Should You Be Taking Probiotics for Acne?

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There's really no better way to put it: Acne freaking sucks. You're not alone if you've incessantly Googled the best spot treatments or slathered your face with countless creams, serums, and other topical acne-reducing products, and no matter how much you've been cautioned against it, you've probably picked at or popped some of your most gnarly zits.

There is no one-size-fits-all approach when it comes to treating acne. Recently, however, there's been some buzz around how good belly bacteria might be the long-awaited solution to clear skin. And that's why seemingly more and more dermatologists are recommending probiotics to patients since these tiny microorganisms are practically the heroes of gut health.

But can a balanced gut microbiome really benefit your face? Here's everything you need to know about the skin-gut connection to beat your breakouts for good, according to a dermatologist.

What Causes Acne?

"A bacteria called Propionibacterium acnes (P. acnes) is usually the culprit behind acne development," says Michelle Henry, M.D., a board-certified dermatologist and founder of Skin & Aesthetic Surgery of Manhattan. Studies show that the presence of P. acnes in the pores can trigger an immune response that causes inflammation that leads to breakouts. (Related: Why You're Breaking Out, According to a Derm)

Other triggers include hormones, which often lead to overactive oil glands that clog your pores and lead to breakouts, explains Dr. Henry. "Hormonal surges are the reason why we see acne in teens going through puberty as well as in women on their periods," she adds.

Finally, you can also blame your acne-prone skin on plain old genetics. While there's no specific "acne gene," per se, there are genetic components that can make you more susceptible to acne, says Dr. Henry. An example of that might be a parent who passed down a hormonal condition such as polycystic ovary syndrome, which increases the chances of developing acne, or a parent who's particularly sensitive to bacteria, which leads to inflammation that often results in acne.

What Are Probiotics, Again?

Probiotics are live microorganisms (e.g. bacteria) that can maintain or improve the growth of good bacteria in the body when consumed through, for example, fermented foods, yogurt, or dietary supplements, according to the Mayo Clinic. And while you're technically born with a whole bunch of probiotics, certain factors such as poor diet and the use of antibiotics can reduce the amount you have in your body.

"Antibiotics are anti-inflammatory, which is why we often use them in dermatology to treat conditions like acne and rosacea," she explains. "But antibiotics don't differentiate between good and bad bacteria in the gut, and often destroy both. This causes an imbalance in the gut and can lead to [patients] developing digestive issues and yeast infections during treatment. Probiotics can help restore balance by reintroducing more good bacteria and reduce some of those symptoms."

These little bugs work primarily in the gastrointestinal tract, where they can positively impact your gut microbiome and, in doing so, help protect your GI tract from an overgrowth of harmful microorganisms as well as improve your digestion and gut function, according to the National Institutes of Health. In addition to keeping your GI system in check, probiotics can also provide a myriad of other health benefits, including (but not limited to) improving your mood, boosting your immunity, and promote healthy skin function.

How Can Probiotics Help with Acne?

"The more good bacteria you have, the more likely it is to suppress bad bacteria," shares Dr. Henry. And while, yes, too much of a good thing — including good bacteria — can lead to some issues (think: bloating, nausea, constipation), too much bad bacteria can also wreak havoc on your health. "Imbalances of bad bacteria lead to inflammation throughout the body which can lead to a series of health problems that can eventually present as acne on your skin," she says. (Related: What Your Gut Says About Your Health)

Essentially, probiotics help establish a healthy balance of microbiota (aka good and bad microbes), which, in turn, can potentially promote clearer skin. So, they act as the catalyst in a waterfall of beneficial health outcomes.

While the gut-skin interface is something that experts are still studying, more and more studies show that the two are deeply connected, notes Dr. Henry. For instance, when you experience issues with your gut — whether that be a bacterial imbalance, inflammation, or even simple digestive issues (e.g. constipation, diarrhea, gas) — you might very well notice a change in your skin as well. In fact, a 2021 study suggests that irritable bowel syndrome is "significantly more common" in patients with acne than those without. What's more, the severity of acne in those with IBS was higher or worse than in healthy participants. Dr. Henry also points out that stomach complications such as small intestinal bacterial overgrowth — which occurs as the result of an abnormal increase in the overall bacterial population in the small intestine — can often lead to flares in rosacea (a skin condition that causes redness, skin bumps, and broken blood vessels). That said, while these examples clearly show there's some kind of relationship between tummy troubles and skin conditions — more research still needs to be done to determine whether one actually causes the other.

"The less inflamed your skin is, the less likely you are to develop inflammatory skin conditions like rosacea, eczema, psoriasis, and even acne," she adds. "Since probiotics improve gut health and help soothe inflammatory digestive issues, they, in turn, [can] reduce the inflammation of the skin barrier [the outermost layer of skin responsible for keeping pollutants or foreign pathogens out and moisture in] and allow it to function optimally, which can [also] keep acne at bay."

Should You Take Probiotics Supplements for Acne?

While most people should be able to add probiotics to their regimen without any issues, there's always the possibility of a reaction when trying a new supplement, explains Dr. Henry. That's why it's always best to consult your own doctor before adding any new supplements to your routine, as they're familiar with your medical history and can help you determine what probiotic would be best for you and your symptoms. (See also: Are Dietary Supplements Really Safe?)

In general, though, "you can take an oral probiotic daily, just like you would a daily multi-vitamin," says Dr. Henry, who frequently recommends oral probiotics to patients who are taking antibiotics for skin conditions such as acne, eczema, or rosacea to encourage the balance of good and bad bacteria. Probiotics are also "great to use for acne prevention and other anti-inflammatory conditions," because they keep the bacteria balance in check and steady, she adds.

When it comes to oral probiotics, Dr. Henry suggests any over-the-counter supplement that contains Lactobacillus, which is a type of "good bacteria" found in the gut and urinary tract. Her go-to is Garden of Life's Dr. Formulated Probiotics Once Daily Women's (Buy It, $27, amazon.com). "I love it because it touts 50 billion elements of 16 probiotic strains," she says. And while there's nothing necessarily wrong with trying a single-strain probiotic, some experts believe that "more strains imply more chances of success," and "a broader spectrum of efficacy" thanks to the increased diversity of bacteria in the product, according to a 2018 scientific review.

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What About Using Topical Skin-Care Products with Probiotics?

You'll be happy to know that probiotics can be equally effective in treating acne when applied topically, according to Dr. Henry. Topical probiotics work by calming the skin barrier and encouraging good bacteria to flourish. This, again, reduces inflammation and allows your skin barrier to fight against acne-causing environmental pathogens. "I usually recommend them to [acne] patients who don't want to use topical antibiotics and would rather try a more holistic approach," she shares. "But anyone who's struggling with breakouts and acne can try topical probiotics to improve their skin" — just remember to chat with your derm first before slathering, say, a microbiota-rich moisturizer all over your face.

Some of Dr. Henry's favorite probiotic skin-care picks include Mother Dirt's Probiotic Face Wash (Buy It, $24, amazon.com), Biossance's Squalane + Probiotic Gel Moisturizer (Buy It, $52, amazon.com), and Elizabeth Arden's SUPERSTART Probiotic Boost Skin Renewal Biocellulose Mask (Buy It, $67, elizabetharden.com). "These companies have proven that their products work, which is why I recommend them to patients," she says. For these topical probiotics to be most effective, Dr. Henry recommends applying them right after washing your face and before applying anything else to your skin, such as a serum or night cream. (Related: The Exact Order to Apply Your Skin-Care Products)

Results will vary from person to person, but Dr. Henry recommends giving the new regimen — whether that includes an oral or topical probiotic — four to six weeks to see if it's working. "The effectiveness of probiotics depends on the amount of inflammation you have," she says.

Bottom Line On Probiotics for Acne

To reiterate JIC: Acne can be a bitch. Breakouts can stubbornly stay put on your face (or body!) no matter how many topicals or orals you might try. But probiotics — be it in the form of a supplement or a serum — might be just what you need to finally bid breakouts adieu. After all, as Dr. Henry puts it: "There's no harm in trying."