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Probiotic supplementation may change the gut microbiome and affect the skin
are live beneficial bacteria that can potentially bestow health benefits when ingested in appropriate doses.[1] In fact, there is expanding research investigating the use of probiotics in pediatric eczema, also referred to as atopic dermatitis.
Probiotics is an umbrella term that includes many different strains of bacteria that are believed to promote health and improve various diseases, such as irritable bowel disease and even some skin diseases.[2] Commonly used strains of microorganisms used in probiotic supplements include Pronionibacterium, Enterococcus, Saccharomyces boulardii, and Lactobacillus. Probiotic supplementation is believed to help replenish the bacteria that normally live in the intestines, called the gut microbiota. The gut microbiota consists of an astonishing 100 trillion bacteria with over 1,000 different species.[3,4] The gut microbiota and the gut microbiome (which includes all the byproducts made by the microbiota) are believed to contribute to proper immune system development, assist in the digestion of food particles, make vitamins, and protect against infections.[3] Recently, probiotic supplementation has become increasingly popular among consumers and their use in dermatology is a hot topic of research.
So far, probiotics have not been widely studied in the treatment of skin diseases. One study involving pediatric eczema reported over a 60% reduction in eczema in children who were given probiotics.[5] It is important to note that other studies have concluded that probiotics given to infants until 12 months old did not have a protective effect against eczema.[7,8] However, evidence supports that mothers who take probiotics during pregnancy have a lower risk of having children who develop eczema. A significantly reduced risk was seen in women who took probiotic supplements beginning two months before their babies’ due dates and throughout breastfeeding until the babies were two months old.[9] Researchers are still not certain about the mechanism behind the potential role of probiotics in preventing or improving eczema in children.[6]
Commercially available probiotics come in various forms, including capsules, powders, beverages, and food forms such as yogurts and fermented milk. Many different products exist claiming different strains of microorganisms at variable doses. However, the true adequate dosage for probiotics has not been established. Published scientific studies in children have used probiotics in doses ranging from 10 million to 30 billion colony forming units (CFUs) per day with more success at higher doses.[5] Probiotic strains that have demonstrated promising effects in reducing the risk of eczema include Lactobacillus GG, Bifidobacterium lactis, and Lactobacillus rhamnosus. However, clinical studies so far have not demonstrated that any one of these strains is superior to the others.
Promising discoveries have been made when looking at probiotics and eczema. However, more research is needed to understand how probiotics may improve or prevent eczema in children. A prevention regimen consisting of prenatal probiotics in pregnant women with eczema may be useful in decreasing the risk of eczema in their infants. As more research is performed, we will start to better understand how the selection of particular bacteria, doses, or forms will make a difference in the use of probiotics.