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Using Probiotics for Acne & Skin Health: All You Need to Know

Written by Dr. Michael Ruscio, DC on April 28, 2025

Written by Dr. Michael Ruscio, DC on April 28, 2025 — Reviewed by Hilary Watts

• The Gut-Skin Axis|
• How Your Gut Microbiota Impacts Acne|
• Probiotics for Acne|
• Oral Probiotic Benefits|
• Topical Probiotic Benefits|
• The Best Probiotics for Acne|
• Can Prebiotics Treat Acne?|

What the Gut–Skin Axis Means for Acne

Acne and other blemishes on the skin are distressing, no matter your age. As someone who suffered from acne, I can attest to the frustration I felt from the lackluster results that common treatments offer. 

Dermatologist-prescribed treatments typically include expensive topical ointments or long-term antibiotics that can have negative side effects, including harming the gut and the immune system 1. Some treatments target specific bacteria, others target hormones, and others reduce oils in your skin. 

Acne may result from multiple factors, including:

• Stress
• Environmental toxins
• Inflammation
• Genes
• Hormones
• Skin care products

That means finding a treatment that addresses these causes upstream can often lead to better results 2. Thankfully, there is a way to shift several of these factors in your favor at the same time—improve your gut health.  

It is often said that the skin is a reflection of the gut. Current science reflects this sentiment as its recognition of the “gut-skin axis” grows. As you may have guessed, the gut-skin axis simply means there’s a powerful link between the gut and skin 3. Just like with the “gut-thyroid” and “gut-brain” connections, researchers and clinicians like me are seeing just how effective targeting the gut is in relieving body-wide symptoms. 

How Your Gut Microbiota Affects Acne

Your gut is home to trillions of microbes—bacteria, viruses, fungi, and more—called the microbiota. This cast of characters plays a surprisingly powerful role in your overall health. Collectively known as the gut microbiome, this diverse ecosystem can influence your digestion, immune system, mood, and skin. 

When the gut microbiome is out of balance—a state known as dysbiosis, when harmful microbes outnumber helpful ones—it can trigger body-wide inflammation, disrupt nutrient absorption, and impair detoxification. These internal problems may show up on your skin as acne, rosacea, dryness, or irritation.

Before we dive into the ways probiotics can benefit your gut and therefore skin health, it’s important to note that building a proper gut health foundation doesn’t just mean taking probiotics—it means first finding the gut-healthy diet that feels best to you. After this step, probiotics can round out that healthy foundation and are more likely to show benefit. 

If you are just getting started on your gut-healing journey, my free Gut Reset Guide is a great place to start. 

The Role of Probiotics for Acne & Healthy Skin

Probiotics—those friendly bacteria you get from supplements or fermented foods—are well-researched for gut health. They can help balance your gut microbiome, the ecosystem of microbial life that lives in your digestive tract and contributes to good digestion and a healthy immune system.

When it comes to improving skin health, probiotics may help by:

• Reducing inflammation in the gut, which may benefit the skin via the gut-skin axis 3 
• Boosting production of short-chain fatty acids (SCFAs), the antiinflammatory compounds made when gut bacteria digest fiber. SCFAs play a part in the gut-skin axis and may help calm skin inflammation 4.
• Regulating hormones and balancing the immune system, which in turn may benefit skin health 5

It’s possible to get probiotics naturally by eating fermented foods like yogurt, sauerkraut, or kimchi. However, it’s hard to get a steady, effective dose from food alone—you’d have to eat a lot of these foods almost every day for months to notice a real benefit. A simpler option is to take a probiotic in powder or capsule form (oral probiotics) to get an effective concentration—a clinical dose—of these good bacteria.  

Another option is topical probiotics, likely as a skin care product that has probiotics added to it. The idea behind this is that our skin actually has its own microbiome. Researchers are working to recreate the success of oral probiotics by adding beneficial bacteria to the skin directly. 

Let’s see what the research says about oral and topical probiotics for acne.

Benefits of Oral Probiotics for Acne

Researchers have been hard at work studying the effects of oral probiotics for acne. There isn’t a mountain of research yet, but three randomized controlled trials show that oral probiotics can reduce acne without negative side effects. Specifically,

• In one study, half of the 40 people who took a probiotic for 12 weeks (containing Lacticaseibacillus rhamnosus and Arthrospira platensis) saw reductions in their acne, compared to only 29% of the 34 people who took a placebo 6. 
• A second study that tested Lactobacillus plantarum for acne found that 14 volunteers who took the probiotic had greater improvements in acne, skin oil balance, skin hydration, and gut bacteria than those who took a placebo 7.
• A third study found that probiotics added to standard treatment (doxycycline) was more effective than standard treatment alone for reducing acne, especially on the forehead, chin, and nose 8.

Taken together, these findings suggest that oral probiotics are a promising, well-tolerated addition to acne treatment—either on their own or alongside conventional therapies. While more research is needed, the early evidence points to real potential for improving skin from the inside out.

Benefits of Topical Probiotics for Acne

In the last few years, researchers have begun to look at the impact of applying topical probiotics to the skin. You may have also noticed an increasing number of skin care products list “probiotics” on the label. Here are a few general benefits that have been observed:

• Topical probiotics may reduce the number and severity of acne lesions 9 10.
• Topical probiotics may increase moisture and skin barrier function in healthy skin 11.
• Topical probiotics often have antibacterial properties and may decrease the negative side effects of other treatments 12.

It may seem strange to add more bacteria to your skin when many believe that too much of the skin bacterium Cutibacterium (formerly Propionibacterium) acnes contributes to acne 12.

However, the case is more complex than just one “bad” bacterial species. For one thing, C. acnes, one of the most common bacteria on your skin, seems to actually help the skin when its numbers are balanced 12. Therefore, removing too much of it may actually be harmful. In fact, one study showed that reducing C. acnes with antibiotics led to an overgrowth of Pseudomonas, a bacteria linked to skin infections 13.

Newer genetic testing has also revealed that there are many sub-strains of C. acnes, only a few of which may be harmful 14. So, it’s not a good idea to remove it indiscriminately.

In short, your skin and gut microbiomes are microbial systems that require balance to work well. The evidence suggests that probiotics, which help cultivate healthy gut and skin ecosystems, are effective for treating acne without the negative side effects of conventional treatments like antibiotics.

The Best Probiotics for Acne Treatment

Should you take oral or topical probiotics to treat your acne?

Topical probiotics are still very new, and human trials are limited. Some of the species clinically tested on skin are also not yet available commercially. But that situation may change as interest grows. For now, there’s likely no harm in trying a probiotic cream if you’re interested in doing so.

However, oral probiotics have an edge for three key reasons: 

1. Oral probiotics are much more extensively researched.
   There’s more evidence supporting the use of oral probiotics for skin conditions, including acne, while studies on topical applications remain more limited.
   
2. Clinically-proven probiotic strains are more accessible in oral form.
   It’s easier to find high-quality, research-backed probiotic blends in oral supplements than in topical formulas, which are still catching up to science.
   
3. Oral probiotics address internal root causes, like gut imbalances.
   Whereas topical probiotics work only on the skin’s surface, oral probiotics target gut dysbiosis and systemic inflammation, both of which are linked to acne.

So, which probiotics are best for acne? Let’s break it down.

Best Oral Probiotics

The good news about oral probiotics is that most strains will benefit your gut-skin axis by reducing gut dysbiosis and inflammation. However, when it comes to a specific blend for acne, a Lacto-Bifido blend (the most studied of all probiotics) is a safe bet.

One study found that people with acne had fewer Lactobacillus and Bifidobacterium bacteria in their guts than people without acne 15. Stress, which is linked to inflammation and acne, can also reduce levels of these beneficial bacteria. Are these things connected? Research of the gut-skin-brain axis suggests that they are 16. 

It’s likely that these beneficial probiotics played a role in the healthier skin seen in the people without acne. Adding Lactobacillus and Bifidobacterium species to your gut may help protect your skin—especially against the effects of stress. 

Best Topical Probiotics

If you want to try topical probiotics, here are some strains that have been clinically tested, and their benefits:

• Lactobacillus paracasei MSMC 39-1 can work as well as 2.5% benzoyl peroxide in reducing acne lesions and skin redness 17. 
• Streptococcus thermophilus may increase moisture levels in healthy skin 11. 

• Enterococcus faecalis may reduce acne by 50% 10.
• Lactobacillus plantarum at 5% may treat mild acne lesions 9. 
• Bifidobacterium longum may help heal extra-sensitive skin 18.  

A few weaker studies are also of note 12. In a cell culture, Streptococcus salivarius reduced the growth of C. acnes. In another study, Lactobacillus paracasei reduced inflammation in human tissue samples. And in a human trial, when added to another topical treatment, Lactobacillus acidophilus and Bifidobacterium bifidum helped acne more than the other treatment alone. 

Topical Probiotic Products to Consider

• LiviaOne Topical Liquid Probiotics: Contains multiple strains that may have skin benefits, including B. longum, L. plantarum, S. thermophilus, L. acidophilus, and B. bifidum
• AllVia Topical Probiotic Cream: Contains 5% L. plantarum, which cleared mild acne clinically 9 
• Missha Time Revolution The First Treatment Essence 5x: Contains Bifida ferment lysate, which is extracted from Bifidobacterium. A cell study showed that Bifida ferment lysate has the potential to help maintain a healthy skin barrier 19. This may be a good pick for those with sensitive skin that is easily irritated.   

These options contain topical probiotics that have shown early promise for skin. But take their marketing claims with a grain of salt. It’s still very early for these products. Most of these topical strains were only tested with a single, small trial. More studies are needed to confirm these findings.

Can Prebiotics Treat Acne?

If you’ve been shopping for skincare products lately, you might have noticed both “probiotics” and “prebiotics” on the label. Since not every product includes both, it’s fair to wonder which may be better for your skin. 

Not as much research has been done on the effect of prebiotics (fiber that helps good bacteria grow) on acne. But here’s what we know so far: 

• The prebiotic galactooligosaccharide (taken orally in combination with a daily oral probiotic) may improve skin hydration in healthy women 20
• The prebiotic konjac glucomannan may reduce acne and help the skin “glow” when applied as a topical face spray 21
• A gluco-oligosaccharide, a type of prebiotic, may improve the skin’s moisture level, the skin barrier, and the symptoms of sensitive skin when applied topically 22

We do know that dietary prebiotics and fiber can help boost healthy gut bacteria, which may benefit your skin via the gut-skin axis. 

Prebiotics show promise for acne, but since studies are still limited, it’s too soon to rely on them as an acne treatment.

Clear Skin Is More Than Skin-Deep

The skin is a reflection of the gut, and acne may be a sign of deeper imbalances in the gut, like inflammation and dysbiosis. Thankfully, oral probiotics can remedy this situation, improving both your gut and skin health. They’re a safe, natural option to add to your acne treatment. When you calm your gut, you just might calm the proverbial fire on your skin, too.

It could also be worthwhile to experiment with topical probiotics and prebiotics, but test them as you would any new substance, and see how you react. As more formulas are clinically studied and come to market, these could become a valuable addition to your skincare regimen.

The Ruscio Institute has developed a range of high-quality formulations to help our clients and audience. If you’re interested in learning more about these products, please click here. Note that there are many other options available, and we encourage you to research which products may be right for you. The information on DrRuscio.com is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment.