You grab a kombucha to go with your lunchtime grain bowl because you know that probiotics are great for your gut. And, since fermented cabbage is so packed with probiotics, you’ve started incorporating kimchi into more of your meals. You’ve got your bases covered when it comes to the microbiome in your gut, but what about the one on your skin?
The Gut-Skin Connection
There is a strong relationship between the gut and the skin called the Gut-Skin Axis. When our microbiome is unbalanced, our skin often suffers from conditions like psoriasis, acne, and dermatitis. Just like interest in the link between gut health and immunity has been building over the last decade, that connection between our gut and skin health is being explored more than ever before, leading to increased interest from researchers and consumers alike.
“With that research comes a deeper understanding of how a healthy microbiome interacts with different organ systems, including the skin. Many beauty brands recognize this interaction and are using probiotics in various ways in their formulas to harness the benefits,” shares Roshini Raj, MD, gastroenterologist, founder of Tula Skincare, and author of Gut Renovation: Unlock the Age-Defying Power of the Microbiome to Remodel Your Health From the Inside Out.
Our skin is our largest organ, making up 15 percent of our body weight. It’s like a superhero’s cape, creating a protective barrier against the potentially harmful outside world. And the microflora–the collection of bacteria, fungi, and viruses–on our skin needs to remain in a delicate balance to maintain that protective shield.
Changes in this microflora, such as certain microbes dying off or a lack of diversity, can cause skin issues to present themselves, explains Mary L. Stevenson, MD, FACMS, associate professor of micrographic surgery & dermatologic oncology at NYU Langone Medical Center. Likewise, Dr. Stevenson says that over-colonization of certain bacteria on our skin’s surface can lead to various skin problems.
Think of the gut-skin-brain axis as one of those giant Jenga puzzles. If you push the piece that represents the gut too far out of alignment with the other elements, it’s likely that the pieces representing the skin and brain will also get out of whack. In one study, researchers looked at the relationship between the gut microbiota (aka microbiome) and the development of psoriasis, an itchy, inflammatory skin condition that affects 3 percent of the adult US population. They found that in patients with psoriasis, the incidence of gastrointestinal symptoms was significantly higher than in healthy people. When they treated the patients’ skin condition, their gut health also improved.
Our modern lifestyle, which is largely sedentary and high stress, may lead us to develop more skin conditions due to changes in the microbial mix on our skin, leading to disruptions in our immune system.
The Science Behind Oral Probiotics
You may see bottles of them every time you stroll the aisles of your local pharmacy, or scroll past various ads on your social feeds, but do you know what probiotics are? Probiotics are live microorganisms that are beneficial to their host. The most common bacteria sold as probiotics are Lactobacillus and Bifidobacterium.
The scientific study of probiotics and their effects is still fairly new, but the overall understanding of their benefits is that they improve immune function by strengthening the mucosal barrier in the gut and by killing off bad bacteria. Since 70 to 80 percent of immune cells reside in the gut, keeping our gut in balance is of vital importance to our overall health.
“Because probiotics help to diminish overall body inflammation, they also have a soothing effect on the skin, helping with redness, hydration, and collagen and elastin production.”
— DR. ROSHINI RAJ
Dermatologists have long speculated about a connection between the gut, our skin, and mental health conditions. Indeed, research from the past 20 years has proven this theory to be true. Individuals with acne often suffer from depression, anxiety, and other psychological issues. The mental health impairment scores of people with acne are higher than those of people with other non-psychological health conditions, such as diabetes. In one study, teens with acne were more likely to deal with gastrointestinal symptoms including constipation, gastric reflux, and bloating. In another study, researchers found that rosacea sufferers were linked to a slew of gastrointestinal issues, including inflammatory bowel disease, celiac disease, irritable bowel syndrome, gastroesophageal reflux disease, H. pylori infection, and small intestine bacterial overgrowth (SIBO).
When we improve the health of the gut, often with a combination of probiotics and medication, skin conditions like eczema, dermatitis, and acne also improve. But does that mean that everyone should add probiotics to their skin-care routine? Dr. Raj thinks so and the benefit comes down to one thing–inflammation. She explains, “Both topical probiotic extracts and orally ingesting probiotics can have a multitude of skin benefits. Because probiotics help to diminish overall body inflammation, they also have a soothing effect on the skin, helping with redness, hydration, and collagen and elastin production.”
What Does Research Say?
When it comes to aging skin, UV radiation from the sun is the biggest culprit. True, the sun does allow us to make vitamin D, but in general, it sends us on a short trip to wrinkle city. But perhaps we can fight those damaging rays with help from some beneficial bacteria.
- One particular strain of probiotics, L. johnsonii, was shown to bolster the balance of the skin’s immune health.
- Other strains, including L. rhamnosus GG, Bifidobacterium breve, and Bifidobacterium longum all show promise in helping prevent the formation of skin tumors caused by UV rays, but these results need to be replicated in humans.
Choosing the Right Probiotic
If you’ve decided that taking a probiotic is the next step in your skincare regime, know what to look for before you shop.
Look for Specific Strains
According to Dr. Raj, “The strains that are good for the gut are also good for the skin, as we know a balanced microbiome helps skin health.” She notes that the specific strains to choose for ultimate skin health are generally in the Lactobacillus and Bifidobacter families. “Skincare companies, like Tula, that are wholly focused on probiotics often choose oral probiotic strains that have been shown to have specific skin benefits,” states Dr. Raj.
Check Out the CFU
In addition to seeing what strain or strains of probiotics are in the supplement, you’ll also see something on the back of the bottle called CFU, which stands for colony forming units, which indicates the number of cells per dose. A typical CFU for a probiotic is anywhere from 1 to 10 billion, and might be written like 1 x 10 to the 9. But unlike thread count, a higher number isn’t always better because it indicates all the organisms in the bottle, both live and dead. Some manufacturers voluntarily list the number of live bacteria at the end of a product’s shelf life, not the total number. This is helpful because you need those little buggers alive to do any good.
Double Check Dosage, Storage Suggestions, and Ingredients
A usual dosage for a probiotic can range from 1 capsule per day to 2 or more twice a day. Make sure to follow the directions on the product for best results and keep in mind that some probiotics require refrigeration. In addition to strains of probiotics, several skin-centered products include prebiotics, which are indigestible fibers that help probiotics flourish. You may find prebiotics such as Jerusalem artichoke or konjac root, as in Hum Nutrition’s Skin Squad Pre+Probiotic.
Incorporating Probiotics Into Your Routine
Once you’ve found a product you like, you may wonder when to take it. Most products will advise you to take the probiotic daily, as you would a multivitamin, but we’ve seen others that advise a pattern of 5 days on and 2 days off, like Cymbiotika’s Healthy Glow. Most can be taken at any time of day, but certain products are designed to be taken with a meal, or even sprinkled over food, like Dermala’s Meant to Be. Whichever one you try, aim to be consistent with the product to see if it’s providing a benefit.
Of course, in addition to probiotics you take in a pill, you’ve no doubt been inundated with ads for probiotics you can slather on your skin. The idea is similar to that of oral probiotics–to improve the skin’s natural protective barrier by adding beneficial bacteria. But is one type —oral or topical— better than the other? If you have a skin condition that is inflammatory, such as rosacea, acne, or eczema, probiotic skincare may be beneficial. Just like a probiotic supplement is often recommended after a course of antibiotics, a probiotic cream or lotion may also help restore the body’s natural bacterial layer.
Dr. Raj offers that putting topical probiotics on your skin can help with hydration, calm the skin, and even boost the production of collagen and elastin. But to get the maximum benefit, she adds, “You should take an oral probiotic as well.”
With all this talk of supplements, you might forget how we got here to begin with. There are several delicious and healthy foods you can incorporate into your diet that provide a probiotic boost.
Probiotic-Rich Foods to Add To Your Diet
- Fermented vegetables (kimchi and sauerkraut)
- Fermented dairy (yogurt, kefir, some brands of cottage cheese)
- Miso, natto (fermented soybeans), tempeh
- Sourdough bread
- Certain cheeses (gouda, cheddar, gruyere)
Remember that with food sources of probiotics, you’re getting additional nutrients your body needs, including calcium, fiber, vitamins, and minerals, along with those helpful bacteria.
Other Factors for Healthy Skin
It’s easy to think that the next shiny new product you pick up at Sephora is going to take your skin to the next level of glow, but let’s not forget that healthy skin requires a foundation based on an overall healthy lifestyle. If you’re enjoying nightly cocktails and skimping on hydration and sleep, there’s no amount of probiotics you can pop and slather on that will make your skin look amazing.
In addition to striving for 8 hours of sleep each night, drinking water throughout the day, and practicing good skin hygiene, make sure you’re getting enough fiber. Yes, we dietitians love talking about fiber because it impacts so many areas of health, including gut health. And to bring things full circle, what affects the gut also impacts your skin.
Within the 25 to 30 grams of total fiber we should all be getting daily, try including some that contain prebiotic fiber, such as onions, asparagus, bananas, oats, beans, avocados, seaweed, apples, and almonds. And don’t forget to refill that water bottle–the more fiber you eat, the more water you’ll need to keep everything moving. Here’s to a healthy balance that helps you feel and look your best, from head to toe.
