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By Sabra Way (bio below)
Can probiotics help eczema? Which kind should you take? Should it be Lactobacillus paracasei or Lactobacillus fermentum? What are CFU’s (colony forming units) and how long should you take them?
Let’s look at a few studies using probiotics and eczema to really understand if probiotics can help eczema!
Can probiotics help eczema? Check out the proof in clinical trials:
One of the longest studies about probiotics and eczema (1) has been following a group of high risk children from womb to 6 years of age. Either one or both of the parents had a history of treated asthma, eczema, or hay fever. In this double blind randomized placebo-controlled trial, two strains of probiotics were given, but one strain in particular was found to reduce the prevalence of eczema.
Women from the 35th week of pregnancy were divided to receive a probiotic (Lactobacillus rhamnosus (HN001 6 billion CFU/day), a Bifidobacterium animalis subsp lactis (HN019 9 billion CFU/day)) or a placebo. Treatment continued to birth and breastfeeding until the infant was 6 months old. All children were given Lactobacillus rhamnosus or Bifidobacterium animalis from birth to the age of 2 years. Eczema prevalence in the Lactobacillus rhamnosus group was significantly reduced, as well as: nasal congestion, runny nose, sneezing and red eyes (rhinoconjunctivitis).
In fact, there was a whopping 50% reduction in eczema prevalence in the Lactobacillus rhamnosus group! At 2 years the probiotics were discontinued and children were revisited at age 6 (2). The effects were still measurably positive. Even four years after ceasing the Lactobacillus rhamnosus supplementation, this group of children showed a significantly lower prevalence of eczema and skin prick test sensitization. The research team concluded that the use of Lactobacillus rhamnosus might be an appropriate preventative for eczema in high risk children.
In an another randomized, double-blind, placebo-controlled study (3), 118 children (ages 1-13) with eczema were given Lactobacillus plantarum CJLP133 at a dosage of 5 billion CFU twice a day for 12 weeks versus placebo. The extent and severity of their eczema was measured and the probiotic group had much greater improvement with eczema symptoms.
In fact, the affected area healed along with redness, oozing, scratching, skin thickening and dryness. In addition blood eosinophils were measured (there is an association between total eosinophil count in the acute exacerbation phase of atopic dermatitis) and it showed there was a reduction in disease activity in the probiotics group. There was no follow-up done with the group. The benefits were only observed during the supplementation period and did not persist when the supplements were stopped.
In our previous post probiotics for eczema in children, a double-blind, prospective, randomized placebo-controlled study was conducted on 220 children (ages 1-18 years) with moderate atopic dermatitis (4). The children were given Lactobacillus paracasei GMNL-133, Lactobacillus fermentum GM-090 (2 billion CFU/day), a combination of the two (4 billion CFU/day) or a placebo.
After three months, eczema symptoms in all the probiotic groups was reduced, and the effects lasted another month without probiotic supplementation. The probiotic also improved quality of life (like sleep, symptoms, feelings and activities affected by their skin). Atopic dermatitis improved especially in children younger than age 12, who had breastfed longer than six months.
If probiotics can help eczema, what should you look for in a supplement?
Keep in mind that several variables can have an effect on probiotics supplementation such as antibiotic use, diet, place of birth, siblings, pets in the home, gender and mode of delivery (C-section, vaginal, home or hospital) (5).
There is no strain that is right for everyone.
Please remember, before starting any supplement, it’s always best to discuss treatment with your physician or naturopath. With regard to probiotics specifically, speak with them to determine which strain and dose is best for you.
If you’re interested in learning more about the probiotic strains that were used in these studies, you can ask your physician about a supplement that contains at least 1-2 of these strains:
- Lactobacillus rhamnosus
- Lactobacillus plantarum CJLP133
- Lactobacillus paracasei
- Lactobacillus paracasei GMNL-133
- Lactobacillus fermentum
- Lactobacillus fermentum GM-090
How many probiotic CFU should you take when treating eczema?
This is best to discuss with your physician; however, all the studies referenced above used 5-6 billion CFU once or twice a day for at least 3 months. Generally 5 billion CFUs/day for children and 10 billion/day for adults are associated with more significant study outcomes. There is no evidence that higher doses are unsafe (6). Most probiotic supplements list the CFU’s or colony forming units on the label. A colony forming unit is a bacteria/yeast that is capable of living and reproducing to form a group of the same bacteria/yeasts.
According to Dr Natasha Campbell-McBride, author of Gut and Psychology Diet.
- An adult should have around 15-20 billion of bacterial cells per day
- An infant up to 12 months of age can have 1-2 billion of bacterial cells per day
- A toddler 1 to 2 years of age can have 2-4 billion of bacterial cells per day
- A child 2 to 4 years of age can handle 4-8 billion of bacterial cells per day
- A child 4 to 11 years of age can have 8-12 billion of bacterial cells per day
- A child 12 to 16 years of age can have 12-15 billion of bacterial cells per day
More on the GAPs diet:
How long should you take probiotics when treating eczema?
The studies mentioned here supplemented with probiotics for at least 12 weeks and one for 2 years. If you are going to start probiotics, you need to be prepared to commit 1-3 months, at least. Longer periods of supplementation seem to confer greater benefit long term even when the probiotics are discontinued. Make sure to to work with a physician to determine the best length of time for your particular case.
Probiotics can be quite expensive, so you can also supplement your diet with naturally fermented foods. Most health food stores have a selection of fermented vegetables (kimchi, pickles, grated vegetables such as carrot and beet), dairy products (yogurt, kefir) and beverages (kombucha) but you can make them yourself for a fraction of the cost. Find some great recipes in this book. Keep in mind that if your child is consuming lots of sugar, grains and fruit juices, probiotics will not be as effective. The sugars from an unhealthy diet feed pathogenic bacteria which would compete with the good bacteria you would be supplementing with.
Internal health is critical when it comes to healing eczema, but it can take a long time. If you need quick relief check out these posts:
Bio: Sabra Way is a Medical Herbalist and a member of the National Institute of Medical Herbalists. She writes about herbal and complementary medicine and how it can heal the body when used effectively. An avid reader, she scans medical journalslooking for studies that have an impact on complementary medicine. She is the editor of Galen’s Watch; a journal watch focused on complementary and alternative medicine for complementary health practitioners to stay up-to-date with the latest studies. You can find her on Facebook, Twitter, and her website.
- A protective effect of Lactobacillus rhamnosus HN001 against eczema in the first 2 years of life persists to age 4 years. https://www.ncbi.nlm.nih.gov/pubmed/?term=22702506
- Early supplementation with Lactobacillus rhamnosus HN001 reduces eczema prevalence to 6 years: does it also reduce atopic sensitization? https://www.ncbi.nlm.nih.gov/pubmed/?term=23957340
- A randomized trial of Lactobacillus plantarum CJLP133 for the treatment of atopic dermatitis. https://www.ncbi.nlm.nih.gov/pubmed/?term=23050557
- Children with atopic dermatitis show clinical improvement after Lactobacillus exposure. https://www.ncbi.nlm.nih.gov/pubmed/25600169
- Early-Life Events, Including Mode of Delivery and Type of Feeding, Siblings and Gender, Shape the Developing Gut Microbiota. https://www.ncbi.nlm.nih.gov/pubmed/?term=27362264
- Probiotics https://www.aafp.org/afp/2008/1101/p1073.html