Dr. Bryant Esquejo, ND • Holistic Acne & Eczema Healing

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Do people with acne need to take probiotics?

Diving into the science behind gut health, acne, & probiotics

If you have acne, I’m sure social media algorithms have pointed you to acne-targeting probiotics. But, do people with acne really need probiotics? And, why are companies advertising probiotics to address acne?

Let’s answer these questions and more in this blog post!

Disclaimer: This post does not constitute as medical advice; is not meant to diagnose, prevent, treat, or cure any medical conditions or disease; and is meant for educational purposes only. Speak to your doctor before starting anything new OR schedule your appointment with me.


Are acne probiotics legit?

Addressing acne holistically means addressing the underlying root issues contributing to acne.

As a licensed naturopathic doctor, that means I’m an expert in both holistic and integrative medicine. And, I aim to identify and treat the underlying causes and triggers of my patient’s skin issues.

As a person who had severe cystic acne as a teenager and had acne reemerge during my mid-20s, I felt the psychological impacts of acne. I also felt that conventional options weren’t providing the meaningful results I was looking for.

I recognized that conventional options only addressed acne as a symptom. And since conventional options didn’t address the underlying issues of my acne, I saw that my acne kept on coming back!

And, it wasn’t until I identified my unique root issues and treated them that I saw longer-lasting relief.

And because of my personal acne journey, I am passionate about looking into the science behind what causes and triggers acne & using that science to holistically treat my acne patients.


Now, to go back to the question at hand: Why are companies advertising probiotics to address acne?

Well, there’s science that says that people with acne experience gastrointestinal dysbiosis. This basically means that people with acne have gut bacteria imbalances.

Science also shows that acne is linked to a gut issue called irritable bowel syndrome (IBS). When people have IBS, they can experience bloat, abdominal distention, abdominal pain, and changes to bowel movement quality and frequency.

And, there’s also science indicating that gut bacteria imbalances may contribute to symptoms of IBS!

So, with this science, companies are trying to bring gut bacteria populations back into balance to address acne.


But, is there any science about probiotics & acne?

Yes! There’s science (linked below) that shows that different types of probiotic preparations and different bacterial strains support skin health in people with acne. However, since there is so much variability amongst strains, some providers are wary about recommending probiotics to their acne patients.

Science on probiotics and acne:

And in all honesty, when patients with acne first see me in-office, probiotics are NOT my first go-to option to support gut health.


Do people with acne really need probiotics?

When people with acne see me for the first time, and they also mention that they experience gut symptoms, I want to identify what is causing those gut issues since they may be playing a role in suboptimal skin health.


After doing a 90-minute initial intake with a new patient, and I suspect that their gut issues might stem from gut bacteria imbalance, I recommend that they get gut testing completed to see what their gut bacteria profile looks like.

This test is called the GI-Map, which uses PCR technology to amplify microbial DNA to measure the amounts of bacteria and indicate if there is imbalance and/or overgrowth that could be conturing to symptoms.


While we are waiting for the results of that lab, I also recommend some dietary options to support general gut bacteria balance and gut health.

Science shows that diet can positively (and negatively) affect gut bacteria balance!

When looking at the data, researchers have seen that eating 30 different plants a week can support healthy and diverse gut bacteria populations. Examples of edible plants are fruits, vegetables, herbs, and spices!

When I saw this research, I wondered myself if i was able to get 30 different plants a week, and to my surprise I wasn’t! I was getting around 20-25 different plants. So, I now make it a point to get 30 different plants a week, and I’ve seen that blending different plants into a smoothie every day helps me reach that goal.


Other than eating 30 different plants a week, science also shows that high fat, low fiber diets may trigger gut bacteria imbalance.

When I saw this research, I also have been making it a point to get my fiber every day. And the cool thing is that most fruits and vegetables are rich in fiber!

Again, I like to make smoothies every morning to reach my 30-plant- a-week quota, and I’ve also been adding in fiber-dense foods in my smoothies, such as oatmeal, flaxseeds, and chia seeds.


I also recommend dietary options to support gut bacteria from the start since diet is a foundational aspect of overall heath and wellness. I feel that we can get the ball rolling on forming health-promoting habits and lifestyle choices from the get-go! I also recognize that diet is much cheaper than taking probiotics.

There’s also science indicating that probiotics may worsen some issues in people with preexisting gut bacteria imbalance. So, I like to err on the side of caution, and wait till we see what lab testing shows before we take on probiotics.

Do you think you’re eating 30 different plants a week or are getting in fiber every day?


What can be done about gut dysbiosis?

If labs show that there is gut bacteria imbalance, there are several options that can be done.

In regards to “imbalance”, labs can show that there is a total depletion of bacteria, that there is an overgrowth of bacteria, or that there is actual infection going on in the gut.

If someone has total depletion of bacteria, their provider may recommend potions to replete the gut of essential beneficial bacteria.

If someone has overgrowth of bacteria, the patient has the option to get further lab testing to see if they have small intestinal bacteria overgrowth, or empirically address gut bacteria balance with herbs and targeted therapeutic diets.

And lastly, if someone has infection, they have the option to start antibiotics to address the infection.

From what I’ve seen in my patients who have acne and both gut bacteria imbalance, many have been able to achieve healthier and and more-resilient skin after addressing these root issues.

Are you ready to tackle the underlying causes of your acne?


Acne is more than just the gut

While gut bacteria imbalance is linked to acne, there are other things that have been shown to cause and trigger acne.

When looking at the science, researchers tell us that testosterone and androgen hormones play a causative role in acne. And when looking deeper, science tells us that insulin hormone imbalance from blood sugar issues can trigger acne-causing hormone imbalance. In addition to that, science also tells us that stress hormones could potentially play a role in acne.

Beyond hormones, science also tells us that nutrient deficiencies may play a role in acne. Researchers have also found that certain medications and supplements can trigger acne.

And, a lot of these underlying root issues can be tested for with labs! So, work with a provider who will see your acne holistically if you want to address the root issues contributing to your acne.

If you want to learn more about these underlying causes and triggers of acne and how to address them from a naturopathic POV, click below to read my blog post all about it.


WHAT IF YOU WANT TO TREAT ACNE NATURALLY?

The answer is simple: Work with a licensed naturopathic provider. As mentioned earlier, licensed naturopathic providers are experts in holistic and integrative medicine.

As integrative medicine experts, we are trained in both natural and conventional options. So, you will be able to capture a vast array of treatment options to help you achieve your skin goals when you work with a licensed naturoapthic doctor.

If you want to see me, I see patients in-person and virtually. The only caveat is that since I am only licensed in the state of California, I can only see patients who are physically in the state of California (especially for telehealth patients).

If you are outside the state a California, a great resource to find a licensed naturoapthic doctor in your state is the Institute for Natural Medicine’s directory: https://naturemed.org/find-an-nd/.


Summary & Takeaways

So, do people with acne need to take probiotics? No, not necessarily.

Yes, there is science that shows that people with acne have gut bacteria imbalance & that many different types of probiotics may support skin health. But, probiotics can be expensive and could potentially worsen gut issues in people with existing gut problems! Before starting a probiotic, it’s always best to speak to a doctor.

When my patients first see me for holistic and integrative acne care, I ask several questions to understand if gut health could be impacting their skin health.

If I suspect that they have gut bacteria imbalance, I recommend that they complete labs to see what their gut bacteria profile looks like. While we wait for those results, I recommend to my patients general dietary treatment to help support gut bacteria balance and overall gut health.

And if gut testing shows imbalance, there are several holistic and integrative options that can be done, which can include probiotics, diet, herbs, and more!



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DISCLAIMER: THIS POST DOES NOT CONSTITUTE AS MEDICAL ADVICE. THIS POST IS NOT MEANT TO TREAT, CURE, PREVENT, OR DIAGNOSE CONDITIONS OR DISEASES; AND IS MEANT FOR EDUCATIONAL PURPOSES. AS ALWAYS, PLEASE CONSULT YOUR DOCTOR BEFORE TRYING ANY NEW TREATMENTS OR SUPPLEMENTS.