Probiotics: can friendly bacteria improve skin health?

Interview with Jo Ann Hattner, MPH RD.
Posted on May 22, 2009 by Joséphine Toulemonde

Probiotics, live microorganism in our gut commonly referred to as “beneficial or friendly bacteria”, are well known to enhance immunity and digestive health. A variety of foods are now enhanced with probiotics as well as prebiotics, the fuel for the beneficial bacteria in our gut, for their positive health results. What about their effect on skin?

Jo Ann Hattner is a nutritionist associated with Stanford University Medical School and in private practice. She is also the author of Gut Insight, probiotics and prebiotics for digestive health and well-being, a new book to help consumers make healthy food choices and get a full understanding of probiotic and prebiotic foods.

We interviewed Jo Ann Hattner to get a better understanding of how probiotics could also work on the skin level.

Optiderma: Thanks Jo Ann for sharing your knowledge on probiotics with us today. Scientifics have attributed many benefits to probiotics: immunity enhancement, improvement in lactose digestion, management of diarrhea in infants, treatment of constipation, improved tolerance to antibiotic therapy, and reduced symptoms of respiratory infections. What about skin health? Can probiotics also positively influence skin?

Probiotics and prebiotics function in our gut. The gut is considered the "command center" for immunoregulation. Because so much of our skin reactions are a result of immune response, for example inflammation, the answer is yes.

Can you explain a little bit more about how probiotics provide protection against chronic inflammation?

Experimental studies have found that probiotics exert special effects in the gut within the intestinal lining. There is both a gut barrier function and the induction of immune responses that are thought to occur beyond the intestinal epithelium. The studies show protection particularly with atopic diseases, for example atopic eczema, a skin condition common in infants.

Would you then say that chronic skin conditions, such as psoriasis or eczema, are gut diseases?

I would say that the status of your gut health certainly influences your ability to maintain the health of your skin. It is interesting how many commonalities there are between the skin and the gut.

Eating foods with probiotics enhance the population of beneficial bacteria in our gut. In your book Gut Insight, you are mentioning dairy and soy. However, many people with a skin condition have trouble with dairy. Would you suggest relying only on soy products - and some cereals and bars containing probiotics?

In my book we included the soy sources for fermented foods, soy yogurts and smoothies which contain live active cultures as well as other food sources such as bars. If you are intolerant to dairy, for example have an allergy to dairy you certainly can use the soy based products. We provide a listing of those products and where to find them in the market.

Not all dairy products are the same obviously. Cheese, yoghurt, milk, kefir, Greek yoghurt have different benefits. Which dairy products are usually better tolerated?

Fermented dairy products, with live active cultures are well tolerated. I advise to start with a plain yogurt and try small amounts to test your tolerance. The starter cultures used for fermentation also help you with the digestion of lactose. For those that are lactose intolerant the yogurt may well be tolerated. You just have to try it and see using small amounts to begin with for example a tablespoon or two. Each individual is different so I advise that you are the best judge of tolerance.

What about cheese? Does it still contain probiotics even if it is pasteurized?

The live active cultures of probiotics have to be added after pasteurization. You can check with the product manufacturer to be sure that the cultures were added after pasteurization.

In your point of view, what are the best prebiotic foods and beverages for someone who has problems with his/her skin?

Prebiotics, which are the fuel for probiotics, can keep the population of probiotics in your gut thriving. Gut Insight is the only book to my knowledge to provide a listing of prebiotic food sources that have been identified in the scientific literature. One of the most common sources in the diet is pictured on the cover of the book. It is wild onions. Onions, garlic, leeks are sources of prebiotics. I find it fascinating that these foods are used all over the world in so many cuisines. Additional sources common to our diet are whole wheat and banana. Again it is interesting that bananas are such a familiar food and one of the first foods we feed to babies is the ripe banana.

Studies also show that probiotics supplements reduce allergy in mothers and infants and breast-fed infant have a lower incidence of eczema because of mother’s milk. Do you believe that early exposure to bacteria can decrease allergic diseases?

The best protection for the decrease of allergic disease in the infant is for the mother to breast feed. The breast milk contains a prebiotic that allows the protective probiotic bacteria to thrive. Researchers are looking at infants and children with low allergy rates and trying to find commonalities.

What about supplementation? In your book, you put emphasis on diet obviously because the focus of your book is food rather than supplement. What do you think of probiotic or prebiotic supplements?

For supplement use I recommend you be under the care of a physician. The focus of the book is on the natural food sources of probiotics and prebiotics. I believe when you use the natural food sources you are more likely to develop a lifelong healthy habit, than if you are only relying on supplements. For example, the studies on populations of people with longevity found that they had established the habit of eating fermented foods.

Some companies have started to develop some kind of probiotic cream for acne. Do you think it could really help improve the balance of bacteria in our skin?

I am not familiar with the probiotic cream for acne, I do know that probiotics are being added to cosmetics and as yet there is not a lot of study that supports their use. However, I always leave the door open when it comes to science.

Is there anything you would like to add in conclusion?

Our skin publicizes our health and our gut plays a major role in determining our health. That is why I am so very passionate about digestive health and well-being.

About Jo Ann Hattner

Jo Ann Hattner received an undergraduate Bachelor of Science Degree from the University of Idaho, a graduate degree from the University of California at Berkeley in Public Health, Registered Dietitian credentials and over thirty years experience practicing nutrition in the dynamic environment of the San Francisco Bay area. She continues to apply her academic skills at Stanford University School of Medicine, where she teaches medical students with an on-line nutrition course. She is a regular guest speaker at national professional meetings of dietitians, physicians, and other professionals.

Her interest in the new, somewhat mysterious, but scientifically solid field of probiotics originated while practicing nutrition with some of the top gastroenterologists and nutritionists in the world at Stanford Medical Center in Palo Alto, California.

She wrote the book Gut Insight, designed to communicate the science supporting the recent surge of interest in digestive health and to interpret for us the science supporting the use of probiotics and prebiotics.

Her book is available both in an e-version and a print version on www.gutinsight.com