Probiotics marketed (and shown) to support a healthy gut microbiome are flourishing as consumers have learned to seek out this benefit. Increasingly, they are making the connection between the status of their microbiome and the potential of better health and improved immune resilience.

Building on this success, a growing niche opportunity for brands is to support the skin microbiome with probiotics and postbiotics.

Summarizing the skin microbiome

In her June 2022 article, “The Interplay of Ultraviolet Radiation (UVR) & the Microbiome,” on the International Probiotics Association (IPA) website, Clare Fleishman, RDN, describes the skin as “harsh, nutrient-poor and acidic” while performing double duty to prevent foreign pathogens from permeating and nourishing a richly diverse commensal microbiota. The varied environments in the skin—oily, dry, humid, warm, cold—provide opportunities for numerous complex communities of bacteria, viruses, fungi, mites and archaea to live; this is the skin microbiome.

“The skin microbiome must maintain a healthy interplay with the skin’s immune system for its survival,” she stated.

The skin microbiome alters with age, and this can inform development of new cosmeceuticals formulated to keep skin youthful. In one study of 37 women in two age groups (21-37 and 60-76), taxonomic profiling showed a dramatic reduction in the relative abundance of the majority skin genus Propionibacterium in the facial microbiomes of the older adults, as well as identified 38 species including many oral bacteria that significantly differentiated the two age groups.¹ Scientists also found chronological age-related parameters correlating with the observed changes in the skin microbiome diversity. “The data suggest that diversification of skin microbiomes in adult women was largely affected by chronological and physiological skin aging in association with oral bacteria,” they concluded.

This study is just an example of the work investigating the complex profile of the skin microbiome, and it represents many forthcoming avenues of investigations of how specific strains work to mitigate various skin conditions and the modification of the gut-skin axis.

Sid Shastri, director of research and business, Kaneka Probiotics, noted several factors have been driving awareness of the gut-skin connection. “In a broad sense, there are an accelerating level of journal publications on the overarching field of microbiome—over 25,000 in 2021.”

In 2014, according to the National Library of Medicine (Pubmed.gov), only seven publications were related to “Gut Skin Axis,” whereas in 2021, the number of publications increased to 52.

Similarly, a proprietary 2022 Lumina Probiotic report showed the recent launch of many “skinbiotics” products. “This category jumped 121% in 2021, and it promises to be a significant addition to probiotic formulations already in commerce,” Shastri added.

Vera Mogna, CEO, Probiotical, concurred with the growth in science and sales. “In recent years, we have witnessed a boom in both research on skin microbiome and the commercialization of topical and oral products targeting skin health,” she said.

AnaMaria Cuentas, director of probiotics, Nutralliance, suggested that consumer concerns about skin health arising from the growing prevalence of skin conditions—as well as knowledge of potentially harmful ingredients in personal care products—are accelerating demand for skinbiotics.

According to Fleishman, anti-inflammatory probiotics could be beneficial in topical applications as skinbiotics. For example, in one study, Limosilactobacillus reuteri showed anti-inflammatory properties on reconstructed human skin models upon UVR-induced inflammation.²

Inflammation is a significant characteristic of atopic dermatitis, also known as eczema, which affects approximately 16.5 million adults.³ It is also a known element in other dermatological states such as psoriasis, rosacea and acne, all conditions associated with the gut-skin axis.

“Probiotics researchers have well established that an alteration in the relationship between the gut microbiome and the immune system can manifest as a disruption to skin health,”⁴ Shastri commented.

While the pathophysiology of atopic dermatitis is multifactorial, up to 90% of individuals with atopic dermatitis exhibit Staphylococcus aureus infection and colonization.⁵ Shastri said atopic dermatitis is also caused in part by immune system dysregulation, characterized by excess activation of Type 2 helper (Th2) lymphocytes and an increase in pro-inflammatory cytokines and chemokines in the skin.

Cuentas emphasized that in the science of skinbiotics, “the most impactful research highlights the production of certain bioactive metabolites that may directly affect skin barrier functions such as the reduction of certain pro-inflammatory cytokines while increasing a balanced production of anti-inflammatory cytokines.”

How strains support skin health

Probiotical’s researchers have been focused on atopic dermatitis—which was one of the first applications of the company’s probiotics in the gut-skin axis—as well as exploring probiotic applications for acne and psoriasis, both in oral and topical deliveries, Mogna reported.

One study of 38 individuals with moderate to severe atopic dermatitis evaluated supplementation with three stains of L. salivarius on cytokine stimulation and changes in intestinal microflora and clinical improvements.⁶ L. salivarius LS01 showed the best immunomodulatory attributes, as demonstrated by a reduction in SCOring Atopic Dermatitis (SCORAD) index score and a significant decrease in the staphylococci load compared to placebo. The strain also showed the ability to reduce production of Th2 cytokines, maintaining production of Th1 cytokines. The researchers concluded that consuming L. salivarius LS01 positively modified clinical and immunological status and dermatology life quality in those with atopic dermatitis.

In another Probiotical study, 107 adult subjects with atopic dermatitis received a synbiotic combination of Lactobacillus rhamnosus LR05, Bifidobacterium lactis BS01 and the prebiotic fructooligosaccharide (FOS).⁷ They were assessed for severity of atopic dermatitis using the SCORAD index and Visual Analogue Scale (VAS) for atopic dermatitis-related global burden of the disease at baseline, and after two and four months of supplementation. The SCORAD results showed significantly reduced atopic dermatitis severity after two and four months, while no effect was registered on the VAS score (a validated, subjective measure for pain).

According to Mogna, previous research showed that consuming L. salivarius LS01 provided an improvement in atopic dermatitis symptoms.⁸ A study evaluated how the association of Staphylococcus thermophilus ST10 and tara gum could improve the activity of high doses L. salivarius LS01 supplementation in 25 adults with atopic dermatitis. Researchers observed a significant improvement in SCORAD index in the probiotic group after one month, whereas no significant changes occurred in placebo subjects. Additionally, slight decrease in fecal S. aureus count was observed in the probiotic group.

Shastri noted Kaneka’s L. sakei Probio 65 (derived from kimchi) is useful in both live (probiotic) and heat-treated, inactivated (postbiotic) formats, as shown in preclinical and clinical research.

One study involved administration of both live and heat-treated forms to assess the potential impact on children and adolescents with atopic dermatitis.⁹ The 12-week, three-arm trial involved giving 10 billion colony-forming units (CFUs) per day of probiotic form (arm #1), 10 billion of the postbiotic form (arm #2) and a placebo group (arm #3).

The results demonstrated the unique protective activity of the ingredient in both probiotic and postbiotic forms. The active form reduced SCORAD indices by 10.72, whereas the heat-treated form reduced the values to 10.51. “These results suggest that both live and dead cells of L. sakei ​Probio 65 may support healthy skin metabolism and provide a healthy inflammation response if experiencing dermatitis,” Shastri commented.

Another option from Kaneka for probiotic product developers interested in offering microbial formulations for skin health is a formulation called SkinShield, which is a blend of novel strains of Lactobacillus rhamnosus KABP-071 and spirulina (Arthospira platensis) powder. Internal pilot data suggest the formulation’s primary mechanisms of action are by promoting a healthy inflammatory response in the gut-skin axis, as well as normalization of insulin signaling of skin. This blend targets immunomodulation to achieve healthy skin.

Ildong’s topical postbiotic CeraGlow is a patented and clinically studied Lactobacillus rhamnosus lysate formulation. A study found the ingredient enhances ceramide production in human epidermal keratinocytes by stimulating sphingomyelinase activity and supports healthy skin barrier function.¹⁰

Postbiotics are glowing

A challenge of live probiotics in the skinbiotic space, according to Cuentas, is remaining viable. “The tough task lies in the survival of the probiotic strains. This is certainly something that can be overcome by choosing coated probiotics or postbiotics which can still provide the skin health benefits while allowing the inclusion into various other applications.”

Shastri agreed, “As product developers know in this industry, postbiotics are quite stable.”

As such, one trend in skinbiotics is the growth of postbiotics. Mogna observed, “We are seeing more interest in heat-treated probiotics for skin health, supporting their use not only in cosmetic formulations, but also as an ingestible, as they’ve been found to enhance skin moisture by strengthening the intestinal and skin barriers and to downregulate expression of pro-inflammatory cytokines.”¹¹

Shastri suggested postbiotics may interact well with collagen powders, and Cuentas took it further by saying postbiotics can likely be combined with an array of skin health ingredients such as beta-carotene, astaxanthin, zinc, hyaluronic acid, vitamin C, argan oil, ceramides and alpha-hydroxy acids.

Conclusion

The beauty of “biotics” is that they are pliable and can be effective for both internal and external consumption to address skin health, as well as help manage inflammatory response in skin and the gut-brain axis. As such, they allow for inventive product development in a space that is bound to open much wider.

Lisa Schofield is a veteran writer and editor who got her start interviewing rock stars for national music magazines. She now writes and edits content for B2B media and suppliers in the natural health product industry. She has served as editor for Vitamin Retailer and Nutrition Industry Executive, and prior to that as associate editor for Whole Foods.

References

1 Shibagaki N et al. “Aging-related changes in the diversity of women’s skin microbiomes associated with oral bacteria.” Sci Rep. 2017;7(1):10567.

2 Khmaladze I et al. “Lactobacillus reuteri DSM 17938-A comparative study on the effect of probiotics and lysates on human skin.” Exp Dermatol. 2019;28(7):822-828.

3 Fuxench ZCC. “Atopic Dermatitis in America Study: A Cross-Sectional Study Examining the Prevalence and Disease Burden of Atopic Dermatitis in the US Adult Population.” J Invest Dermatol. 2019;139(3):583-590.

4 De Pessemier B et al. “Gut-Skin Axis: Current Knowledge of the Interrelationship between Microbial Dysbiosis and Skin Conditions.” Microorganisms. 2021;9:353.

5 Haslund P et al. “Staphylococcus aureus and hand eczema severity.” Br J Dermatol. 2009;161(4):772-777.

6 Drago L et al. “Changing of Fecal Flora and Clinical Effect of L. Salivarius LS01 in Adults with Atopic Dermatitis.” J Clin Gastroenterol. 2012;46 Suppl:S56-63.

7 Manzotti G et al. “Probiotics as a Novel Adjuvant Approach to Atopic Dermatitis.” J Contemp Immunol. 2014;1(2):57-66.

8 Drago L et al. “Treatment of Atopic Dermatitis Eczema with a High Concentration of Lactobacillus Salivarius LS01 Associated with an Innovative Gelling Complex: A Pilot Study on Adults.” J Clin Gastroenterol. 2014;48 Suppl 1:S47-51.

9 Rather IA et al. “Oral administration of live and dead cells of Lactobacillus sakei Probio65 alleviated atopic dermatitis in children and adolescents: A randomized, double-blind and placebo-controlled study.” Probiotics Antimicrob Proteins. 2021;13(2):315-326.

10 Kim MS et al. “Enhanced ceramides production by Lactobacillus rhamnosus IDCC 3201 and its proposed mechanism.” Appl Biol Chem. 2021;64:50.

11 Niccoli AA et al. “Preliminary Results on clinical Effects of Probiotic Lactobacillus salivarius LS01 in Children Affected by Atopic Dermatitis.” J Clin Gastroenterol. 2014;48(1):S34-S36.