Should You Take Probiotics For Acne?

The term "microbiome" has never been more popular...and for good reason! In recent years, more research has surfaced that has allowed us to understand better the gut and its role in our health—especially skin health. An imbalance in gut bacteria seems to lead to poor absorption of food nutrients and poor filtering out of toxins from the intestinal tract. This gnarly combination can take a severe toll on our digestive and integumentary systems (that's a funny way of saying "skin"), leading many people to develop and worsen inflammatory skin conditions, including acne. Fortunately, there are several ways we can improve the health of our microbiome and help fight acne from the inside (while also treating it topically) using probiotics and Prebiotics.

What causes an imbalance in gut bacteria?

The most common cause of gut bacterial imbalance (i.e., too much "bad bacteria," not enough "beneficial bacteria") is long-term use of oral antibiotics. This includes antibiotics for acne specifically, as well as for other conditions. Think of antibiotics as the bacterial security guards of your macrobiotic nightclub and your "good bacteria" as by-standing good samaritans. The antibiotics are strong and mighty and knock out harmful bacteria to keep the club running smoothly with little to no issues. Unfortunately, antibiotics also take out some good bacteria along the way. Once you stop taking antibiotics and there aren't enough "good guys" to keep the bad guys in line... you've got a problem.

But antibiotics aren't the only thing throwing off our microbiome. In today's world, we're constantly exposed to toxins in our environment, homes, and even dish soap. These toxins can have an equally gnarly impact on our gut health.

What is leaky gut syndrome, and how does it affect acne?

Leaky gut (or leaky intestine syndrome) is a disorder that occurs when our gut lining (its protective shield) is compromised, and toxic compounds are more easily absorbed into the bloodstream. This poisonous load increase triggers an immune system response and subsequent low-level chronic inflammation that causes damage to multiple organs, including the skin, which can trigger or worsen acne breakouts.

What are probiotics, and how do they impact the skin?

Probiotics are live "good bacteria" (pro: good, biotic: bacteria). They are naturally occurring in our gut as well as in fermented foods like yogurt and sauerkraut. There are hundreds of different (identified) probiotic "strains," but the most commonly known are Lactobacillus and Bacillus Bifidus (both Bifidobacterium). These gut-friendly bacteria are well equipped to fight the "bad" bacteria that can damage our intestines and may benefit our immune system and overall health. When taken by mouth, they can help normalize gut bacteria, improve the microbiome balance of your gastrointestinal tract, and subsequently reduce inflammation throughout the body—including your skin.

Recent studies have shown that inflammation-related skin disorders—acne (predominantly cystic acne), rosacea, and eczema—can flare up when our gut microbiome balance is damaged. One study found that people with acne had fewer bacteria than those without acne.

Do probiotics help with acne?

While there is still much research to be done, it appears (and many individuals have self-reported) that probiotics may be a helpful tool added to an acne treatment program and can help calm other inflammatory skin conditions by balancing the microbiome and reducing systemic inflammation. However, this rebalancing effect can take time and should be considered an adjunct therapy to an effective, medical-grade topical acne treatment. Additionally, in some cases, for example, in patients with SIBO (small intestinal bacterial overgrowth), probiotics may not be the best choice and could exacerbate the issue. Before starting a probiotic supplement, it is always a good idea to consult your physician first and, if possible, get tests to understand your microbiome's condition better.

Clinical Results for the Use of Probiotics in People with Acne

Several clinical studies have examined the efficacy of oral probiotics in treating acne conditions. For instance, a 2013 study by Jung et al. compared the use of a probiotic blend containing Lactobacillus acidophilus, Lactobacillus delbrueckii bulgaricus, and B. bifidum to minocycline, finding a 67% reduction in acne lesions with fewer side effects. Another study by Kim et al. in 2010 reported a 30% decrease in inflammatory acne lesions and a substantial reduction in sebum and free fatty acid levels after 12 weeks of treatment with L. bulgaricus and S. thermophilus. Fabbrocini et al. conducted a study in 2016 using LGG (Lactobacillus rhamnosus GG), which resulted in a 32% decrease in back acne and a 65% increase in IGF1 and FOX01 gene expression in the skin. Additionally, a 1961 study by Siver showed that 80% of subjects, especially those with inflammatory lesions, saw improvement when treated with Lactobacillus acidophilus and Lactobacillus bulgaricus. Finally, a study from 1987 by Marchetti et al. reported improved clinical outcomes and better tolerance for oral antibiotics with the use of L. acidophilus and Bifidobacterium bifidum.

What are the best probiotics for acne?

There are mixed opinions on the best probiotics to help treat acne. We recommend taking probiotics with (at least) the following probiotic strains (live cultures):

• Lactobacillus acidophilus
• Lactobacillus paracasei
• Lactobacillus plantarum
• Enterococcus faecalis
• Streptococcus salivarius

Here are some of our favorite probiotic supplements: (note: probiotics can get pricey, but it's worth investing in a high-quality brand if you're looking to balance your gut flora and achieve healthy skin.)

• Garden of Life Dr. Formulated Once Daily Women's Shelf Stable Probiotics 16 Strains, 50 Billion CFU - $26.54
• Renew Life Women's Probiotic - Ultimate Flora Probiotic Women's Care - $15.99

In addition to probiotic supplements, you can increase your consumption of foods with naturally occurring probiotics, such as yogurt (non-sweetened!), sauerkraut, kombucha, etc. The American Academy of Family Physicians suggests a dosage of 10 to 20 billion colony-forming units per day. Probiotic yogurts contain 5 to 10 billion colony-forming units per 4-ounce portion, so they may not be enough to help combat skin inflammation independently.

Do topical probiotics help with acne?

Using skincare products with topical probiotics may seem attractive and can work well as a skincare option. However, it is best for acne patients to stick to oral probiotics and focus on skincare products (such as salicylic acid and benzoyl peroxide) proven to fight the acne vulgaris bacteria.

--> To find the right acne treatment products for your skin type, acne severity, and sensitivities, take the free MDacne skin analysis.

What are Prebiotics?

Prebiotics are the food of good bacteria. These include several fiber-rich foods and herbs that help support probiotics. Here are some of our favorites;

1. Artichokes
2. Asparagus
3. Leaks
4. Garlic
5. Onion
6. Carrots
7. Bananas
8. Omega three fish oil capsules

Is it possible to cure acne with probiotics or Prebiotics?

The insights from the latest studies show that:

1. Poor Gut Health is believed to increase skin Inflammation:

• Poor gut health creates a positive feedback loop, amplifying host metabolism and inflammation.
• Factors like the Western diet, stress, and low stomach acidity contribute to poor gut health.
• These factors can lead to gut dysbiosis and systemic inflammation.

2. How Poor Gut Health and Inflammation Cause Acne:

• Stress-induced changes in gut microflora result in systemic inflammation, potentially worsening acne.
• High-fat diets and specific dietary components can further reduce gut health, increase inflammation, and potentially worsen acne.

3. The Role of Probiotics and Good Gut Bacteria in Acne Treatment:

• Probiotics, such as Lactobacillus and Bifidobacterium, play a vital role in gut health.
• These beneficial bacteria help balance the gut microbiota and strengthen the intestinal barrier.
• Incorporating probiotics into acne treatment may have potential benefits for improving gut health and, consequently, skin health.

Conclusion:

Probiotics and Prebiotics can help improve digestive health and, therefore, aid in treating acne for some acne patients. However, the benefits of probiotics in treating acne still have yet to be studied at length and are not likely to cure acne on their own as a single therapy. If you want clear skin, consider supplementing and increasing your prebiotics and probiotics intake while committing to an effective topical anti-acne treatment plan.

FAQs:

Sure, here are the FAQs about the microbiome and its relation to skin health, especially acne.

Q. What causes an imbalance in gut bacteria?
A. An imbalance in gut bacteria, commonly caused by long-term use of oral antibiotics, results in an excess of "bad bacteria" and a lack of "beneficial bacteria." The problem isn't only antibiotics, though. Toxins in our environment, homes, and everyday products can also disrupt our gut health, leading to an imbalance.

Q. What is leaky gut syndrome, and how does it affect acne?
A. Leaky gut syndrome is when the gut lining becomes compromised, allowing harmful compounds to enter the bloodstream. This leads to an immune response and low-level chronic inflammation that can damage various organs, including the skin. As a result, acne breakouts can be triggered or worsened.

Q. What are probiotics, and how do they impact the skin?
A. Probiotics are "good bacteria" naturally found in our gut and fermented foods like yogurt and sauerkraut. There are many probiotic "strains," but the most common are Lactobacillus and Bacillus Bifidus. They help normalize gut bacteria, improve the microbiome balance in your gastrointestinal tract, and reduce inflammation throughout the body—including your skin.

Q. Do probiotics help with acne?
A. While more research is necessary, evidence suggests that probiotics may help with acne. They seem to rebalance the microbiome and reduce systemic inflammation, both beneficial for calming inflammatory skin conditions. However, probiotics should be considered an adjunct therapy to medical-grade topical acne treatment, and some individuals, such as those with small intestinal bacterial overgrowth (SIBO), may not benefit from probiotics.

Q. What are the best probiotics for acne?
A. We recommend taking probiotics with the following strains: Lactobacillus acidophilus, Lactobacillus paracasei, Lactobacillus plantarum, Enterococcus faecalis, and Streptococcus salivarius. Additionally, you can boost your probiotic intake with foods rich in naturally occurring probiotics. We suggest considering high-quality probiotic supplements such as Garden of Life Dr. Formulated Once Daily Women's Shelf Stable Probiotics and Renew Life Women's Probiotic - Ultimate Flora Probiotic Women's Care.

Q. Do topical probiotics help with acne?
A. Although topical probiotics in skincare products seem appealing, oral probiotics and proven skincare products such as salicylic acid and benzoyl peroxide are typically more effective for treating acne.

Q. What are Prebiotics?
A. Prebiotics are the "food" for good bacteria. They can be found in several fiber-rich foods and herbs that support probiotics. Artichokes, asparagus, leeks, garlic, onions, carrots, bananas, and omega-3 fish oil capsules are all excellent sources of Prebiotics.

Q. Is it possible to cure acne with probiotics or Prebiotics?
A. Although probiotics and Prebiotics can support digestive health and help treat acne in some cases, they are unlikely to cure acne independently. We recommend increasing your prebiotic and probiotic intake and maintaining an effective topical anti-acne treatment plan for optimal results.

References:

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2. O'Neill CA, Monteleone G, McLaughlin JT, Paus R. The gut-skin axis in health and disease: A paradigm with therapeutic implications. BioEssays. 2016;38(11):1167-1176.
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6. Goodarzi A, Mozafarpoor S. The potential of probiotics for treating acne vulgaris: A review of literature on acne and microbiota. 2020;(February).
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8. Silverberg J, Silverberg N. Epidemiology and extra-cutaneous comorbidities of severe acne in adolescence: A US population-based study. Br J Dermatol. 2014;170(5):1136-1142.
9. Bowe WP, Logan AC. Acne vulgaris, probiotics, and the gut-brain-skin axis - Back to the future? Gut Pathog. 2011;3(1):1.
10. Egeberg A et al., (2016) Rosacea and gastrointestinal disorders: a population-based cohort study. British Journal of Dermatology, 176(1):100-106.
11. Jung GW, Tse JE, Guiha I, Rao J. Prospective, randomized, open-label trial comparing the safety, efficacy, and tolerability of an acne treatment regimen with and without a probiotic supplement and minocycline in subjects with mild to moderate acne. J Cutan Med Surg. 2013 Mar-Apr;17(2):114-22.
12. Fabbrocini G, Bertona M, Picazo Ó, Pareja-Galeano H, Monfrecola G, Emanuele E. Supplementation with Lactobacillus rhamnosus SP1 normalizes skin expression of genes implicated in insulin signaling and improves adult acne. Benef Microbes. 2016 Nov 30;7(5):625-630.
13. Siver R.H. Lactobacillus for the control of acne. J Med Soc N J. 1961;59:52–53.

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