In a previous post we have discussed probiotics (bacteria living in our gut) as a promising treatment for seborrheic dermatitis. That post mainly focused on the l. paracasei bacterium and its positive effects. In this post I want to briefly discuss a recent study1 that shows that oral ingestion of another probiotic, known as Escherichia coli Nissle, is very effective for treating seborrheic dermatitis.
Facial dermatoses, including seborrheic dermatitis, are often associated with gastrointestinal diseases2. The mechanism by which intestinal diseases induce skin issues is not known. It is known however that intestinal-borne dermatoses are accompanied by a shift of gut bacteria population towards more aggressive types. Due to their potential to invade the mucosal barrier (leaky gut syndrome), they activate the immune system. The immune cells then attack the affected areas of the skin and cause seborrheic dermatitis.
The above mentioned study1 argues that E. coli Nissle may have an impact on the functionality of the mucus barrier. The production of short-chain fatty acids increases the nutritional state of the mucus and its capability to absorb water and sodium. Because the mucosal barrier is strengthened, pathogens cannot easily penetrate and, thus, the E. coli Nissle application prohibits systemic activation of the immune system (which was, in the first place, the hypothesized cause of intestinal-borne dermatoses).
Experiment and results
The study recruited 57 patients that suffered from various skin conditions. Out of them, 22% were diagnosed with acne, 36% with rosacea and 57% with seborrheic dermatitis. The patients were divided into two groups. The ‘probiotics’ group (the EA group in the figure), consisting of 37 patients, were randomized to receive a daily oral probiotic supplement with E. coli Nissle. The ‘placebo’ group (the CA group in the figure), consisting of the remaining 20 patients, were given a placebo. After one month, in the probiotics group (EA), 32% showed recovery and 57% significant amelioration, whereas in the placebo group (CA) only 17% revealed recovery and 39% significant amelioration (see figure below).
In conclusion, E. coli Nissle was demonstrated to be very effective to treat seborrheic dermatitis (next to other skin diseases). It shows good tolerability and no adverse events. The mechanism of action is based on the change of the intestinal microbiota towards less aggressive bacteria. This in turn ameliorates the immune response characterized by a reduced inflammation of the skin lesions.
Dosage
E. coli Nissle is commercially available under the brand Mutaflor. The patients that participated in the experimental study have consumed 1 capsule of Mutaflor daily for the first 4 days, followed by 2 capsules daily for one month. One capsule of the E. coli Nissle 1917 contained 2.5 – 25 × 109 live bacteria (CFU).
Additional reading
https://daringmigration.com/proven-leaky-gut-supplements/
- 1.Manzhalii E, Hornuss D, Stremmel W. Intestinal-borne dermatoses significantly improved by oral application of Escherichia coli Nissle 1917. World J Gastroenterol. 2016;22(23):5415-5421. doi:10.3748/wjg.v22.i23.5415
- 2.Fölster-Holst R. Probiotics in the treatment and prevention of atopic dermatitis. Ann Nutr Metab. 2010;57 Suppl:16-19. doi:10.1159/000309054
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seborrheic dermatitis
This is such an interesting idea! I never would have thought a probiotic could have autoimmune implications. Excited to see where the research goes.
Doug Cragoe
It’s now late 2025. You have mentioned 2 specific strains that have been shown to help with seborrheic dermatitis in your articles from several years ago. Mutaflor used to be sold by Amazon. Now it is not available. A few firms sell it but cannot guarantee how effective it will be once it gets a bit warm during the delivery. One says leave out a cooler for the delivery service to put it in.
In your article on Lactobacillus paracasei NCC2461 ST11 the original manufacturers of skin products with this in it no longer sell those products. A follow up addition to the article mentioned 2 that for sure had this probiotic, but both of them stopped selling their products. Thus, there are no known manufactures with this probiotic in their skin care formula.