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Probiotics: More than Skin-Deep

The New Science in Cosmeceuticals

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]


In summary, when it comes to skin health, the best evidence for oral probiotic is the strongest for effectiveness and safety, while topical postbiotic skin care is gaining more acceptance. Hopefully, from this article we can gain more appreciation for the interconnectedness of our gut to our skin. By taking care of our internal gut, we can make a significant and more sustainable improvement on our skin.

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

Dr. Lo is a naturopathic doctor who graduated from the Canadian College of Naturopathic Medicine (CCNM) in 2006. With over 20 years in the medical esthetics industry, she combines her knowledge with naturopathic training to offer a unique perspective on antiaging.


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