Acne is a common nuisance for those in their teenage years. This skin condition occurs when skin pores get clogged with skin cells and other substances. At times, bacteria can become trapped inside the pore, causing the surrounding area to become red and swollen. This area is known as a “pimple.”
It is estimated that 85-90% of the population may be affected by acne in countries eating western diets. Some dermatologists actually consider acne to be a normal development process.
If this bacterial infection penetrates deep into the skin, large, red, tender pimples can form, which are full of pus. When these pus pockets burst, the infection may spread, causing an increased number of pimples, which can also be called “cysts.” This condition is known as cystic acne.
If cystic acne is left untreated, it may lead to scarring.
We are still unsure of the exact cause of this condition. Androgens in males play a part, and the hormonal changes in females, due to menopause, pregnancy, or polycystic ovarian syndrome may also be involved.
The usual over-the-counter acne products containing benzoyl peroxide often have little effect on cystic acne. Dermatologists may prescribe the following treatments.
- Spironolactone: This is a “water pill” used for hypertension by eliminating excess water from the body. It has also been shown to be effective for the treatment of acne in women.
- Antibiotics: These can help control the bacteria leading to a decrease in inflammation. Minocycline is often used.
- Accutane: This is available by prescription only. This medication must not be used by women who are, or may become, pregnant.
- Steroid injections may be performed at your physician’s office. These medications are injected directly into the cysts.
- Prescription topical products containing retinoids can help unplug skin pores.
There is evidence that probiotics may be useful in the treatment of acne. The formation of acne is dependent on:
- Follicular hyperkeratinization
- Excess production of sebum
- Propiobacterium acnes colonization
- The inflammatory cascade
Fifty-four percent of patients with acne vulgaris have marked alterations in their intestinal flora.
Probiotics may help treat acne in several ways:
They reduce inflammation present in patients with acne.
Probiotics may decrease the amount of sebum present, which lessens the colonization of P. acnes.
They may also work indirectly by decreasing side effects caused by other acne treatments.
Studies have been done to access the effects of probiotics in the treatment of acne. John Stokes and Donald Pillsbury, both dermatologists, believed depression, anxiety, and skin conditions, such as acne, could be improved by ingesting Lactobacillus acidophilus cultures. This was their belief nearly eighty years ago.
In 1961, Robert Siver, a physician from Baltimore, followed 300 patients who were given L. acidophilusan and L. bulgaricus tablets. His report claimed 80% of these patients who had acne showed clinical improvement. He also observed the probiotics were more helpful in those with inflammatory acne. Although this was not a placebo-controlled study, it seems to suggest probiotics can be useful in the treatment of acne.
More recently, a review was published in the International Journal of Dermatology highlighting several studies regarding the use of probiotics in the treatment of acne. These studies consisted of topical as well as systemic treatments.
A study was conducted on acne patients between the ages of 18 and 30 years of age investigating the effectiveness of daily ingestion of fermented milk enriched with 200 mg of lactoferrin for 12 weeks. The lactoferrin group showed 38.6% less inflammatory acne lesion compared to placebo.