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Good skin health and a diverse microbiome go hand-in-hand

Article-Good skin health and a diverse microbiome go hand-in-hand

Cosmetic products with prebiotics, probiotics and postbiotics may be beneficial in treating eczema, a physician reported at the Fall Clinical Dermatology Conference held earlier this month in Las Vegas.

“Cosmetic products contain preservatives that prevent bacterial contamination. Because of that, it is not possible to have live bacteria in skincare products,” said Joshua Zeichner, M.D., director of cosmetic and clinical research at Mount Sinai Hospital’s department of dermatology. “Instead of true probiotics, products contain prebiotics, probiotic extract or postbiotics. We have data showing that these products are beneficial in treating eczema.”

However, there is not enough data to show if probiotic skin care is more effective than traditional skin care products that don’t contain probiotic ingredients, he said.

• Prebiotics are high-fiber food for live bacteria.
• Probiotic extract is the non-living bacterial lysate along with the medium in which it grew or fermented, that contains beneficial byproducts.
• Postbiotics is a relatively new term that refers to soluble metabolic byproducts of probiotic bacteria, short chain fatty acids and enzymes that are released after bacterial lysis or secreted by live bacteria. Postbiotics have antioxidant and anti-inflammatory properties that may help improve physiological functions.

The three types are derived from the gut, skin, soil or water. Dr. Zeichner shared findings from evaluations of different prebiotics present in thermal spring water and colloidal oatmeal, as treatments for atopic dermatitis.


He studied two thermal spring water products from France, La Roche-Posay and Eau Thermale Avene. He found Posay contains high levels of selenium, which has been shown to have probiotic benefits.

Selenium has anti-inflammatory properties, mitigates lipid peroxidation, and protects against UV-B induced skin damage. It can enhance microbial diversity in the skin and clinically improve eczema, he said. 

Avene contains an extract from aquaphilus dolomiae bacteria which has been shown to have anti-inflammatory properties and can reduce itching. Previous studies have shown that it is effective for eczema, and Dr. Zeichner cited a more recent in-vitro model study that evaluated ES0, a biological extract of aquaphilus dolomiae, for its anti-inflammatory, antipruritic, and immunomodulatory properties. The study concluded that these properties make the bacteria potentially valuable as an ingredient in topical preparations to treat eczema.

Colloidal oatmeal contains proteins, vitamins B and E, lipids and polysaccharides, and has anti-inflammatory and antioxidant properties.

“Colloidal oatmeal has long been recognized as a skin protectant and it’s included on the FDA monograph to treat eczema,” Dr. Zeichner said. “We are now gaining a greater understanding of how it works.”

It has been widely accepted as a prebiotic for gut health, but data suggests benefits for the skin too. It can increase skin hydration, decrease skin pH, and improve microbial diversity. In addition to anti-inflammatory and skin soothing properties, colloidal oatmeal exhibits prebiotic benefits to enhance growth of healthy bacteria on the skin.

He summed up the main takeaway clinicians need to keep in mind about beneficial bacteria for skin care.

“We know that a diverse microbiome is associated with skin health, and overgrowth of abnormal bacteria is associated with skin disease,” Zeichner said. “Addressing the microbiome is an important part of treating skin disease, along with traditional moisturizers and anti-inflammatory products.”


Zeichner, J. 2018. Fall Clinical Dermatology Conference, Las Vegas. October 18, 2018. Microbiome and the skin


Aries, MF. Anti-inflammatory and immunomodulatory effects of Aquaphilus dolomiae extract on in vitro models. Dove Medical Press. May 19, 2016.