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. 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. Recently, probiotic supplementation has become increasingly popular among consumers and their use in dermatology is a hot topic of research.
How Might Probiotics Improve My Child’s Eczema?
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. 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. Researchers are still not certain about the mechanism behind the potential role of probiotics in preventing or improving eczema in children.
How Are Probiotics Given and What Is the Correct Dose?
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. 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.
The Bottom Line
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.
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Food and Agriculture Organization of the United Nation and the World Health Organization. Probiotics in food: Health and nutritional properties and guidelines for evaluation. In: consultation RoajFWe, ed2001.
Sanchez B, Delgado S, Blanco-Miguez A, et al. Probiotics, gut microbiota, and their influence on host health and disease. Mol Nutr Food Res.2016;10.1002/mnfr.201600240PMID: 27500859.
Moschen AR, Wieser V, Tilg H. Dietary Factors: Major Regulators of the Gut's Microbiota. Gut Liver.2012;6(4):411-416; PMID: 23170142.
D'Argenio V, Salvatore F. The role of the gut microbiome in the healthy adult status. Clin Chim Acta.2015;451(Pt A):97-102; PMID: 25584460.
Michail SK, Stolfi A, Johnson T, et al. Efficacy of probiotics in the treatment of pediatric atopic dermatitis: a meta-analysis of randomized controlled trials. Ann Allergy Asthma Immunol.2008;101(5):508-516; PMID: 19055205.
Moroi M, Uchi S, Nakamura K, et al. Beneficial effect of a diet containing heat-killed Lactobacillus paracasei K71 on adult type atopic dermatitis. J Dermatol.2011;38(2):131-139; PMID: 21269308.
Abrahamsson TR, Jakobsson T, Bottcher MF, et al. Probiotics in prevention of IgE-associated eczema: a double-blind, randomized, placebo-controlled trial. J Allergy Clin Immunol.2007;119(5):1174-1180; PMID: 17349686.
Soh SE, Aw M, Gerez I, et al. Probiotic supplementation in the first 6 months of life in at risk Asian infants--effects on eczema and atopic sensitization at the age of 1 year. Clin Exp Allergy.2009;39(4):571-578; PMID: 19134020.
Rautava S, Kainonen E, Salminen S, et al. Maternal probiotic supplementation during pregnancy and breast-feeding reduces the risk of eczema in the infant. J Allergy Clin Immunol.2012;130(6):1355-1360; PMID: 23083673.