteria and/or S. thermophilus), with a reduction in lesions and severity in the case of acne.12,23 The positive effects of oral probiotics may be due to their ability to reduce systemic oxidative stress, regulate cytokines and reduce inflammatory markers.9 In the case of psoriasis, there are still few clinical data, but two studies in humans show beneficial effects: a reduction in inflammation markers with B. infantis; a reduction in the severity and appearance of lesions with B. longum, B. lactis and L. rhamnosus alongside a topical corticosteroid treatment.13 There were similar results for seborrheic dermatitis, with inflammation and symptoms relieved by oral L. paracasei.12 Some probiotics may even protect against skin cancer.16 However, clinical trials are still required to identify the most effective formulation of probiotic strains, the optimal duration of supplementation and the patients most likely to benefit.14

Sources

9 Dréno B, Dagnelie MA, Khammari A, et al. The Skin Microbiome: A New Actor in Inflammatory Acne. Am J Clin Dermatol. 2020 Sep;21(Suppl 1):18-24.

12 Yu Y, Dunaway S, Champer J, et al. Changing our microbiome: probiotics in dermatology. Br J Dermatol. 2020;182(1):39-46.

13 Rigon RB, de Freitas ACP, Bicas JL, et al. Skin microbiota as a therapeutic target for psoriasis treatment: Trends and perspectives. J Cosmet Dermatol. 2021;20(4):1066-1072.

14 Szántó M, Dózsa A, Antal D et al. Targeting the gut-skin axis-Probiotics as new tools for skin disorder management? Exp Dermatol. 2019 Nov;28(11):1210-1218.

16 Squarzanti DF, Zavattaro E, Pizzimenti S et al. Non-Melanoma Skin Cancer: news from microbiota research. Crit Rev Microbiol. 2020;46(4):433-449.

23 Salem I, Ramser A, Isham N, et al. The Gut Microbiome as a Major Regulator of the Gut-Skin Axis. Front Microbiol. 2018 Jul 10;9:1459.

29 Drago L, Toscano M, De Vecchi E, et al. Changing of fecal flora and clinical effect of L. salivarius LS01 in adults with atopic dermatitis. J Clin Gastroenterol. 2012;46.Suppl:S56-S63.

30 Niccoli AA, Artesi AL, Candio F, et al. Preliminary results on clinical effects of probiotic Lactobacillus salivarius LS01 in children affected by atopic dermatitis. J Clin Gastroenterol. 2014;48 Suppl 1:S34-S36.

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Psoriasis Acne Skin health Rosacea Probiotics Gut-skin axis Atopic Dermatitis

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    Focus
    Skin under triple influences : gut, brain, skin microbiota
    • The skin microbiota
      • A unique set of skin microbiota for each individual
      • Factors affecting the skin microbiota
      • Functions of the microbiota and its interactions with the host
    • Skin diseases associated with a dysbiosis
      • Skin diseases associated with a dysbiosis
      • Non-pathological skin conditions associated with a dysbiosis
    • The gut-skin axis
      • Psoriasis, atopic dermatitis, rosacea: gut-skin axis involved
      • A gut-brain-skin axis?
    • Modulating the skin microbiota
      • Modulating the skin microbiota via topical applications
      • Modulating the skin microbiota with oral solutions
    • Expert opinion
      • Dr. Markus Eger : Probiotics, a complementary therapeutic option
    Created 22 April 2021
    Updated 12 October 2021

    About this article

    To know more about this topic.

    Main topic

    Skin health

    Medical practice

    Dermatology

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    Dossier detail
    Modulating the skin microbiota via topical applications
    Dr. Markus Eger : Probiotics, a complementary therapeutic option
    Focus

    Skin under triple influences : gut, brain, skin microbiota

    The skin microbiota

    A unique set of skin microbiota for each individual Factors affecting the skin microbiota Functions of the microbiota and its interactions with the host

    Skin diseases associated with a dysbiosis

    Skin diseases associated with a dysbiosis Non-pathological skin conditions associated with a dysbiosis

    The gut-skin axis

    Psoriasis, atopic dermatitis, rosacea: gut-skin axis involved A gut-brain-skin axis?

    Modulating the skin microbiota

    Modulating the skin microbiota via topical applications Modulating the skin microbiota with oral solutions

    Expert opinion

    Dr. Markus Eger : Probiotics, a complementary therapeutic option
    Dermatology

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