Probiotics for Acne: Do They Work, How to Use Them and More

• Probiotics are live bacteria and yeasts that can provide many potential benefits including supporting a healthy digestive system and immune system 
• There is a strong link between a balanced gut flora and healthy skin
• Science has established that oral and topical probiotics can help treat and prevent acne through several mechanisms of action

Acne is a chronic skin condition that develops when excess sebum (oil), dead skin cells and grime combine to plug hair follicles. This condition can deteriorate when Propionibacterium acnes multiply and inflammation causes worsening symptoms. Fortunately, there are many tried-and-true topical and oral medications available to manage symptoms; probiotics for acne are another high-performing tool to add to your arsenal. 

What Are Probiotics?

Probiotics are a combination of live microorganisms and yeast. Gut bacteria is made up of  about 100 trillion microorganisms that comprise bacteria, viruses, fungi and protozoa. These form a community that is referred to as the microbiome, microbiota or gut flora. 

Not only are most of these microorganisms harmless, they play a crucial role in protecting against pathogens, regulating the immune system, supplying nutrients and maintaining a healthy mucosal surface in the gut to inhibit the proliferation of harmful bacteria and toxins.   

An imbalance between healthy bacteria and bad bacteria is associated with an altered immune response which has a negative impact on skin by promoting inflammation and the development of skin diseases and conditions such as psoriasis, atopic dermatitis, rosacea and acne. 

This imbalance is referred to as a leaky gut, and describes weakened intestinal walls which  allow bacteria and toxins to enter the bloodstream. A leaky gut promotes inflammation which leads to increased sebum production which can alter the skin microflora and result in acne.

Studies demonstrate this relationship is bidirectional as it is thought that many skin disorders are accompanied by an altered dysbiosis (or balance) in the skin or gut microbiome which triggers an altered immune response.

Science has long known that acne and gastrointestinal health are linked, and that gut microbiota and the skin can be influenced by diet. Gut microbes and oral probiotics are linked to the skin and particularly acne severity, by their ability to influence systemic inflammation, oxidative stress, glycemic control, tissue lipid content and even mood.

This bidirectional crosstalk is referred to as the gut-brain-skin axis.

As a natural component of a healthy gut, probiotics play a key role in maintaining the integrity of gut flora which in turn provides health benefits and improves overall health. Dysregulation of microbiota results in dysbiosis, which spurs the development of inflammatory diseases such as acne. 

Do Probiotics Help Clear Acne?

Yes, probiotics can help clear acne. Oral intake and topical application of probiotics can provide a number of benefits:

• Prevents acne development by directly inhibiting Cutibacterium acnes bacteria on skin
• Reduces inflammation and acne severity
• Reduces oxidative stress which is known to drive the acne process, by scavenging free radicals
• Rebalances gut dysbiosis by increasing levels of beneficial bacteria and inhibiting the growth of bad bacteria
• Supports skin barrier function by increasing antimicrobial properties
• Induces the production of healthy ceramides to help restore healthy fats, which can directly benefit acne, protect skin and counteract the dryness and irritation that results from acne therapies

Studies show that gut microbiota is greatly important in the formation of acne pimples and that acne can be linked to the state of the digestive tract and its microbiome. 

Probiotics maintain an equilibrium in the digestive tract by killing unhealthy bacteria and guarding the intestinal lining. This prevents harmful substances from entering the bloodstream and triggering the body’s inflammatory response. As a result, inflammatory acne will react the best to probiotics as a form of treatment.

Probiotics also reduce acne by lowering the pH of the skin. Human skin is normally at a pH between 4 and 5.5, but this often rises due to internal and external factors. Studies have shown that a lower skin pH provides protection by inhibiting the growth of some bacteria and supports the skin barrier, leaving it less susceptible to acne development. 

Best Probiotics for Acne

There are more than 500 different kinds of probiotic species available that perform different functions within the body.

Looking specifically at acne, the best probiotics belong to the Lactobacillus and Bifidobacterium groups:

Lactobacillus strains work to reduce inflammation and support the skin barrier function:

• In vitro tests demonstrate that Lactobacillus paracasei inhibits skin inflammation and significantly accelerates skin barrier function recovery
• Oral administration of L. casei can reduce inflammation
• L. fermentum has antimicrobial, antioxidative and anti-inflammatory properties
• Topical application of L. rhamnosus GG, L. plantarum WCFS1 and L. pentosus lactobacilli strains have been demonstrated to positively alter the skin microbiome and reduce acne blemishes in mild-to-moderate acne

Bifidobacterium works to balance gut microbiota by fermenting indigestible oligosaccharides (a type of carbohydrate) and inhibiting the growth of harmful bacteria. This improves the intestinal barrier and decreases intestinal permeability to lower the risk of aggravating or causing acne development. 

• Bifidobacterium lactis HN019 has been demonstrated to improve gut health by reducing inflammation and fighting off infection; one study demonstrated significant increases in good bacteria and decreasing the overgrowth of harmful bacteria 
• B. lactis Bi-07® has been shown to have a significant reduction in severity of AD in the Bi-07 group

In addition, topical application of Enterococcus faecalis has demonstrated excellent results, with investigators reporting improvements in acne severity, patient satisfaction and changes in skin parameters. 

Lastly, in one study, Lactococcus sp. HY 449 demonstrated antimicrobial activity to control the growth of P. acnes, prevent skin inflammation and the formation of acne.

Oral probiotics

Both topical application and oral ingestion of probiotics are effective in stabilizing the microbiome and calming acne, however oral probiotics directly influence the gut to bring about improvements to skin. They have also been extensively researched, therefore there are more studies supporting their use. 

Oral supplements typically combine a blend of proven probiotics to bring about greater results; combining several probiotics has also been shown to significantly reduce inflammatory lesions.

Oral probiotics can be ingested in supplement form or obtained from specific probiotic rich foods such as yogurt, kefir, miso, kombucha, sauerkraut and tempeh. You can also combine both for greater effects in what is known as probiotic therapy.

An Imbalanced gut flora can lead to oily skin and acne. Gut harmony lowers the risk of inflammation and reduces excess oil production, two key instigators of acne.  

Topical probiotics

Studies of topical probiotics are limited; and while the precise mechanisms of action are not fully understood, the evidence that it has beneficial effects on skin is supported in several studies. Topical application balances the skin microbiome and reinforces the skin barrier to effectively treat and prevent acne symptoms.

Creams and lotions containing probiotic extracts work to harmonize the skin’s microbiome. They balance skin’s pH, provide a protective shield to strengthen the skin barrier, maintain hydration, and protect against harmful pathogens.

How To Use Probiotics for Acne 

You can choose among oral supplements, foods or topical skin care products; you can also use a combination of formulations and as well as different probiotics. For best results, speak with your dermatologist first, especially if you are taking any medications, to ensure there are no contraindications. 

There are a great range of excellent quality probiotic supplements to choose from including capsules, powders and liquids – and among these you can also opt for dairy, vegetarian or vegan. 

There are a variety of strains and doses, so ensure you read the label carefully to choose the appropriate strain.  

Fermented foods have a wealth of vitamins and minerals and provide multiple health benefits such as lowering blood pressure. They have also been shown to have antioxidant, antimicrobial, antifungal, anti-inflammatory and antidiabetic effects. The best fermented foods are:

• Buttermilk
• Kefir
• Kimchi
• Kombucha
• Miso
• Natto
• Pickles
• Sauerkraut
• Tempeh
• Yogurt

If you opt for topical skin care products, ensure you select the appropriate probiotic for acne prevention and follow the directions on the label for best results. Some contain live cultures that sustain the skin’s natural supply of bacteria, while others contain prebiotics, which stimulate the natural production of healthy bacteria. 

Can Probiotics Cause Acne?

No, probiotics shouldn’t cause acne.

However, starting any new oral supplement or medication can bring about unwanted side effects. With probiotics, you may experience gas or bloating as well as stomach upset. This could trigger an acne breakout but this should resolve quickly once your system becomes accustomed to the product.

Alternatives to Probiotics for Acne

Some dietary changes can go a long way in preventing acne formation. Avoid eating foods that promote inflammation such as dairy products, processed foods, chocolate and sugary drinks. Foods for healthy skin include spinach, whole wheat bread and brown rice, beans and legumes. 

Also, in one systematic study review, researchers identified fatty acids, fruits and vegetables as acne-protective factors. Additionally, as with skin care products, many foods also contain prebiotics, These can be found in bananas, apples, onions, whole oats and garlic. 

Takeaway

In the last two decades probiotics have become increasingly popular with growing evidence that they have benefits for human health.

The gut-brain-skin axis describes the interconnectivity between gut microbiota, emotional states and systemic and skin inflammation. Studies have demonstrated how an imbalance in gut flora can cause widespread inflammation throughout the body as well as the skin. There is a strong relationship between digestive health and skin health. 

The treatment of acne can be a challenging experience. There are a wide range of established oral and topical treatments available that work to heal and manage acne through various mechanisms of action. Consuming fermented foods, taking oral probiotic supplements and applying topical probiotics are another way to improve skin health and treat acne.