Changing Our Microbiome: Probiotics in Dermatology

Y. Yu; S. Dunaway; J. Champer; J. Kim; A. Alikhan


The British Journal of Dermatology. 2020;182(1):39-46. 

In This Article

Abstract and Introduction


Background: Commensal bacteria are a major factor in human health and disease pathogenesis. Interest has recently expanded beyond the gastrointestinal microbiome to include the skin microbiome and its impact on various skin diseases.

Objectives: Here we present current data reviewing the role of the microbiome in dermatology, considering both the gut and skin microflora. Our objective was to evaluate whether the clinical data support the utility of oral and topical probiotics for certain dermatological diseases.

Methods: The PubMed and databases were searched for basic science, translational research and clinical studies that investigated differences in the cutaneous microbiome and the impact of probiotics in patients with atopic dermatitis, acne vulgaris, psoriasis, chronic wounds, seborrhoeic dermatitis and cutaneous neoplasms.

Results: Few clinical trials exist that explore the utility of probiotics for the prevention and treatment of dermatological diseases, with the exception of atopic dermatitis. Most studies investigated oral probiotic interventions, and of those utilizing topical probiotics, few included skin commensals. In general, the available clinical trials yielded positive results with improvement of the skin conditions after probiotic intervention.

Conclusions: Oral and topical probiotics appear to be effective for the treatment of certain inflammatory skin diseases and demonstrate a promising role in wound healing and skin cancer. However, more studies are needed to confirm these results.


Commensal bacteria play important roles in the maintenance of a healthy immune system. Disturbances in the microbiome allow for opportunistic species and pathogenic bacteria to colonize and thereby cause disease. The microbiome of the gastrointestinal system in relation to disease has been extensively studied, including its impact on the skin.[1,2] Although fewer in number than gastrointestinal bacteria, the bacteria residing on our skin have similar functions in immune regulation and disease pathogenesis.[3]

With our growing understanding of the microbiome's role in disease,[4] treatments to modulate the immune system using microbes are a promising new avenue of research. One of the most direct ways to accomplish this is via the use of probiotics,[5] which consist of live microorganisms that, when administered in adequate amounts, may confer a health benefit to the host.[6] Here we review the role of the microbiome in human health with a focus on how both oral and topical probiotics may be of use in the prevention and treatment of skin disease.