Do Probiotics work for Acne? An MD Explains

Acne is a common skin condition that affects people of all ages. While there are many factors that can contribute to acne, recent research has shown that gut health and the microbiome play a significant role. (1) This has led many people to turn to probiotics as a possible solution to their acne. But do probiotics really work for acne?

Below Dr. Naheed Ali, MD, PhD shares his thoughts on the effectiveness of probiotics for acne and provides valuable insights into the gut-brain-skin connection.

What Is the Gut-Brain-Skin Connection?

The gut is home to a diverse community of microorganisms, collectively known as the gut microbiome, which play a crucial role in many aspects of our health, including digestion, metabolism, immune system function, and even our skin. (2) 

The gut-brain-skin connection refers to the interrelationship between these three organs, and how they all impact each other's health and function. (3) 

For example, negative thoughts have been shown to disrupt the gut microbiome (which in turn can lead to inflammation and breakouts), while certain strains of bacteria in the gut can produce neurotransmitters like serotonin, which can affect mood and behavior. Too many “bad bacteria” in the gut can not only negatively impact our mood, that can leave us craving refined sugar and unhealthy foods, which ultimately negatively impact our skin.

Studies have shown that imbalances in the gut microbiome, such as decreased diversity or overgrowth of harmful bacteria, can contribute to acne and other inflammatory skin diseases. (4) This is thought to occur because the gut microbiome influences inflammation levels in the body and affects the production of hormones and immune system function.

The gut-brain-skin connection is a complex relationship highlighting the importance of gut health to overall well-being. By taking care of our gut microbiome through a healthy diet, probiotics, and other lifestyle factors, we can not only reinforce our digestive and immune system functions but also improve our mental and skin health while at it.

How Do Probiotics Work to Improve Acne?

Probiotics work to improve acne by improving the balance of bacteria in the gut: increasing the number of beneficial bacteria, reducing the growth of harmful bacteria, and supporting the gut lining. (5) The following are several mechanisms by which probiotics may help reduce acne:

1. Probiotics regulate hormone production

Some strains of bacteria have been shown to reduce excess androgens, which are hormones that increase oil production and can lead to acne when in excess. (6) By regulating hormone levels, probiotics may help prevent excess oil production and improve acne.

2. Probiotics reduce inflammation

Probiotics support the immune system and help to reduce excess inflammation. (7, 8) Inflammation in the skin is a key factor in the development of acne and other inflammatory skin conditions, and by addressing inflammation, probiotics may help curtail acne symptoms and encourage overall skin health.

3. Probiotics strengthen the gut lining

Probiotics may also improve gut health by reducing the permeability of the gut lining, also known as "leaky gut." (9, 10)  A leaky gut can allow harmful substances to pass from the gut into the bloodstream, leading to systemic inflammation and a range of health issues, including skin issues like acne. By reducing gut permeability, probiotics help prevent the development of acne and other skin conditions.

4. Probiotics compete with harmful bacteria

Probiotics compete with harmful, pro-inflammatory bacteria that can contribute to skin conditions such as acne. (11) 

5. Probiotics improve microbial diversity

Acne patients have been found to have lower levels of beneficial lactobacillus and bifidobacteria compared to controls. (12)  Several studies have found oral supplementation with probiotics to be beneficial for acne patients. (13, 14)  

6. Probiotics offset the negative impact of antibiotics

Antibiotics can cause an imbalance in the gut microbiome by killing beneficial bacteria along with the harmful ones, which can result in negative side effects, such as yeast infections or UTIs. Patients who supplement with probiotics show greater tolerance of and compliance with oral antibiotics. 

For example, a recent clinical trial indicated that probiotics decrease the side effects (i.e., vaginal candidiasis) associated with systemic antibiotics (i.e., minocycline) while providing synergistic benefits for inflammatory acne. (15) 

The Best Probiotics for Acne

The best probiotics for acne are those that are clinically validated and have shown a positive impact on the skin and/or gut. Here are some of the best probiotic strains for acne:

1. Lacticaseibacillus rhamnosus (SP1) 

L. rhamnosus (SP1) is a strain of probiotic bacteria exhibiting potential benefits for skin health, including reducing the severity of acne. A randomized, double-blind, placebo-controlled study found that supplementation with LSP1 for 12 weeks normalized skin gene expression related to insulin signaling and improved the appearance of adult acne. (16) 

2. Lactobacillus acidophilus

L. acidophilus may have been the first probiotic strain recommended by dermatologists for acne. Nearly 100 years ago, dermatologists John H. Stokes and Donald J. Pillsbury, largely credited as the forefathers of what would later become known as the gut-brain-skin axis, studied and recommended L. acidophilus for acne patients. (17) Studies have also shown promise for L. acidophilus as a beneficial probiotic for atopic dermatitis or eczema. (18, 19) 

L. acidophilus has shown to have beneficial effects on gut health, immune health, and inflammation levels (20, 21, 22), which all support healthier skin. It has also been found to be beneficial for vaginal health, particularly, strain L. acidophilus La-14. (23) 

3. Lactobacillus paracasei 

L. paracasei has been found to support skin barrier function, reduce skin sensitivity, modulate the skin immune system, and support skin homeostasis. (24) It has also been found to exert a positive impact on mood. In a randomized, double-blind, placebo-controlled trial, the strain L. paracasei (Lpc-37) was found to improve psychological and physiological markers of stress and anxiety in healthy adults. (25) This is important for acne-prone skin, as mental stress can set off the chain of events that leads to breakouts. 

4. Bifidobacterium lactis 

B. lactis supports skin health through its effects on the gut barrier, immune system, and overall digestive health. It aids in regularity, (26)  which is important for acne-prone skin, as constipation has been linked to acne. (27) It exhibits anti-inflammatory benefits (28) which may be especially beneficial for acne, as acne is considered an inflammatory skin condition. Bifidobacterium like B. lactis have been shown to supports the mucosal gut-barrier, (29) which may be beneficial for not just acne, but psoriasis-prone skin, too. (21, 30) 

5. Lactobacillus plantarum

L. plantarum has been found to support skin health by aiding in skin hydration and reducing inflammation. (31) It has been found to inhibit common pathogens, support gut barrier integrity, and support the immune system, (32) which further support the skin indirectly.  

Final Thoughts

Probiotics have demonstrated potential as a complementary solution for acne. Incorporating probiotics into a daily routine, along with a healthy diet and lifestyle, and suitable skincare routine may help enhance the skin's overall appearance and reduce breakouts.

It is important to note that while probiotics may be effective for some people in improving acne symptoms, they are not a one-size-fits-all solution or a quick fix.

Individual results may vary, and it takes time and consistency to see results. It may take several months to reap their full potential. It is always best to speak with a healthcare provider before starting any new supplement regimen, including probiotics.

When choosing a probiotic supplement, beyond looking for the key strains you desire, ensure that the manufacturer has strict quality standards in place. 

Glow Biome offers a simple and effective solution for clearer and healthier skin. By promoting a balanced microbiome, this specially formulated probiotic supports skin health from the inside out, with 6 clinically-validated probiotic strains that target the gut-brain-skin axis. It’s made in an NSF-certified facility, ensuring strict adherence to good manufacturing practices (GMPs) and it is third-party verified for purity and safety.