Can Probiotics Help With Eczema?

Probiotics are a type of beneficial bacteria being explored to ease eczema, a common disorder that results in red, swollen, and itchy skin. The use of probiotic supplements in particular is purported to protect against immune dysfunction and reduce inflammation—two key factors in the development of eczema.

Naturally present in the human body, probiotics are also found in foods like yogurt, kefir, and certain fermented foods, in addition to dietary supplements. There are more than 400 different strains of probiotics. Lactobacillus rhamnosus and Bifidobacteria are among the strains commonly used for eczema.

Oral Probiotics and Eczema

Some researchers believe that eczema starts in the gut, meaning that the collective microorganisms that live in the digestive system (the gut microbiome) is out of balance. Some studies have shown that people with eczema have a gut microbiome that is less diverse compared to those who don't have the condition.

It's theorized that the lack of diversity of bacteria in the gut may reduce immunity and leave people predisposed to inflammatory conditions such as eczema.

Probiotics can influence the gut microbiome. A change in the gut microbiome doesn't always correlate with an improvement of eczema, though, so much more research needs to be done in this regard.

What Research Says

So far, research on the use of probiotics in the treatment of eczema has yielded mixed results.

A meta-analysis published in the Annals of Allergy, Asthma, and Immunology found that probiotics show some promise for the prevention and treatment of atopic dermatitis, the most common type of eczema. Looking at findings from previously published clinical trials on probiotics and atopic dermatitis, the report's authors found that probiotics (especially Lactobacillus sp.) appear to be effective in preventing the condition.

However, while some studies show that probiotics help reduce the severity of eczema symptoms, the majority of trials have found that probiotics failed to reduce inflammation.

Another research review published in the Cochrane Database of Systematic Reviews found that probiotics were no more effective than a placebo when it came to reducing the severity of eczema symptoms. The review, which included 39 controlled trials with a total of 2,599 participants, also found that the use of probiotics "carries a small risk of adverse events," such as infections and bowel dysfunction.

Topical Probiotics and Eczema

Research shows that the bacteria colonies living on the skin are different in those who have eczema compared to those who don't. As with the gut, it seems the skin's microbiome isn't as diverse in people with eczema. This can leave it vulnerable to so-called "bad" bacteria, such as Staphylococcus, to proliferate.

Staph has been linked to eczema flare-ups, as it can trigger an inflammatory response on the skin. Those who have eczema tend to have much larger populations of Staph on their skin.

The idea behind topical probiotic therapy for eczema is to build a healthier, more diverse skin microbiome by introducing more of the right strains of bacteria onto the skin. The multitude of "good" bacteria help keep the harmful "bad" strains of bacteria in check.

What Research Says

In recent years, researchers have taken a closer look at how topical probiotics may affect the skin. While the exploration of this is still relatively new, the research so far has been promising.

One possible probiotic strain that may be helpful in treating eczema topically is Roseomonas mucosa. This bacterium is naturally found on healthy human skin.

A small study published in 2018 found that a lotion containing Roseomonas mucosa reduced the amount of Staph on the skin. It also improved the severity of eczema in those who used it.

Various strains of Lactobacillus have had positive results as well. For example, a study published in Clinical, Cosmetic, and Investigational Dermatology found that lotion containing Lactobacillus johnsonii created clinically significant improvement of eczema and reduced Staph on the skin.

The main drawbacks of all of these studies are their very small sample sizes. Much more research is needed to fully understand the impact topical probiotics have on eczema.

While topical probiotics may, in some cases, help improve the severity of eczema, they should not be used as a replacement for conventional eczema treatments and regular moisturizing.

If you're interested in trying a topical probiotic on your, or your child's, eczema first talk to your healthcare provider for advice and recommendations.

Probiotics and Childhood Eczema Prevention

Eczema is common in babies and children, possibly due to the fact that their immune systems are still developing and are, therefore, more vulnerable to this condition.

While research on the use of probiotics as a treatment for childhood eczema is somewhat limited, the available studies have produced conflicting results.

In a review published in Pediatric Allergy and Immunology, for example, scientists analyzed 19 clinical trials on the effectiveness of probiotics in treating atopic dermatitis in children and concluded that there is not enough evidence to support their use.

A study published in Pediatrics in 2017 examined the effect of probiotics on eczema, asthma, and rhinitis in high-risk infants. Newborns were given Lactobacillus rhamnosus GG (a daily dose of 10 billion colony-forming units) for six months. The researchers found that early supplementation with Lactobacillus rhamnosus GG did not prevent the development of eczema or asthma at age 2.

However, there's some evidence that children whose mothers used probiotic supplements while pregnant may have a reduced risk for eczema. In a research review published in the British Journal of Nutrition, investigators looked at seven previously published clinical trials and found that the use of certain probiotics during pregnancy helped prevent eczema in children ages 2 to 7.

The review's authors noted that, while Lactobacilli bacteria appeared to protect against eczema, supplements containing a mixture of various probiotic strains did not affect eczema development.

Side Effects and Safety

Supplements haven't been tested for safety and, due to the fact that dietary supplements are largely unregulated, the content of some products may differ from what is specified on the product label. Contamination of probiotic supplements with bacteria, fungi, or other substances is also possible.

Pregnant or breastfeeding women should consult a healthcare provider before taking probiotics. Do not give probiotics to a baby or child without consulting your pediatrician first.

If you have a compromised immune system (due to a medical condition or medication), you should avoid probiotic supplements due to an increased risk of adverse effects. Probiotic supplements may interact with certain medications, such as immunosuppressants.

In addition, if you're considering using probiotic supplements in combination with other medications, it's important to seek medical advice prior to taking the supplements.

Keep in mind that self-treating a condition and avoiding or delaying standard care may have serious consequences.

How to Choose a Probiotic

There are many different ways to include probiotics in your diet or daily skincare routine. Consider the following after getting your healthcare provider's OK.

Foods

An easy way to get probiotics is through the foods you eat. Fermented foods like sauerkraut, kimchi, and miso naturally contain probiotics. In addition, probiotics are found in cultured dairy products, such as yogurt or kefir.

Due to differences in processing methods, the number of live organisms may vary greatly from product to product.

Although probiotics in normal amounts in food are generally considered safe, some consumers may experience mild digestive problems, such as gas and bloating.

Supplements

Probiotic supplements are sold over the counter (OTC) in many natural food stores and in stores specializing in dietary supplements.

In general, it's preferred to get probiotics from foods rather than from supplements, as foods generally have more probiotics per serving. But if you don't care for cultured or fermented foods, supplements are a good alternative.

The strength of probiotic supplements is measured in colony-forming units, or CFU. The CFU is the amount of probiotic you will get per serving.

Topical Preparations

Skincare products containing probiotics are becoming more popular. You can find these over the counter at beauty and cosmetic retailers, salons and spas, and even some big box stores.

All OTC topical probiotic products available today are considered cosmetics by the U.S. Food and Drug Administration (FDA). Although cosmetics are regulated by the FDA, the agency does not require manufacturers to prove that their cosmetics live up to their claims. The amount of probiotic in any product can vary widely from brand to brand.

Don't expect a topical probiotic to clear up your eczema. Remember, topical probiotics are not classified as drugs, meaning they cannot treat eczema.

If you decide to try a topical probiotic, choose one as you would any skincare product. Ideally, look for one that is fragrance-free and hypoallergenic so as not to irritate your eczema.

Summary

More research needs to be conducted before probiotics can be recommended as a treatment for eczema. However, it's possible that increasing your intake of probiotic-rich foods may be of some benefit to your overall health. If you're considering the use of probiotic supplements for the treatment of eczema (or any other chronic condition), make sure to consult your healthcare provider before starting.