If you understand the causes of acne and the type of treatments available, then it makes sense why probiotics can help.
The good news is that when probiotics are used in conjunction with the antibiotics your dermatologist prescribes, the side-effects associated with taking these medications is reduced.
Taking a probiotic can also reduce the number of future acne breakouts. Read below to learn how probiotics play a role in acne control and why these beneficial flora should be part of your acne treatment plan.
What Causes Acne?
Acne develops in a structure of the skin called the pilosebaceous unit. The central canal of this unit is called the follicle, which includes a hair shaft and an opening to the skin or a pore. In the follicle are small sacs called sebaceous glands which secrete sebum, a skin and hair lubricant.
The adrenal hormone testosterone stimulates the production of sebum as well as keratin, a fibrous protein that lines the follicle. In acne, these skin cells shed excessively and stick together. When combined with excess sebum, an enlarged follicle or microcomedo is formed.
In this ideal environment, Propionibacterium acnes or P. acnes, a bacterium that normally reside on the skin, proliferate. Their overgrowth causes a destruction of the pore lining and cellular debris enters the surrounding area, leading to inflammation.
What Role do Antibiotics Play in Acne?
Given that acne is caused by a number of factors, finding the best acne treatment can be a challenge. To make matters worse, what works for one person may not work for another.
One of the most common acne treatments is the use of both topical and oral antibiotics. These medications work by reducing the bacterial colonization of P. acnes.
Topical antibiotics reduce small infections in the pore and help to keep the pores open. These topical medications include clindamycin, erythromycin, tetracycline and metronidazole.
Like topical antibiotics, oral antibiotics decrease the numbers of P. acnes. These medications also work by reducing irritating chemicals produced by cells and reducing inflammation. Commonly prescribed oral antibiotics include tetracycline, erythromycin, minocycline, doxycycline and clindamycin.
What’s the Problem with Antibiotics?
If your doctor has prescribed an oral antibiotic to treat your acne, you should be aware of the negative side-effects associated with taking these medications.
Many antibiotics used today are not targeted but medium and broad spectrum. That means they kill bacteria without prejudice – killing both the bad and the beneficial bacteria that reside in your gastrointestinal (GI) tract.
Upsetting the natural balance in the digestive tract causes all sorts of digestive problems. But, the most common complaint associated with these medications is antibiotic associated diarrhea. In fact, this negative effect is the number one reason why patients discontinue antibiotic therapy.
In women, another common side-effect of taking antibiotics is a yeast infection caused by an overgrowth of Candida albicans. This yeast normally inhabits the GI tract. But, if allowed to reproduce too quickly, can cause a yeast infection. Oral antibiotics can also lessen the effectiveness of birth control pills.
Probiotics and Antibiotics
If you’re taking an antibiotic for acne control, taking a probiotic at the same time can lessen this medication’s unwanted side-effects. The good news is that taking a probiotic will not lessen the effectiveness of antibiotic therapy.
Studies support the use of probiotics to avoid diarrhea resulting from antibiotic use. Importantly, researchers found that probiotics were found to rarely cause adverse effects even in children.
Probiotics work by restoring the beneficial bacteria lost due to antibiotics. Taking a probiotic helps to repopulate the digestive tract with beneficial bacteria to get your digestive function back to normal. These “good guys” reduce the symptoms of antibiotic associated diarrhea by killing off the bad bacteria. How do they do this? The beneficial flora produce compounds that are toxic to bad bacteria, suppressing their growth. In addition, they prevent bad bacteria from adhering to intestinal walls.
Probiotics and Acne Control
While a key benefit of taking a probiotic is to prevent antibiotic associated diarrhea, supplementing with beneficial bacteria also addresses other issues associated with acne.
Promote Bacterial Balance
Studies indicate that almost half of people with acne have lower than normal stomach acids (hypochlorhydria), which is a risk factor for bacterial imbalance. Researchers theorize that less than adequate stomach acid alters the normal intestinal microflora. Supplementing with a probiotic can normalize your digestive tract and help with acne control.
Improve Gastrointestinal Function
In a Chinese study involving over 13,000 adolescents, researchers found that gastrointestinal dysfunction is an important risk factor for diseases of the sebaceous glands and is correlated with their occurrence and development. In the study, patients with seborrhea, seborrheic dermatitis, acne and rosacea were more likely to have bad breath, gastric reflux, abdominal bloating and constipation than non-acne patients. Daily supplementation with a probiotic enhances regularity.
Inhibit Growth of Bad Bacteria & Remove Gut Toxins
Some studies have shown increased blood levels of toxins absorbed from the gut in acne sufferers. These toxins are released from the bad bacteria that are multiplying faster than the beneficial bacteria. The body responds to these toxins by increasing inflammation in the body. Probiotic supplementation inhibits the growth of these harmful bacteria. The inhibitory effects of a probiotic are enhanced when combined with a prebiotic (type of fiber), the food used by beneficial flora.
Reduce Acne Lesions, Sebum Content & Inflammation
A recent study showed that in young adults with moderate acne, those who took a probiotic drink showed significant improvement in their acne. After taking the supplement for 12 weeks, this group had 23% fewer pimples in total and 40% less inflammatory lesions. The probiotic drink used in the study improved acne by reducing sebum content and decreasing skin inflammation due to its broad antibacterial and anti-inflammatory activities.
What’s the Best Probiotic Supplement?
Not all probiotics are created equal. So, you want to choose a probiotic that best meets your needs.
Many antibiotics used today are broad spectrum meaning they wipe out a wide range of both bad and good bacteria. To compensate, you’ll want to select a probiotic that replenishes your digestive tract with a broad range of beneficial bacteria. Two key probiotic families are Lactobacillus and Bifidobacterium. Find a probiotic that contains species from both of these families such as L. acidophilus and B. bifidum.
Within each of these two families are species that are hardier than others. Species like L. acidophilus. L. rhamnosus and L. salivarius are remarkably tolerant of the harsh conditions in the digestive tract. Other species like L. casei and B. longum are beneficial in preventing diarrhea associated with antibiotic use.
The best probiotic supplement will also be enteric-coated. This ensures that the probiotic supplement bypasses the harsh conditions of the stomach and doesn’t break-down until the small intestine where the beneficial bacteria are liberated.
A supplement that combines a probiotic with a prebiotic (the food these beneficial flora like to eat) is ideal. The prebiotic food ensures that the beneficial bacteria have an ideal environment in which to flourish.
VitaMedica’s Probiotic-8 supplement meets all of these criteria. The supplement contains a wide range of beneficial bacteria to restore your body’s natural flora including 4 strains of Lactobacillus, 4 strains of Bifidobacterium and 1 strain of Streptococcus. Probiotic-8 is also formulated with a prebiotic fiber called FOS for optimum synbiotic support. Enteric-coated capsules ensure that the friendly bacteria survive the trip to the GI tract.
What Else Can I do to Control Acne?
The relationship between diet and acne has garnered significant debate in the medical community. Unfortunately, it is the exception, not the rule that a dermatologist will inquire about your diet. That’s because most dermatologists believe that diet has no relationship to acne. Sadly, this belief is based on two poorly designed studies conducted over 30 years ago!
More recent studies indicate that diet and lifestyle play a key role in the development of acne. For example, a study involving almost 50,000 women provided conclusive evidence of an association between milk intake and acne.
Importantly, a significant body of evidence now exists demonstrating that diet influences a number of hormones that regulate abnormal skin cell function in the follicle. In particular, diets high in refined grains; refined vegetable oils (e.g., soybean, corn or safflower oils); trans-fats and saturated fats; dairy products, whole grains and legumes, directly influence the formation of acne. To learn more, read The Dietary Cure for Acne by Loren Cordain, Ph.D.
Topical Probiotics and Acne
Like their oral counterpart, topical antibiotics are designed to reduce the overgrowth of P. acnes. They are also indiscriminant – meaning that they kill both the bad and the beneficial bacteria that reside on the skin’s surface.
As an alternative to topical antibiotics, a number of skin care companies have started offering topical probiotic products. Similar to oral probiotics, topical probiotics are designed to balance the microflora on the skin.
The U.S. has been slower than Europe in developing topical probiotic skin care products. MyBody offers a probiotic peel that is administered by a skin care professional. Brands like Bios offer BiosClinical, an acne skin care line that uses probiotics. The natural brand Eminence offers a probiotic moisturizer. Other companies include SK1N Probiotic Systems and Andalou. Stay tuned as more companies offer solutions in this burgeoning area of natural acne treatments.
David H. Rahm, M.D. is the founder and medical director of The Wellness Center, a medical clinic located in Long Beach, CA. Dr. Rahm is also president and medical director of VitaMedica. Dr. Rahm is one of a select group of conventional medical doctors who have education and expertise in functional medicine and nutritional science. Over the past 20 years, Dr. Rahm has published articles in the plastic surgery literature and educated physicians about the importance of good peri-operative nutrition.