The role of topical probiotics in skin conditions: A systematic review of animal and human studies and implications for future therapies

Abstract

There is increasing evidence that the intestinal microbiome plays an important role in modulating systemic inflammation and disease. Oral probiotics can modulate the intestinal microbiome and have demonstrated to be efficacious in treating topical skin conditions, such as atopic dermatitis, acne and rosacea. By proxy, exogenous application to the skin of probiotics should also promote a positive bacterial balance to mitigate or potentially eliminate pathologic conditions. The goal of this article was to provide a systematic review of studies that have investigated the role of topical probiotics in mitigating skin conditions. Additionally, skin conditions where dysbiosis has been identified but topical probiotics have not been investigated are discussed. We hope this review both analyses the evidence for the role that topical probiotics could play in topical skin conditions and highlights additional areas in need of research and exploration.

Skin Microbiota Dynamics Following B. subtilis formulation Challenge

“…The concept of skin microbiota manipulation, either by promoting bacterial balance or by pathogen inhibition, is well established [35,36]. However, despite signi cant progress in the eld, transplantation of bacteria or bacterial ingredients that selectively stimulate or inhibit the growth and activity of one or a limited number of bacterial species is still at a very experimental stage in skin therapy [4].…”

Extrinsic Factors Shaping the Skin Microbiome

“…The use of probiotics has been proven to reduce infection frequency and antibiotics usage. Particularly, researchers have demonstrated their efficacy in the treatment of skin conditions such as AD and acne vulgaris, potentially due to their contribution to the inhibition of skin pathogen growth [ 97 ] and promotion of a positive bacterial balance [ 98 ]. Bacterial probiotic genera for the skin include Lactobacilli and Bifidobacterium [ 98 ].…”

“…Particularly, researchers have demonstrated their efficacy in the treatment of skin conditions such as AD and acne vulgaris, potentially due to their contribution to the inhibition of skin pathogen growth [ 97 ] and promotion of a positive bacterial balance [ 98 ]. Bacterial probiotic genera for the skin include Lactobacilli and Bifidobacterium [ 98 ]. Probiotics, which are not only efficient for the treatment of skin conditions, are also used in general skin healthcare, to improve the skin’s physicochemical properties (hydration, elasticity, melanin production, etc.)…”

Modulation des Mikrobioms

“…das Ergebnis einer Probiotikagabe ohne die assoziierten Risiken reproduzieren. Neben der Isolation der Moleküle können auch abgetötete Organismen im Sinne eines Postbiotikums verabreicht werden [38]. Zurzeit basieren die meisten Forschungsergebnisse auf Erkenntnissen aus der Grundlagenforschung, die klinische Relevanz ist noch offen.…”

“…Tiermodellen als auch in einer Pilotstudie mit 15 Patienten einen mildernden Effekt auf die Krankheitssymptomatik sowie die S.-aureus-Last hatte. Roseomonas mucosa von gesunden Probanden wurde isoliert und dann in einer Saccharoselösung topikal aufgetragen[37,38]. Weitere klinische Studien fokussieren sich ebenfalls auf die topikale Anwendung von verschiede-…”