Although bacteria usually get a bad rap and are often blamed for causing breakouts, the reality isn’t so cut and dried. In fact, there are many types of bacteria, some of them good and some of them bad. Probiotics, live bacteria and yeasts that help keep the gut—or digestion system—healthy, are also showing up in a variety of skincare products, thanks to the benefits they provide. According to Cord Coen, founder and president of Zents, the term probiotic can also refer to anything that helps support the health of such bacteria. “In order to be healthy inside and out, you need to keep the balance of good and bad bacteria,” says Celeste Hilling, cofounder, CEO, and product formulator of Skin Authority. “Probiotics help replace ‘good’ bacteria lost in the body and balance ‘bad’ bacteria to keep the body working in balance.” Of course, most people still think of probiotics as something to add to their diets, usually in the form of yogurt; fermented foods, such as sauerkraut and kimchi; or a supplement. It turns out that both ingested and topical probiotics play a key role in maintaining healthy skin. “Recently, probiotics have been documented to help improve atopic eczema and atopic dermatitis, heal burns and scars, rejuvenate skin, and improve skin’s innate immunity,” says Steven Rosenfeld, president of Columbia Skincare. Here, we give you the lowdown on how probiotics can help your clients achieve clearer and younger-looking skin.
Relevant Research

While studies on the effectiveness of probiotics are ongoing, there is still much to be learned. Here is a quick look at some of the noteworthy research:

• In the article “Anti-Aging Effects of Probiotics” published in January 2016 in the Journal of Drugs in Dermatology, Divya Sharma BS, Mary-Margaret Kober, M.D., and Whitney P. Bowe, M.D., reveal how probiotics can restore acidic skin pH, alleviate oxidative stress, reduce photoaging, improve skin barrier function, and improve hair quality.

• In the article “The Effect of Probiotics on Immune Regulation, Acne, and Photoaging” published in the International Journal of Women’s Dermatology in February 2015, Kober and Bowe look at the role of probiotics in the development of the immune system, the treatment of acne and rosacea, and the protection against aging and photodamage.

• In the article “Acne Vulgaris, Probiotics and the Gut-Brain-Skin Axis: From Anecdote to Translational Medicine” published in Beneficial Microbes in 2013, Bowe and colleagues reviewed a 1930's theory that distressed emotional states could alter gut flora and contribute to systemic inflammation and acne and the evidence that gut microbes and topical probiotics could be linked to the skin

• A 2011 study conducted by Korea University revealed that participants who consumed lactobacillus-fermented dairy beverages reduced their inflammatory acne symptoms by 40 percent and decreased oil production.

A Gut Feeling

Recently, gut health has been getting a lot of play in the media and for good reason. “There is a profound connection between the health of our gut and our complexion,” says Chelsea Bartolotta, sales and marketing vice president for Epicuren Discovery. “When the flora of the gut is not in balance, it can trigger a system-wide inflammation response, which can be seen in the skin as acne, redness, irritation, and dryness.” According to Neal Kitchen, vice president of strategy and development at HydroPeptide, probiotics have long been recognized for their inflammation-fighting abilities in the gut, and more recently, scientists and nutritionists have shown that these abilities extend beyond the digestive tract. “Products containing probiotics help our microbiome form a protective shield for our cells and minimize the need to trigger the body’s immune defense system and inflammatory pathways,” he says. “These calming effects provide a significant decrease in flares that lead to acne and rosacea.”

Whitney P. Bowe, M.D., FAAD, a board-certified dermatologist and clinical assistant professor of dermatology at Icahn School of Medicine at Mt. Sinai Medical Center in New York, and adjunct assistant clinical professor of dermatology at State University of New York (SUNY) Downstate College of Medicine in Brooklyn has long studied the effect of probiotics on the skin and recommends that patients incorporate both topical and oral probiotics. She says, “Eating foods rich in probiotics, such as yogurt with live cultures, can prevent skin sensitivity, redness, and itching by blocking the release of inflammation-causing chemicals.”

Need to Know

It can be somewhat confusing choosing the right probiotic-related skincare products for your clientele when you don’t know what to look for. Here, Epicuren Discovery’s Chelsea Bartolotta reveals what matters most when it comes to effectiveness:

Quantity “Look for a product that contains a high number of organisms per serving, which can be seen on the label as CFU, or colony-forming units,” she says.

Diversity “It is equally important to select a supplement that contains a diverse combination of different bacteria strains,” she says.

Topical Applications

While taking probiotics internally can certainly help improve digestive health and have a systemic effect on the skin, applying them topically is proving to be especially effective. “Dermatologists are now looking into the benefits that topical probiotics provide to treat acne, psoriasis, and rosacea, to name a few,” says Karen Asquith, director of education for G.M. Collin. According to a news release from the American Academy of Dermatology (AAD), probiotics are showing real promise in the treatment of acne and rosacea. Dermatologist Whitney P. Bowe, reveals how topical probiotics can benefit the skin:

• Create a protective shield

• Provide antimicrobial properties

• Produce a calming effect

This is promising news for those who suffer from acne and rosacea. “Topical probiotics sit on the skin’s surface and prevent the skin cells from seeing bad bacteria and parasites that can cause the immune system to respond,” says Bowe. “This response is known as bacterial interference, as probiotics protect the skin and interfere with the ability of bad bugs—or bacteria and parasites—to provoke an immune reaction. Probiotics are billed as having a calming effect on skin redness and irritation like stubborn acne or rosacea flare-ups.” According to her, probiotics send signals that stop the skin cells from reacting to the bad bacteria. It’s those reactions that cause acne and rosacea. Skin Authority’s Celeste Hilling agrees that topical probiotics are key to treating such skincare concerns. “In order to attack surface-level conditions like acne and psoriasis, probiotics have to be applied to the skin,” she says. The reasoning is that the skin benefits by directly absorbing the probiotics when applied topically.

Probiotics are also showing promise in treating anti-aging concerns. According to Hilling, they reduce the physical signs of aging by building collagen. In addition, they reduce the impact of sun exposure to reduce the appearance of fine lines and wrinkles. Bowe, who has co-authored a number of articles on the effects of probiotics on the skin, confirms that they have a role to play in anti-aging. “As we age, the pH of our skin rises and triggers certain enzymes in the skin to break down collagen, thereby accelerating the signs of aging,” she says. “We need probiotics that produce metabolites, such as lactic acid to bring that pH back down and slow the aging process.”

The Yogurt Myth

“The natural bifidius cultures found in yogurt and dietary supplements can also be used topically,” says Teresa Stenzel, director of education for Bioelements. “However, this does not mean that slathering the skin with yogurt will make a difference. According to the AAD, there is currently no research or studies that demonstrate the effectiveness of a DIY home remedy. Instead, look for professional skincare products clinically formulated with topical probiotics.”