Probiotics are supposed to clear up your skin…right? Not always. Warning: probiotics can cause skin breakouts. Especially if these 5 causes of skin breakouts is at play.
The (Skin) Struggle is Real
If you’re like most people, you’ve had acne or “skin issues” at some point in your life.
In fact, 8 in 10 teens have acne—often considered a “normal part of puberty.” And, even if you lived to tell about your teen acne, 1 in 2 adults also experience acne and skin breakouts in their post boy-band-loving, lip-gloss-wearing teen years.
The root cause behind skin issues? Skin health is a direct byproduct of our gut health (Salem et al, 2018).
Although many dermatologists blame acne and skin issues on hormone changes, excess oil production, topical bacteria, clogged pores and bad face wash, your skin health is an inside job.
In fact, your gut microbiome is the key regulator of the hormones that influence the blemishes on your face in the first place (Fukui et al, 2018), and excess skin oil, clogged pores or topical bacteria are often signs of inflammation and increased lipopolysaccharide (LPS) endotoxins stemming from your gut (Tulkens et al, 2018; Bowe & Logan, 2011).
The Gut-Skin Connection
The “gut-skin-” connection may sound trippy (How is your skin health related to your gut health?!), but it all comes down to understanding your immune system and your liver—both attributed to your gut.
Skin-Gut Fact #1: 80% of Your Immune System is in Your Gut.
Approximately 80-percent of your immune system is housed and produced in your gut—specifically your GALT (gut associated lymphatic tissue), which stores your T-cells and B-cells (immune cells that carry out attacks and defend against pathogens) (Wu & Wu, 2012). However, if you have a leaky gut, bacterial dysbiosis, candida or fungal overgrowth, mold or a bacterial or gut infection (parasite, Lyme, etc.), then your immune system take a hit. A complete upheaval of T-cell (immune cell) response—stemming from the gut—is a common finding in the skin of acne patients and research shows that improving gut health is a critical step toward decreasing baseline inflammation (Cazzola et al, 2010; Sardarna & Verma, 2017; Sugisaki et al, 2009).
Skin-Gut Fact #2: Your Skin is Your Largest Active Immune Organ
Your skin “microbiome” is your largest active immune organ (Guttman-Yassky et al, 2019)–responsible for defending your body against pathogens. Keeping this in mind, ever wonder why eczema (Atopic Dermatitis) is called an “autoimmune condition”? It starts in your gut—the house of your immune cells to support your immune system (Lee et al, 2018).
Skin-Gut Fact #3: Your Liver—Part of Your Gut—Detoxes Toxins (Sometimes Through Your Skin)
Your liver is also part of your gut health, and by default your skin health. As your body’s “master detoxifier,” your liver is a key accessory organ during digestion that filters and detoxes every single nutrient you eat, and toxin you ingest or inhale. These toxins often are excreted through your stool, your urine, your sweat and pores in a very natural way. However, if your liver is overburdened or unable to do its job of breaking down toxins efficiently, toxins must be eliminated from your body by other means – in some cases they come out through your skin! Your liver is also responsible for balancing and clearing out any excess hormones—especially cortisol and estrogen. But, again, if your liver is also overburdened or unable to do its job effectively, hormone “imbalances” can arise…sometimes through your skin! This is often why doctors cite “hormone changes” or imbalances as a key trigger for skin problems.
Put all of three of these gut-skin connection facts together, and, voila! You can see how gut imbalances, immune imbalances and/or liver imbalance issues can also be reflected on your skin. In short: if your gut health, immune system and/or liver are “off”, then inflammatory immune response (via your skin) is more likely.
Probiotics for Better Skin Health
So obviously, if your skin health is related to your gut health, then improving your gut health is a no brainer, right?!
Bring on the probiotics!
The health community rants and raves about the benefits of probiotics—and there’s no doubt that probiotics do some wonderful things for your body and health.
Probiotics are “good gut bacteria” that act like gasoline in a car—when you take them they help “fill your gut ecosystem tank” with bacteria that aid in nutrient absorption, digestion and elimination of wastes and toxins.
In fact, several studies sing praises about using probiotics for better skin health.
Survey Says: Skin-Probiotic Studies
- Research shows that Lactobacillus reuteri 100–23—commonly found in many probiotic formulas— stimulates anti-inflammatory cytokines, such as interleukin (IL)-1, fighting off inflammatory cytokines behind skin breakouts (Livingston et al, 2009).
- B. coagulans—a popular probiotic in “soil based” supplements prevents the formation of stress-induced reactive oxygen species (ROS) that are high in acne (Bowe & Logan, 2010)
- SIBO (small intestinal bacterial overgrowth) is 10 times more prevalent in those with acne rosacea vs. healthy controls, but correction of SIBO however leads to marked clinical improvement in patients with rosacea (Parodi et al, 2008); and, contrary to popular belief, taking probiotics has proven beneficial in the reduction of SIBO (Barrett et al, 2008).
- Patients who take probiotics with antibiotics for acne—compared to patients who just take antibiotics alone—experience a significantly greater reduction of acne over a 12 week period (Jung et al, 2013)
- Glucomannan (konjac root), a prebiotic, in conjunction with probiotics (specifically Lactobacillus casei NCFB 161, Lactobacillus acidophilus NCFB 1748, Lactobacillus plantarum DSM 12028, Lactobacillus gasseri NCFB 2233) inhibit the growth of acne (Al-Ghazzewi & Tester, 2010).
However, although the research on probiotics and improved skin health sounds promising, what’s going on if you take a probiotic, and you start to break out?!
Here are 5 Reasons Why Probiotics Cause Skin Breakouts.
5 Reasons Why Probiotics Cause Skin Breakouts
Skin Breakout Reason #1: You Are Taking a Bad Probiotic
95% of probiotics do not contain the probiotics they claim on the label. In other words: most probiotics on store shelves are toilet flushers. This is due to a few reasons:
(1.) Many probiotic formulas are not designed to survive stomach acid, bile acids and digestion; very few companies formulate probiotics with a special capsule or prebiotics (a “synbiotic”) to help the probiotic make it to your colon—where the majority of probiotics belong. The result? Malabsorbed probiotic species in your upper GI (hello SIBO?).
(2.) Many probiotics are unstable and do not survive manufacturing itself due to high heat or poor processing practices. The CFU counts on a majority of probiotic labels represent the amount of probiotics that were in the formula before manufacturing, not after.
(3.) Most probiotics don’t specify the strain being used on the label. A probiotic strain is like the specific type of probiotic species in the formula. For example, Lactobacillus casei NCFB 161 is a probiotic strain that prevents acne (Al-Ghazzewi & Tester, 2010), whereas Lactobacillus casei TISTR 389 is a strain from the same species that over activates the immune system and may cause acne (Priyadarshani & Rakshit, 2011).
Skin Breakout Reason #2: You Have SIBO, Dysbiosis or Candida
Small intestinal bacterial overgrowth (SIBO) or yeast overgrowth, like candida, can inhibit the absorption and transit of probiotics to your lower GI (colon) where they belong. Additionally, if you have SIBO, dysbiosis or candida, certain probiotics may be synonymous to the species you already have in high abundance your gut, further exacerbating dysbiosis, bacterial overgrowth and consequently skin flares and breakouts.
Ever wonder why doctors sometimes prescribe antibiotics to help “cure” acne? Antibiotics kill bacteria and fungi—both good and bad bacteria. And much of that bacteria stems from your gut, like SIBO, dysbiosis and candida (even if your dermatologist doesn’t realize it). The “effectiveness” of antibiotics in skin issues goes to show that there is something to do with bacteria imbalances in the body—namely your gut. However, be warned: antibiotics are only a band-aid h to put acne into remission. In the long term, they actually kill off a vast amount of healthy gut bacteria for better gut and skin health.
Skin Breakout Reason #3: You’re Experiencing a Healing Reaction
“Healing reactions” or “HERX” reactions are side effects or symptoms that can arise when starting a new supplement, food or a detox habit.
When you begin taking a (quality) probiotic, in conjunction with a nutrient rich diet, you may begin experiencing big shifts inside your gut microbiome (Fact: your gut microbiome can rapidly change in as little as 3 days (David et al, 2014).
In turn, this “shift” in your internal ecosystem can also trigger a reshifting, die off or removal of unhealthy gut bacteria. Inflammatory bacteria rise to the surface of your skin.
Skin Breakout Reason #4: You’re Missing Pre-biotics
Probiotics are useless without prebiotics. Prebiotics are fiber—found in foods, supplements and some probiotic formulas—that serve as food for your probiotics. If you take probiotics without prebiotics, it’s like pouring water pouring water into a bottomless vase. Sure you can briefly water the flowers with a little bit of water when you pour it on, but the water never sticks around to keep the flowers hydrated from their roots. Probiotics don’t stick in your gut without food (prebiotics) to feed them. Adding a probiotic into the mix without a prebiotic won’t significantly alter or shift your biome. Partially hydrolyzed guar gum, glucomannan and beta glucans help soothe and calm irritated skin.
Skin Breakout Reason #5: You Need to Support Your Detox Pathways
If your skin is breaking out, your liver is screaming, “support me!”
The liver is a hub for removing toxins from the blood and plays an important role in the body’s processes for converting food into energy. Since it is “downstream” of the gastrointestinal tract in the digestive process, it makes sense that the composition of bacteria in the gut can affect the function of the liver.
Consequently, as you “shift” your gut biome with probiotics, you can shift your liver—kicking it into turbo “detox”—seeking to excrete and eliminate toxins through its various detox pathways. Your skin is one of 7 primary “detox” pathways in your body by which your body releases toxins—along with your bloodstream, lymph system, lungs, kidneys, colon (poo) and liver. Hence, skin breakouts are often merely a sign that your liver is working hard.
The good news? You can support your liver to calm down inflammation. Some liver loving tactics include:
- Eating 2-3 cups of dark leafy greens daily
- Drinking celery juice on an empty stomach
- Dandelion and stinging nettle tea
How to Choose the Best Probiotic for Your Skin
Given the fact that the majority of probiotics do NOT contain the supportive bacteria they claim…which probiotic should you get?!
Here are 3 essentials to find the best probiotic for you:
Essential #1: Look for Probiotic Strains on the Label
A complete probiotic name includes the Latin name for genus and species, and, ideally, the strain name: for example, Lactobacillus rhamnosus GG or Lactobacillus rhamnosus GR-1.
Many probiotics don’t include the strain in their formula, which is a red flag–since not all probiotic strains are equal.
For example, Lactobacillus rhamnosus GG is ideal for skin conditions (eczema, dermatitis), IBS and beneficial in the prevention of antibiotic-associated diarrhea, while Lactobacillus rhamnosus GR-1 is best for vaginal and urethra health.
Essential #2: Look for Clinical Trials
Is it tested? Third-party validated–not just tested by the company? If so, this is a winner, winner chicken dinner!
Essential #3: Look for the “Survivability” Factor
Many probiotics don’t survive the acid and bile of the stomach and intestine. Quality probiotics take this into account and demonstrate survivability through digestion.
Ideally, the supplement will specifically list the CFU counts (in billions) at the time after manufacture (not before) and may even include a “symbiotic” (pre-biotic fiber) or special, additive-free gel capsule to transit the upper GIi to make it to the colon (where the majority of your probiotics belong).
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