Role Of Probiotics In Skin Infection Prevention

Everyone knows that bacteria and viruses are bad for our health as they make us sick. But, do you know there are some good bacteria too? Yes, our body has good bacteria which helps in strengthening our immune system. They are mostly found in our gut and help in many ways. If we have sufficient quantities of good bacteria, they can help in fighting an attack from bad bacteria. 

What are probiotics?

Probiotics or good bacteria are live bacteria that are healthy for our bodies. Probiotics or good bacteria are found in several parts of our body, such as the gut, vagina, urinary tract, mouth, skin and lungs. They can also be obtained through food or dietary supplements; however, these don't go through rigorous testing like pharmaceutical probiotics. 

The measurement units for probiotics are Colony Forming Units (CFU). As probiotics are only healthy when they are consumed live it is essential to check the CFU at the end of a product’s shelf life.

Prebiotics are foods that are consumed by these good bacteria for survival and are necessary to maintain adequate levels of good bacteria or probiotics in the body. A Synbiotic is a product containing both prebiotic sugars and probiotic organisms.¹

There are seven common genera of probiotic products:

1. Lactobacillus
2. Bifidobacterium
3. Saccharomyces
4. Enterococcus
5. Bacillus
6. Escherichia
7. Streptococcus

Importance of skin health and probiotics

As the largest organ of the body and the first line of defense against pathogens, skin health is as equally important as maintaining overall health. It is advised to bathe regularly and wash your hands frequently. Apart from that, skin plays a major role in the cosmetic sense and people are very careful about maintaining skin health. Studies have shown that probiotics can improve skin health and that they are less toxic compared to common chemical ingredients found in skincare products. 

Let's check out a few probiotics and how they affect our skin health.²

• Lactobacillus acidophilus and Lactobacillus rhamnosus: This probiotic is beneficial for treating photoaging, premature skin ageing. It can occur due to exposure to natural sunlight or artificial UV rays. It is also more commonly referred to as sun damage, solar damage, photo damage or dermatoheliosis. 
• Bacillus ferment extract: It helps retain the firmness and elasticity of the skin. 
• Lactobacillus ferment filtrate: It helps in cleaning away bad bacteria from the skin which can help treat acne for teenagers or anyone suffering from acne breakouts. 
• Bacillus coagulans: It helps the skin to look light and bright and improves skin complexion.
• Lactococcus ferment lysate: It helps in maintaining the skin balance and renews the skin barrier to keep it healthy. It can be used in the form of facial pads or gel.
• Lactococcus ferment lysate and live kefir probiotics: This combination can help reduce fine lines and wrinkles from the skin. It also helps in boosting the defence system.
• Saccharomyces black tea ferment and Lactobacillus: This combination provides moisturisation to the skin for a prolonged period by balancing the nutrients in the skin.
• Lactococcus ferment lysate, inactivated strains of Lactobacillus casei and Lactobacillus acidophilus: This combination helps in strengthening the natural defence of the skin by optimising the microflora levels in the skin cells. It keeps the skin moisturised and smooth. 

Types of skin infections

There are various skin infections which can be treated by probiotics.^²,³,⁴

Atopic dermatitis: This condition is also known as atopic eczema and is mostly seen in babies during their first year. The skin becomes dry, cracked and itchy. It mostly affects the face, back of knees, inside of elbows, scalp and hands in children. Studies have shown that oral probiotics help treat this condition. Streptococcus thermophilus has been proven to reduce the severity of atopic dermatitis. Another study’s results using probiotics such as Lactobacillus and Staphylococcus aureus showed significant skin infection prevention.  

Acne: Acne is a common skin condition, especially in teenagers characterised by spots on the skin. It is mostly seen on the face, but it can also develop on the back or chest. Different types of spots are whiteheads, blackheads, pustules, papules, nodules and cysts. In teenagers, it is caused due to fluctuation in hormone levels. Sometimes, adults also suffer from acne due to hormone fluctuation or improper hygiene measures. Streptococcus thermophilus can help balance water in the skin, thus reducing acne. Probiotics suppress acne-causing bacteria, so they are helpful in skin infection prevention.

Psoriasis: Psoriasis is a skin condition where itchy scaly patches develop on the body. It is mostly seen on the elbow, knees, scalp or lower back. Usually new skin cells are produced every 3 to 4 weeks but in psoriasis, it happens every 3 to 4 days. So, this increased production of cells causes the appearance of scaly skin. Some studies have hinted at psoriasis being an autoimmune disorder. Oral probiotics have shown a significant reduction in psoriasis symptoms. 

Seborrheic dermatitis: Seborrheic dermatitis is a skin condition mostly affecting the scalp but it can also affect other oily areas of the body such as the face, chest or ears. The most common symptoms are scaly patches and dandruff on the scalp.  It can occur due to yeast overgrowth and reduced levels of microbiota. Lactobacillus paracasei has been shown to lead to a significant reduction in dandruff and other symptoms related to seborrheic dermatitis. 

Rosacea: Rosacea is another skin infection of the face characterised by facial redness,which lasts for a few minutes. Some may experience a stinging sensation while using water or skincare products. Oral probiotics in combination with antibiotics can help in the treatment of scalp rosacea.   

Wound healing: Wound healing is due to the activation of the immune response. Lactobacillus plantarum application can reduce bacterial growth on the wound site and promote the wound healing process. Pseudomonas aeruginosa can help reduce inflammation and help treat burns.

Other infections treated by probiotics

Probiotics use is not limited to skin infection prevention. Apart from skin health, probiotics helps treat several health conditions.⁵

• Irritable bowel syndrome
• Antibiotic-associated diarrhoea
• Inflammatory bowel disease
• Diarrhoea due to cancer treatment
• Constipation
• Sepsis in infants
• Infant colic
• Dental caries
• Gum disease
• Hay fever
• Asthma
• Upper respiratory tract infections
• Urinary tract infections

Limitations 

Probiotics are very helpful in treating various health conditions. Most of the probiotics are safe to use and don't show any adverse reactions. Here is a list of some commonly used probiotics which are considered safe.

• Lactobacillus acidophilus
• Lactobacillus fermentum
• Lactobacillus casei
• Lactobacillus johnsonii
• Lactobacillus paracasei
• Lactobacillus plantarum
• Lactobacillus rhamnosus
• Lactobacillus salivarius
• Bifidobacterium adolescentis
• Bifidobacterium animalis
• Bifidobacterium longum
• Bifidobacterium breve
• Bifidobacterium bifidum

However, there are some reports where adverse health effects have been observed after the use of probiotics. The side effects are minor gastrointestinal symptoms such as gas in several cases but some immunocompromised people can suffer severe side effects such as:

• Bacteremia (presence of bacteria in blood): The useUse of Lactobacillus probioticsprobiotic also showed ahigh risk of developing bacteremia in patients admitted toin Intensive Care Units and fed through feeding tubes. 
• Fungemia (presence of fungi/yeast in the blood): The use of probiotics containing Saccharomyces cerevisiae has have been reported to cause have fungaemia in some cases. 
• Other infections

Therefore, the World Gastroenterology Organisation advises restrictive use of probiotics in immunocompromised individuals.¹

Source of probiotics

Now that we have discussed the health benefits and limitations of the use of probiotics let's discuss the source of probiotics. Probiotics can be obtained through dietary supplements, creams or gels and through food sources. Several fermented foods contain live microbes that are beneficial for health.¹ These foods are: 

• Commercial yoghurts
• Sourdough bread
• Commercial pickles
• Cheese
• Kimchi
• Kombucha
• Miso
• Buttermilk
• Sauerkraut

Probiotic supplements can be taken in the form of:

• Powders
• Drinks
• Liquids
• Capsules

Skincare products can come in the form of gels, creams or facial pads. 

Summary

Probiotics are good bacteria or yeast that are beneficial for the body. They are very beneficial in skin infection prevention by strengthening the skin barrier. They also kill bad bacteria or pathogens that harm our body, thus helping in immune response.  They are found in the gut, skin, lungs, vagina, urinary tract and mouth. 

As skin covers the entire body, it is essential to maintain skin health. Probiotics are also beneficial in maintaining skin by reducing wrinkles, photo ageing, acne, atopic dermatitis, wound healing, psoriasis, rosacea, and seborrheic dermatitis. Apart from skin health, probiotics are beneficial in other health conditions such as irritable bowel syndrome, sepsis in infants, infant colic, diarrhoea, inflammatory bowel syndrome, constipation, hay fever, asthma, upper respiratory tract infections and urinary tract infections. The bacterial strains mostly used as probiotics are Lactobacillus, Bifidobacterium, Saccharomyces, Enterococcus, Bacillus, Eschericia, Streptococcus. 

There are no specific guidelines for the use of probiotics in healthy individuals. However, in immunocompromised individuals, the use of probiotics should be restricted unless advised by a healthcare professional.  It is due to reports of some cases of bacteremia and fungemia. 

Probiotics can be obtained through food or dietary supplements. Foods such as commercial yoghurt, cheese, commercial pickles, kimchi, sauerkraut, miso, kombucha, sourdough bread and buttermilk are good sources of probiotics.