How good are probiotics for acne? Can they help treat hormonal acne and break outs in teenagers or do they worsen the condition? What do studies say? Basing on user rating and reviews on acne.org, mayo clinic etc, what is the best probiotic for acne? Read on to find out.
Probiotics and Acne-How effective?
Proposals have been made since nearly a century ago on the relation between depression and skin diseases and conditions. This relation depends on a gastrointestinal mechanism postulated by John H. Stokes and Donald m. Pillsburry. The theoretical basis of this mechanism relies on the brain-gut and the gut-brain axis and the resulting hypothesis is that emotional states can alter the balance of the normal intestinal flora and microbiota. This may also lead to systemic inflammation.
According to Stokes and Pillsburry, there exists an extension of the gut-brain axis with a resultant gut-brain-skin axis. Research studies have tried to validate this theory with success in the explanation of the pathology of skin conditions such as acne. The following are some of the reasons researchers give:
- The gut normal flora have a positive influence on systemic inflammation, tissue lipid content, oxidative stress and mood.
- Probiotics help in the maintenance of the balance between ‘good’ and bad bacteria in the intestinal region of the gastrointestinal tract. Manufacturers of cosmetics are currently utilizing the pros of probiotics in dosage forms of creams, paints and ointments.
Probiotics help in the management of acne in a variety of ways. These mechanisms may take different paths but may all elicit the beneficial attributes in acne. Such include:
- Antimicrobial attributes – when you ingest probiotics with various strains that balance out harmful bacteria in the gut, they treat dysbiosis (imbalance). The ‘good’ strains prevent the adherence of harmful bacteria along the intestinal wall and therefore prevent them from releasing toxic compounds into the intestinal epithelia. When this harmful bugs are suppressed, inflammation is countered. The gut-brain axis is therefore suppressed and so is the gut-brain-skin axis ( Bowe). When probiotics are applied on the skin (topically), they also compete with the harmful bacteria. The latter can therefore not trigger an immune response.
- They offer a protective shield – bacterial interference is a phenomenon through which ‘good’ bacteria in the probiotics prevent the induction of cell inflammation on the skin dermal layer. Perhaps if the epidermis is scoured and the dermis is exposed to the harmful effects of bacteria as observed in acne.
- Reduction of flares and itch in acne – this occurs via the prevention of inflammation when the immune response of the body is suppressed. In the pathology of acne, the itch and flares occur as a result of attack by the immune system.
It therefore occurs that strains of bacteria in probiotics including Lactobacillus acidophilus and Bifidobacterium, could influence skin conditions positively by shifting the ratio of normal flora of the gut to harmful bacteria close to the 1:5 ratio regarded as the expected ratio.
There are a good number of research done to prove the effectiveness of probiotics on skin condition such as acne. International studies have fortunately shown the suspected correlation. Some of these researches include:
- Total acne lesion count in patients who were subjects in a Korean study, found that ingestion of Lactobacillus-fermented dairy products reduced the count. In addition, in a period of 12 weeks, the total oil production was reduced in these patients.
- Another study showed that patients with acne to whom probiotics were orally administered as a supplement to the conventional synthetic therapeutic interventions had a better outcome. This is as compared to another group of patients in the same study who only received the synthetic treatment. This shows that there is quick recovery in patients who are already in treatment with the conventional drugs (Italian Study).
- A Russian study showed that there is indeed a correlation between impaired gut flora and acne. In this study, 54% of the acne patients participating as subjects showed that they had an imbalance of the normal microbiota in the intestines. If this dysbiosis could be treated, then this would mean a faster recovery and lower risks of complicated acne (Volkova LA, Khalif IL)[i]
- Another study did not quite show the relation between the dysbiosis and acne but at least gave leverage to the existence of the gut-brain-skin axis theory. This study done in China had results showing the correlation between the impairment of normal gut flora and dandruff. Dandruff is scientifically referred to as seborrheic dermatitis. This study still shows that this axis sure may lead to the occurrence of skin conditions such as acne (Zhang H, Yu L, Yi M, Li K)[ii]
- A condition known as rosacea, which is pathologically similar to acne due to their symptoms, is shown to be linked to small intestinal bacterial overgrowth (SIBO). When you have this, a strain of bacteria known as coli takes over in the intestine and faces little resistance during dysbiosis. The mechanism of this is through creation of perforations that lead to ‘leakage’ in the intestines. Bacteria that are considered harmful can easily pass through the breached wall and triggers an immune response in the systemic circulation. This may manifest as inflammation and allergic reactions on the skin. According to Devin and Sonia’s Book, ‘How to Get Rid of Acne with Diet and Lifestyle Changes’, inflammation that occurs broadly and non-selectively in the system may also contribute to the pathology of acne.
What are the best probiotic for Acne
What should you consider when Selecting the Best Acne Probiotics
Considerations during selection of the best acne probiotics are as follows:
- The bacterial count, quality and manufacturer – at times the actual colony count may not be commensurate with what the label states and that may have a negative implication on the effectiveness of the probiotic. Studies have shown that in deed some probiotics have this kind of inaccuracy[iii]. It is therefore important that you check the manufacturers of the respective probiotics before buying them. Know the manufacturers who have vast experience in formulation of these supplements too. Check to see that the manufacturer has reputable standards and manufacture methods.
- The bacteria strains present in the probiotic – if you want to choose the best probiotic, do not entirely go with the number of bacteria in a strain present in it. You might have seen this in form of CFUs (Colony Forming Units). However, choose to believe in the number of strains themselves. This is because they have different functions and this mean you will have vast benefits. The most important strains are Longum, L. rhamnosus, L. fermentum, B. bifidum, B. longum and L. acidophilus.
- The delivery form of the probiotic – if the delivery form doesn’t work out for your condition, it would be worthless having it. Check for the different forms that probiotics exist. Surety goes that you would not want a probiotic with dead bacteria for instance. Probiotics exist in form of capsules, controlled-release tablets and liquids. Look for a probiotic which preserves its colonies and ensures that they are duly delivered to the part of the body intended. Enteric-coated tablets have a delayed release and are less susceptible to the corrosive effects of stomach acid and keeps them alive.
Probiotics for Hormonal, Teenage Acne & Cysts
Estrogen, testosterone and androgen are hormones whose imbalance may lead to hormonal acne. When they fluctuate say, an increase testosterone and a decrease in estrogen, oil is produced in higher amounts in the sebaceous glands in the skin. The oil, in high amounts is what results in congestion in the oil-ducts of the face. This congestion especially around the mouth and on the chin, breeds bacteria that cause acne.
Teenage acne is caused by hormonal changes and may still persist into adulthood suggesting that there is more to just the imbalance in your hormones.
Probiotics can increase the amount of beneficial bacteria in the gut and resultantly creating the well needed balance of bacteria. Remember that the skin is a really reliable window to what is going on in the body. Having an imbalance of bacteria is bad for your digestion and if this is not happening, toxins and not properly excreted. Nutrients are also poorly absorbed. According to the afore-mentioned studies, there is a big correlation between patients with acne and bloating, fatigue and indigestion. This shows that the skin and GIT are well connected. As mentioned, along the gut-brain-skin axis.
There are moisturizers, masques and cleansers that contain probiotics in the market. These help regulate the bacteria levels on the skin surface. They ‘Bio-Kult Advanced Multi-Strain Formula Probiotics’ is one such example.
Reviews- Mayo Clinic & Acne.org
According to top popular online stores such as Amazon.com, customer reviews on the effectiveness of probiotics in the treatment of acne appear to be positive. Below is a screenshot of bio-kult, a probiotic product mentioned above
Basing on the user reviews and rating, the product has worked in most people. From hear-say comments, few appear to be negative.
In Mayoclinic’s Platform, people have mentioned the correlation of gut problems with the occurrence of acne and one comment that supported the effectiveness of probiotics was well received and supported.
The effect of antibiotics in patients who are on and off antibiotics has also been mentioned in the platform and in deed has an effect in causing an imbalance in bacteria in the intestines. One of the respondents to the question posed states that acne has occurred in such an instance.
Views according to acne.org, suggest that the advent of probiotics in fighting acne is groundbreaking especially after studies showed that taking minocycline alone proved less efficient that taking it with probiotics. Acne.org however maintains that the effect of probiotics is not that earth-moving but since it is not harmful to the body, it may help somewhat.