Probiotics promise a cure for seborrheic dermatitis!

Seborrheic dermatitis (SD) is often seen as a condition that should be treated locally, directly at the surface. On this blog we have discussed a number of such treatments: sea salt, selenium sulfide (in Selsun), zinc oxide and zinc sulfate (in Avene Cicalfate), zinc pyrithione (in DHS Zinc Shampoo), and piroctone olamine (in Sebclair/PromiSeb).

These products can definitely be very efficient and many people have reported great results. However, products applied topically (on the surface of the skin) only affect the top layers of the skin. And, as we know, those layers are shedding away constantly. To achieve positive and permanent improvements, the skin needs to be affected from the inside.

Probiotics are live microorganisms which can internally initiate the healing of the skin. Here is a testimonial from someone who cured his SD by consuming probiotics in home-made kefir:

I had been suffering from moderate eczema (seborrheic dermatitis) on my scalp for 5 years. I was fed up with topical medications, and was looking for alternative treatments when I read somewhere that probiotics can help. The problem with probiotic pills is that there are a lot of brands where the probiotic is not strong and there are only 2 or 3 species of bacteria in them. They also have to be stored at certain temperatures, which is also why some of the products you buy may not help because they simply contain dead bacteria, but you just don’t know unless you test it.

So I decided to make my own milk kefir, and started drinking it every morning, and guess what, my eczema completely disappeared within 2 months. I could only tell it was getting better after 3 weeks and at 1.5 months it was barely noticeable. At 2 months it was just gone. I haven’t had any eczema for a year now. Also, if you buy kefir from the supermarket, just don’t expect it to help if at all.

Reproduced from here.

Bacterial and fungal populations colonising the skin

Seborrheic dermatitis is known to be a consequence of an overgrowth of a fungus/yeast called malassezia. However, a scientific study from 2013^​1​ has shown that skin affected by SD not only had a higher incidence of malassezia, but also a significantly larger population of a bacteria strain called staphylococcus epidermidis. At the same time the population of propionibacterium acnes was considerably lower on SD affected skin than on healthy skin.

The graph below compares the microflora on healthy skin (left) to the microflora on skin affected by SD. The red color corresponds to staphylococcus and the blue color corresponds to propionibacterium.

Staphylococcus and propionibacterium have a co-dependent relationship. That is, if one population increases, the other decreases, and vice versa. Thus, in theory, one could create conditions on the skin to encourage the growth of propionibacterium. As a result, the population of staphylococcus (which correlates with SD incidence) would automatically decrease. This could lead to a complete cure of SD!

How does one encourage the growth of propionibacterium? Luckily for all SD sufferers, scientists from Nestlé and L’Oréal have found a probiotic which exhibits this effect^​3​. This probiotic is known as Lactobacillus paracasei or ST11. Note that before the Nestlé/L’Oréal study, another study^​4​ has shown that lactobacillus paracasei ST11 also inhibits skin inflammation.

The Nestlé/L’Oréal study

The Nestlé/L’Oréal study^​3​ was conducted in 2016 and had the following set-up: 60 individuals with SD and/or dandruff were recruited. Participants were randomly divided into two groups. One group received a pill of lactobacillus paracasei ST11 every day. Another group received a placebo. After 56 days of use 85.7% of participants (see graph below) taking the lactobacillus paracasei ST11 probiotic reported a significant (moderate to good) improvement in their SD and dandruff. A small group (3.6%) even reported total healing! How amazing is that?!

How probiotics cure SD

Scientists hypothesize that ST11 triggers the release of cytokines into our blood stream. Cytokines are a type of immune cell involved in the growth of keratinocytes – cells responsible for forming a healthy skin barrier. This mechanism is often referred to as the gut-skin axis: your gut health impacts your skin health. Once the keratinocytes have built a healthy skin barrier, dryness and irritation decrease and hydration (water content) is restored. And, as shown in this study^​2​, propionibacterium “love” water. As a result, propionibacterium can favorably grow.

Where can I find probiotic lactobacillus paracasei?

Together, L’Oréal and Nestlé have launched the product Santé capillaire DS containing the lactobacillus paracasei ST11. Unfortunately, they stopped the production some months ago. Therefore, it may be difficult to find the original product on the market. However, you can find the lactobacillus paracasei in other probiotics.

Hyperbiotics PRO-15 Advanced Strength Probiotics
The 15 strains that Pro-15 contain are as follows: L. Acidophilus, L. Plantarum, L. Fermentum, B. Infantis, L. Casei, B. Longum, L. Rhamnosus, B. Lactis, L. Reuteri, L. Salivarius, L. Paracasei, L. Gasseri, B. Bifidum, B. Breve, S. Thermophilus.
The formula contains 5 Billion CFU over 15 strains of probiotic including lactobacillius paracasei. The probiotic organisms in this formula are released over an 8-10 hour period. In this way, they bypass your stomach acids and reach deep into your intestinal tract alive so you can experience the benefits that probiotics have to offer. Based on this, Hyperbiotics claim that their 5 Billion CFU is actually like taking 75 billion CFU.

Raw Probiotics Ultimate Care
This 100 billion CFU probiotic supplement includes lactobacillus paracasei as one of the 34 different strains.

Visbiome – High Potency Probiotics, 112.5 Billion CFU Live Bacteria, 60 Capsules
Visbiome is a high potency probiotic medical food, containing 8 strains of live bacteria in a concentration of 112.5 billion (112.5 x 10^9) bacteria per capsule.
Live Ingredients: Lactobacillus acidophilus DSM24735, Lactobacillus plantarum DSM24730, Lactobacillus paracasei DSM24733, Lactobacillus, delbrueckii subspecies. bulgaricus DSM24734, Streptococcus thermophilus DSM24731, Bifidobacterium longum DSM24736, Bifidobacterium breve DSM24732, Bifidobacterium infantis DSM24737. Inactive ingredients: Cornstarch.

[UPDATE November 2021] While the above products contain lactobacillus paracasei, they do not explicitly state the presence of the specific ST-11 strain. Recently, a reader of the post (thanks Matteo) suggested two products that are known to contain the specific ST-11 strain:

Douglas laboratories skin probiotic
Each serving size (1 vegetarian acid-resistant capsule) contains: Vitamin A (as beta-carotene) 2350 mcg, Astaxanthin (Haematococcus pluvialis algae extract) 4 mg, Lycopene 2.5 mg, Lactobacillus johnsonii (La-1) 1 Billion CFU, Lactobacillus paracasei (St-11) 10 Billion CFU. Other ingredients: Capsule (hydroxypropyl methylcellulose, pectin, glycerol, purified water), microcrystalline cellulose, ascorbyl palmitate, hydroxypropyl cellulose.

Dr. formulated probiotics platinum skin
Ingredients: Vitamin A (as beta-carotene), Lycopene, Skin+ Probiotic Blend [Bifidobacterium lactis, Bifidobacterium bifidum, Bifidobacterium infantis, Lactobacillus paracasei, Lactobacillus plantarum, Lactobacillus johnsonii La-1®, Lactobacillus bulgaricus, Lactobacillus paracasei St-11, Lactobacillus acidophilus, Lactobacillus reuteri, Lactobacillus casei, Bacillus subtilis 5 Billion CFU], Other Ingredients [Organic Potato Starch, Organic Acacia Fiber (A. senegal), Non-GMO Vegetable Cellulose (capsule)].

Additional reading

https://rosaceagroup.org/The_Rosacea_Forum/showthread.php?38233-Probiotics-for-Skin-Seborrheic-Dermatitis-Dandruff-amp-Rosacea

https://simpleskincarescience.com/probiotics-for-skin/

https://www.dandruffdeconstructed.com/can-probiotics-cure-dandruff