New Probiotics For Acne Lactobacillus / Bifido Studies

In this guide, I will be sharing the earliest study on probiotics for acne right up to the latest study published just recently in 2022.

By the end of this probiotics guide, you will learn what strains work best for acne and what the limitations are.

Let's start with if the gut impacts the skin in any way.

1955 Study Looked At Links With Gut Health & Skin Health


The link between acne with gut health is nothing new with a study from 67 years ago led by David E. Loveman, M.D checking to see if people with acne had altered gut microbiomes in comparison to healthy individuals.

Back in 1955, the cause of Acne Vulgaris was not known but what they did know at the time was that sulfonamide and antibiotic therapy occasionally provided relief to Acne Vulgaris leading them to believe that the intestinal flora could be partly responsible.

To test this theory, 10 patients aged twelve to ten years old with Acne Vulgaris for this study. Today discreet fecal samples would be taken to analyze gut bacteria but back then unfortunately it was a cotton swab that was inserted into where the sun doesn't shine.

10 other male patients who did not have Acne Vulgaris also went through this (possibly for some) not very enjoyable experience but thanks to their bravery the researchers were able to see remarkable differences in the gut bacteria.

No differences were seen in the control groups vs the acne patients and the study at the time concluded that the microbiome played no part in Acne Vulgaris. They did endorse the fact that further studies should be carried out and thankfully more were.

2018 Study Looking At Acne Gut Bacteria

Many years later technology mainly with 16S rRNA gene sequencing allowed researchers to get a better understanding of bacteria. Instead of cotton swabs and agar plates, this 2018 Chinese study used hypervariable tag sequencing of the V3–V4 region of the 16S rDNA gene on stool samples.

The Chinese study claimed that a western diet high in animal dairy, carbohydrates, chocolate, and saturated fats may be able to contribute to the formation of acne potentially because of the effects this unhealthy diet has on the gut microbiota.

Dysbiosis can be best described as an imbalance in your microbiome with too many bad bacteria and not enough good bacteria. It's thought that the western diet could contribute to dysbiosis. It was hoped that analysis of stool samples from 43 patients with acne vulgaris and 43 without any acne would prove this.

Stool samples in the 43 patients with acne had higher levels of gram-negative Bacteroidetes bacteria and lower levels of gram-positive Firmicutes bacteria. The decreased ratio of Firmicutes/Bacteroidetes bacteria in the gut was thought too potentially responsible for the development of acne. The study claimed that further studies on serum hormones and microbiota were needed.

Probiotics Could Help With Acne Inflammation

Whilst there are currently no studies testing the use of probiotic bacteria on its efficacy against acne inflammation there is plenty of peer-reviewed studies that show certain probiotic bacteria can have Immunomodulatory Effects on Cytokine profiles that cause inflammation.

Some Lactobacillus and Bifidobacterium probiotic strains may be able to increase anti-inflammatory cytokines whilst reducing pro-inflammatory cytokines and not just in the gut but the whole body. With acne being caused by inflammation of the skin probiotics could potentially help.

Other studies like this one also showed that bacteria like Lactobacillus Casei LTL 1879 could reduce inflammation markers directly through the gut whilst also reducing bacteroides which were found to be high in the previous Acne Vulgaris study.

Probiotics May Reduce Oxidative Stress

Oxidative Stress is basically an imbalance between free radicals and antioxidants and is thought to be harmful for overall skin health. A 2005 study, looked at the links between acne vulgaris and oxidative stress in a total of 89 patients that consisted of patients with and without acne. 

Parameters for measuring Oxidative stress included hydroperoxide, catalase, glucose-6-phosphate dehydrogenase, superoxide dismutase, and malondialdehyde.

The findings from this study showed that it was clear oxidative stress was exited in patients with acne and played and may play an important role in the formation of acne.

This 2018 study published in the British journal of nutrition found that Bifidobacteria lactis HN019 probiotic strain in fermented kefir milk was able to have positive effects on inflammatory and oxidative stress markers.

The study included 33 participants from Brazil who either had metabolic syndrome or didn't. They were split into groups randomly and either took 3.8 Million CFU of the Bifidobacteria Lactis milk every day for 3 months or a placebo.

Improve Gut & Skin Barrier

It has been suggested that intestinal permeability (leaky gut) could be a gateway for the development of acne and other skin conditions like eczema, through it dubbed the gut-brain-skin axis.

Whilst more research into leaky gut and acne is needed, some probiotic strains like Lactobacillus paracasei CNCM I-2116 (ST11) have been studied in vitro to show improvements in the increased speed of skin barrier function recovery.

Microbiome, Probiotics and Acne Vulgaris

Just recently in 2022, a huge review looked at the link between probiotic bacteria in the microbiome and Acne Vulgaris a condition that causes blackheads, cysts, papules, and pustules. 

The motivation for the hypothesis was that bacteria in the intestines were thought to be linked to the formation of acne lesions and that 70% of immune cells are located in the gut. Both of these things were thought to be major factors for Acne Vulgaris.

The review claimed that the bacteria inside of the intestines were "greatly important" in the formation of acne lesions because of the gut & skin axis and it was stated that the use of certain probiotics could even "reduce skin eruptions".

Probiotic Efficacy On Propionibacterium Acnes Bacteria

This 2020 review found that oral administration of Lactococcus gram-positive bacteria was effective in reducing inflammatory markers produced by Propionibacterium Acnes which is a bacteria so closely linked with acne it's what the bacteria was named after.

In the review, it was stated that the probiotic bacteria was able to mediate antibacterial proteins and have immunomodulatory effects on on keratinocytes and decreasing cytokine IL-8 in epithelial cells.

Rosacea Linked With Gastrointestinal Disorders

In 2016 this Danish observational study was published in the British Journal of Dermatology looking at potential links between the inflammatory skin health condition Rosacea gut disorders like SIBO, IBS, Celiac Disease, Chrons, and Ulcerative Colitis.

To confirm if there was any link between gut and skin health they performed a huge study involving 49,475 patients with Rosacea and hundreds of thousands in the control group. The results showed that compared to control groups, those who had Rosacea also were more likely to have gastrointestinal disorders.

Kactoferrin-Enriched Fermented Kefir Milk For Acne

An applied nutritional investigation from South Korean institutes in 2010 looked at whether Lactoferrin-enriched fermented milk could clinically improve acne vulgaris and its efficacy against sebum skin surface lipids. The hypothesis for the study was that in the past, Lactoferrin in vitro studies had shown an anti-inflammatory effect.

36 participants from South Korea aged 18 to 30 years of age agreed to take 200mg of fermented Lactoferrin milk or a placebo every day for 12 weeks. The skin health condition, hydration, sebum levels, pH, and skin surface lipids were all checked at the beginning and the end of the 12 weeks.

The results of the study showed that the Lactoferring milking containing various Lactobacillus Bulgaricus & Streptococcus Thermophilus probiotic strains was able to decrease inflammatory lesion counts in the milk group by an impressive 38.6%. It was found that sebum levels decreased by 31.1% but interestingly in both the placebo and milk groups skin surface lipids dropped suggesting that the probiotic milk didn't have any effect there.

Antibiotics vs Probiotic's Study

When visiting a Doctor or dermatologist for your acne they may prescribe a course of minocycline, doxycycline, or a macrolide antibiotic. This is treatment is effective but antibiotics can cause side effects like diarrhea and can wipe out all of the good bacteria in your microbiome leading to Dysbiosis which funnily enough could once again cause acne.

This 2013 randomized controlled trial carried out by the Department of Medicine, University of Alberta, Edmonton, Canada tested safety, efficacy, and general outcomes on acne lesions.

45 participants were split into three groups with the first taking probiotics, the second minocycline antibiotics, and the third both antibiotics and probiotics. I wasn't able to find the CFU count but the probiotic contained Lactobacillus bulgaricus LB-51, Lactobacillus acidophilus NAS and Bifidobacterium bifidum Malyoth.

At various stages the participants had their skin health results checked and compared to baseline scores. After just the first week everyone in the trial had improvements in their acne.

At the 12-week mark, it was found that patients who took both antibiotics and probiotics had a "significant" decrease in total lesion counts compared to the group that took only antibiotics or probiotics. It was noted that antibiotics with probiotics had a synergistic anti-inflammatory effect whilst minimizing the antibiotic side effects.

Kimchi's Lactobacillus Plantarum For Acne

This next randomized clinical controlled trial is once again from South Korea and it tested the Effects of 10 Billion CFU Lactobacillus Plantarum CJLP55 taken daily for 12 weeks in 30 acne vulgaris patients versus placebo.

The reason for the L. Plantarum CJLP55 strain was that in previous Vitro studies it showed both anti-pathogenic bacterial and anti-inflammatory activities.

Another interesting fact from the study was that L. Plantarum CJLP55 was one of the Lactobacillus probiotic strains that have been isolated from Kimchi in the past.

At the end of the 12 weeks, it was found that in probiotics compared to placebo, the clinical severity of acne vulgaris was improved and gram-negative Proteobacteria was decreased in urine.

L. Plantarum bacteria taken orally did modulate the skin health through the gut & skin axis. Firmicutes gram-positive bacteria were shown to be increased in the hydration of the skin which proved this anti-dysbiosis effect.

Lactobacillus Rhamnosus For Skin Health

Lactobacillus Rhamnosus is considered to be one of the best probiotic strains concerning known efficacy because of the sheer amount of human clinical studies involving the strain.

A 2016 article published in the peer-reviewed Beneficial Microbes journal looked at the effects of Lactobacillus rhamnosus SP1 probiotic bacteria on skin expression related to insulin signaling and adult acne.

For a total of 12 weeks, twenty adults either took a 3 billion CFU probiotic drink daily or a similar liquid drink that contained no probiotic bacteria.

Paired skin biopsies were taken at the start of the study and then once again at the end to analyze the efficacy of the Lactobacillus Rhamnosus probiotic strain.

The results showed that insulin-like growth factor 1 (IGF1) and forkhead box protein O1 (FOXO1) gene expression both increased by 65% in the L. Rhamnosus group whereas nothing changed in the placebo group. Because of this, it was concluded that the probiotic strain "improved the appearance of adult acne" through healthy skin.

Topical Probiotics For Skin Health

This second study made public in 2022 from the University of Antwerp, Belgium also looked at the probiotic efficacy of Lactobacillus Rhamnosus GG but as a topical treatment with some other Lactobacillus strains.

The study specifically tested if the topically applied probiotic cream could inhibit skin pathobionts and reduce inflamed acne lesions.

To test this hypothesis, 30 volunteers were included in the experiment and their facial cheek skin was immediately checked for Lactobacilli presence. The most popular probiotic strains found were Lactobacillus crispatus, Lactobacillus iners, and Lactobacillus gasseri. 

After applying a Lacticaseibacillus rhamnosus GG, Lactobacillus plantarum WCFS1, and Lactiplantibacillus pentosus KCA 106 CFU cream twice per day for 8 weeks.

It was noted that topically applied "Lactobacilli, could reduce acne lesions after daily application on the skin". Probiotics for acne could help because of their anti-inflammatory effects on the skin.

Probiotics For Acne FAQ

What Are Probiotics?

Probiotics is a generic term that refers to the billions and trillions of bacteria that reside within our gastrointestinal tract. These live bacteria play an essential role in our digestive process and are essential for working of our immune system.

Any imbalance in probiotics can lead to serious health issues such as diarrhea, irritable bowel syndrome, inflammatory bowel disease, constipation, gum disease, lactose intolerance, colitis, eczema etc.  Probiotics also fight against bad bacteria that may enter your body through food or any other medium and a low number of probiotics in your gut may leave you vulnerable to many health conditions and diseases.

Doctors routinely prescribe probiotic supplements for various ailments and one can also get probiotics for acne naturally from fermented food items such as yogurt, kimchi, sauerkraut, kombucha, cottage cheese, sourdough bread etc.

What Is Acne?

Acne is a common skin health condition that is mainly caused when hair follicles on your skin become clogged with oil and dead skin cells.

Pimples, whiteheads, and blackheads are the most common outcomes of such a clogging and are also among the most noticeable forms of acne. Acne is usually quite common among teenagers whose body is undergoing hormonal changes, but the condition can affect almost anyone and is not age-bound.

Acne is among the most persistent skin conditions out there as when it seems that it is healing there is a high chance that another pimple will appear at some other place on your skin. Still, acne is completely treatable with proper medication and changes to your diet and lifestyle.

It should also be noted that hormonal changes and lifestyle also play a crucial role in an acne outbreak and as such it may not be possible to prevent an outbreak in the first place.

What Can Cause Acne?

There is no single identifiable cause of acne as a number of reasons might be behind your recent acne outbreak. Acne are usually caused by:

  • Excess oil secretion by skin cells as the excess oil accumulates in skin pores thus effectively blocking them.
  • Buildup of dead skin cells in the pores.
  • Growth of bacteria in skin pores.

These three are among the most common causes of acne while following factors may increase your risk of developing acne:

Hormones: Hormones are among the primary causes of acne outbreak as any imbalance in hormonal levels directly affects the oil secretion by our skin. Androgen is the male sex hormone that causes acne and its levels increase in teenage years in both boys and girls. This increase is largely responsible for the acne outbreak that one sees among teenagers.

Age: While it’s true that people of all ages can get acne, the vast majority of people affected by it are in their teens and as such age is another factor that can lead to acne.

Family History: You are more susceptible to an acne outbreak if either of your parents had acne in the past.

Medications: Certain medications can also lead to an acne outbreak and this is specially the case with medicines that contain hormones, lithium, and corticosteroids.

Tips For Assisting With Acne

  • Don’t touch your face as it may lead to further complications.
  • Try to take a healthy diet as it will help you recover faster.
  • Drink a lot of water.
  • Exercise regularly as the sweat generated during exercise can lead to the opening of pores.
  • Apply a yogurt face mask.
  • Final Thoughts

    The studies shared in this guide do seem to suggest that gut health does play a role in the skin microbiome and that by taking probiotic bacteria orally or topically you can over time affect immune health or levels of inflammation but it is strain specific.

    The studies do not, however, prove that probiotics can cure acne and if you have acne you should always consult with a doctor first and never use probiotics as a replacement for prescribed treatment. I am not a doctor.

    Some of the best probiotic strains for acne according to studies shared are Lactobacillus Acidophilus, Lactobacillus and Rhamnsos, and Bifidobacterium Lactis at over a 1-Billion CFU taken daily for at least 3 months. This may give you the best effects.

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