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Abstract

This review article exclusively explores the growing interest and potential of topical probiotics. It briefly presents the history, estimated market value, and merits of topical probiotics. The composition of skin microbiota, interaction between skin and beneficial microbiota and their role in maintaining skin health has been described. The factors responsible for causing skin disorders are discussed. The natural sources of topical probiotics, the involvement of microorganisms and their therapeutic uses are explained. The steps involved in the formulation of topical probiotics have been outlined. A comparison of existing marketed topical probiotics to outline the formulation aspects and techniques to be followed during their development has been emphasized. The applications of topical probiotics in treating various skin disorders have been elaborated. The challenges to be addressed regarding formulation, stability, efficacy, and regulatory guidelines have been substantiated. The impact of orally administered probiotics on skin health is beyond the scope of this article.

Keywords

Topical Probiotics, Skin Microbiota, Beneficial Microorganisms, Dermatology, Regulatory Challenges.

Introduction

The World Health Organisation defines “probiotics” as “live microorganisms that, when administered in adequate amounts, confer a health benefit on the host”1. The term “probiotics” was used by Lilly and Stillwell, for the first time, in 19652.  Topical probiotics are the emerging set of formulations in the field of pharmaceutical sciences. It can be defined as the preparations which consist of beneficial microorganisms that can improve and supplement the skin health when administered topically. In 1912, the first known attempt of topical bacteriotherapy was made, using Lactobacillus bulgaricus, to treat acne3. The topical probiotics is in nascent stage, in terms of research and development, in comparison to oral probiotics. Oral probiotics have gained immense popularity due to the establishment of gut-brain axis relationship along with research-based evidences. It has demonstrated effectiveness in treating various digestive disorders, systemic diseases and enhancing the immune system. The global market value of cosmetic probiotics was estimated to be USD 311 million in 2023 and expected to reach USD 706 million in 2032 at an annual growth rate of 8.5%4. The oral probiotics has the largest global market for any probiotics and is valued at USD 2.5 billion in 2022 and can breach the USD 4 billion mark in the year 2032 with a projected annual growth rate of 6.5%5.

Topical probiotics is gaining popularity due to rise in awareness among people about maintenance of skin health. The need for the topical probiotics can be attributed to following reasons:

1. Growing demand for safe and natural alternatives to conventional, synthetic topical interventions.

2. Increased customer awareness for products which can be used to treat various skin disorders such as acne, dermatitis, dry skin etc.

3. Need for novel approaches to treat skin infections is becoming critical as the causative pathogens have developed resistance to existing antibiotics6.

Merits Of Topical Route Of Probiotic Delivery

Topical probiotics are significantly different in comparison to oral probiotics. These preparations are designed to deliver beneficial microbes directly into the skin, alongside active medicaments, to enhance the therapeutic effects specifically at the skin surface. The topical preparations can confer better activity in strengthening the property of skin as a physical barrier. The topical route provides an opportunity for painless, non-invasive administration of drug; which is comparatively easy and convenient. It also provides target- specific action, of medicament on skin, with immediate effects. It can be viewed as a tool to carry useful microorganisms to address several dermatological concerns for various skin types. Unlike oral probiotics, topical probiotics do not involve the gut-skin axis interaction.

 

Role Of Skin Microbiota

Composition of Skin Microbiota

The skin is the largest organ which encompasses an average area of about 1.8 m2 in an adult human7. The skin microbiota houses distinct types of microorganisms that serve as a physical barrier against the external environment. The skin microbiota comprises two main groups of microbes, resident and transient microbiota. The resident microbiota refers to the group of microbes present superficially in the epidermis (stratum corneum). These non-pathogenic microorganisms form an integral part of skin physiology. They regulate the number of colonizing microbes and inhibit the growth of pathogenic transient microbes8. The transient microbiota refers to the group of microbes that temporarily resides on the skin for varied period of time. The presence of these microbes can be due to exposure of skin to different surfaces in environment. The four most prevalent bacterial phyla in skin microbiota are Actinobacteria, Firmicutes, Proteobacteria and Bacteroides. The three most common genera, constituting about 60% of residential microbiota, are Corynebacterium, Cutibacterium and Staphylococci9,10. The most common bacteria found among transient microbiota include Escherichia coli, Klebsiella, Pneumococci, Clostridia and Acetinobacter11.

A Note on Skin Types

The skin state can be defined as the condition of the skin at a given time. It can be classified as normal, dry, oily or combination type of skin12. Oily skin is characterized by excess secretion of sebum by sebaceous glands, thus providing an anaerobic environment in the skin13. It provides an ideal environment for thriving of Cutibacterium acnes which causes acne11, 12. It can facilitate the growth of aggregates of Cutibacterium species around the hair follicles, inhibit the action of macrophages and utilize the lipid molecules for their growth14.  Dry skin occurs due to inability to retain sufficient amount of moisture by the skin. It can be caused due to excess contact with water, exposure to dry climate, synthetic medicaments or altered genetic makeup. It is characterized by scaling, itching, flaking of the skin as well as formation of powdery mass from the skin surface15. The decreased lipid content in the skin makes it prone to microorganisms like Staphylococcus, Malassezia and Corynebacterium16. These organisms tend to grow better in moist and humid conditions as well13.  The normal skin is characterized by the optimal levels of moisture and oily secretion. The combination skin state refers to existence of oily and dry skin at different parts of the body, based upon their location and exposure to environment.

Factors affecting Skin Conditions

Various factors affect the general status of skin microbiota. Host factors such as age, sex, hormonal changes, diet, stress, exercise and environmental stresses such as sun exposure, pollution, climatic factors and geographical location may cause a shift of the non-pathogenic microbes into pathogenic microbes. This shift might result in inflammation, itching, scaling and other clinical signs, suggesting an imbalance between the skin and its microbiota13, 17.  Any imbalance in these microorganisms results in skin disorders18.

Natural Sources of Topical Probiotics

Natural topical probiotics include yoghurt, kefir, kimchi, sauerkraut, miso and kombucha.

Yoghurt (curd) is one of the most commonly used sources of topical probiotics. It is a natural remedy which is rich in Lactobacillus and Streptococcus. It contains lactose, lactic acid and enzymes such as lipase, protease and amylase19.

Kefir is a fermented dairy product produced by inoculation of milk with kefir grains. Kefir grains are white, gelatinous clumps of inoculum which is useful in milk fermentation and can be recovered after the process20. It is a complex structure which houses homofermentative and heteroferementative bacterial species (Lactobacillus, Acetobacter) and yeast species (Saccharomyces, Candida and Kazachstania). These microbes are embedded in a matrix made up of polysaccharides and proteins. Kefiran, an exopolysaccharide obtained from Lactobacillus kefiranofaciens, is an excipent of pharmaceutical importance due to its rheological properties20-22.  Kimchi is a Korean vegetable dish prepared by fermentation in the presence of Lactobacillus species23. Sauerkret is prepared by fermentation of raw cabbage in the presence of lactic acid bacteria24. Miso, a traditional Japanese seasoning, involves the fermentation in presence of several microbial species. It involves the fermentation of steamed rice, barley or soyabean by Aspergillus oryza (Koji) for a particular period of time. Addition of salt as a preservative prevents the spoilage of miso by unnecessary microbes25. Kombucha is a tea drink prepared by fermentation process in the presence of symbiotic culture of bacteria and yeast (SCOBY). SCOBY comprises yeast species such as Zygosaccharomyces, Brettanomyces and bacterial species of Lactobacillus and Acetobacter26. Table 1 lists out the beneficial microorganisms which are involved in preparation of topical probiotics.

Table 1: Beneficial Microorganisms Involved in Topical Probiotics

 

S. No.

Genera

Species

1.

Lactobacillus

L. bulgaricus, L. acidophilus, L. casei, L. rhamnosus, L. johnsonii, L.acidophilus, L.delrueckii, L.salivarius, L.paracasei, L.fermentum, L.reuteri, L. plantarum, L.hilgardii, L.iners, L.paraplantarum, L.sakei, L. buchneri

2.

Bifidobacterium

B.breve, B. lactis, B. longum, B. animalis, B.biftdum

3.

Streptococcus

S. thermophilus, S.pyogenes

4.

Staphylococcus

S. epididermis, S.hominis, S.aureus

5.

Saccharomyces

S.cerevisiae

Preparation Of Topical Probiotics

Formulation of topical dosage forms using microbes is quite different from one that includes an active drug. Efforts have been made to develop topical pharmaceuticals as well as cosmetics with the inclusion of microorganisms. Fermentation and lyophilization are the two most common methods that are employed for incorporating probiotics into the topical formulations.

Fermentation

Fermentation is the process in which the microorganisms break down the natural polysaccharides into simple sugars. The microorganisms can act on natural substances such as plant extracts, milk, and raw fruits and vegetables. The process is characterised by formation of fermentate which is rich in metabolites such as lactic acid, glycerol, short chain fatty acids (SCFA) like propionate, butyrate etc.31. The fermentation by Lactobacillus facilitates the growth of antimicrobial proteinaceous molecules called as bacteriocins. The fermentation in presence of Aspergillus facilitates the release of proanthocyanidins which confers antioxidant property to improve the skin health32. The release of fatty acids maintains acidic environment and acts as a self preservative31.

Lyophilization

Lyophilisation, commonly called as freeze drying, is the process in which the moisture is frozen and sublimated, thus resulting in removal of moisture and formation of a dry product. The concentrated cell culture is frozen. The crystallised water is removed during primary drying by application of heat and reduced pressure. The remaining moisture is removed by the process of desorption. The effects of the ice crystals on the cell morphology, the selection of suitable lyophilising solvent and the relationship between the physiological functions of the microbial genera on the process has to be determined and taken care during preformulation studies28,33. The most commonly used cryoprotectants are sugars such as sucrose, glucose, lactose, trehalose; polyhydroxyl alcohols such as adonitol, glycerol, polyethylene glycol etc.30. The generalised formulation scheme in preparation of topical probiotics is outlined in Figure 1. The steps involved in the preparation of topical probiotics can be summarised as follows46,47:

  1. Procurement of source of the microorganism
  2. Identification of the microbial strains using molecular techniques.
  3. Isolation and characterisation of the identified microbial strain.
  4. Culture of the identified microbial strain on suitable culture media.
  5. Processing of the cell culture
  6. Product recovery and purification.
  7. Preparation of the purified probiotics to optimal concentration.
  8. Incorporation of the probiotic preparation into pharmaceutical formulation.
  9. Evaluation of the probiotic formulation by necessary quality control tests.
  10. Stability studies for assessing the properties of the formulation on storage.
  11. Optimization of the formulations.
  12. Proper packaging and labelling instructions.
  13. Regulatory guidelines regarding quality, safety and efficacy to be complied.

       
            pc-1.png
       
   Fig 2: Generalised formulation scheme for topical probiotics (Created with BioRender.com)

Comparative Analysis Of Marketed Topical Probiotics

Considerable efforts are being made in development of effective topical probiotics formulations. The comparative review of various marketed products has helped in identifying the common ingredients and techniques that can be employed in development of topical probiotics. The different marketed brands of topical probiotics along with their key ingredients have been described in Table 2.

Table 2: Different marketed brands of topical probiotics

 

S.No.

Brand Name

Dosage Form

Comments

References

1.

SebaMed Pro!

Serum

It contains Lactococcus ferment lysate and leaf cell extract of Psilanthus bengalensis. It helps in treating wrinkles.

48

2.

Glowbiotics

Lotion, Cream

It involves incorporation of probiotic derived bioactives (PDBs) through fermentation process. It produces varied therapeutic uses to treat skin disorders and addresses the needs of different types of skin.

49

3.

Mother Dirt

Cosmetics in the form of body wash, body oil, deodorant and serum

It involves combination of herbal extracts, active phytoconstituents along with beneficial microbial strains across the entire skin.

50

4.

TULA

Cream

It is a non toxic, anti-aging cream which contains prebiotics, probiotics and extracts of apple and watermelon.

51

5.

Probiotic Action

Spray, lotion and cream

It contains various dosage forms with probiotic concentrates that could be used to maintain the skin health as well as treat skin disorders.

52

6.

Pacifica

Cream

It contains probiotics as well as coconut water. It promotes skin hydration.

53

7.

LiviaOne

Spray

It is proprietary probiotic blend which contains 12 symbiotic microbial strains. It is a vegan and organic preparation.

54

8.

Hyalogic

Powder

It is used as an adjuvant which can be used along with application of serum or moisturiser. It contains Triclyst® (combination of bacterial species) and sodium hyaluronate.

55

9.

Clinique

Gel

It is an oil-free dosage form which provides necessary hydration to skin.

56

10.

BioGaia

Ointment

It is used for skin care of babies.

57

11.

FCL

Lotion

It contains probiotics, fensobiome and aquaxyl. It is useful in detoxifying the skin and improving the skin microbiome.

58

Applications Of Topical Probiotics

Skin disorders can arise due to various reasons such as genetic factors, age and hormonal changes. Environmental factors such as exposure to allergens (pollen, dust, animal dander) can trigger skin concerns. Sedentary lifestyle, poor diet and stress negatively impact the skin health48. Underlying medical conditions can severely affect the skin health. These factors can alter the cutaneous microbiota and make the skin susceptible to microbial infections49. Topical probiotics have shown promise in treating various skin diseases such as acne, atopic dermatitis and rosacea. It has shown promise to treat wrinkles and can be explored as anti-ageing agent50,51. Although, the exact mechanism of action and potential side effects are not completely understood, the probable activity and safety of the probiotics have been outlined using the available literature52. Acne vulgaris, commonly called as acne, is one of the most common skin diseases. It is caused by factors such as altered follicular keratinization and increased sebum resulting in the colonization of C. acnes. The bacterial action helps in the release of pro-inflammatory mediators and makes the skin more oily and sticky50,53. Studies have shown that certain Lactobacillus strains have suppressed the lipid degradation activity of C. acnes. Lactic acid was found to have antimicrobial and anti-inflammatory activity on the oily skin54. Lactobacillus paraplantarum, isolated from kimchi, was found to have anti-acne effect55. Atopic dermatitis (AD), also called as eczema, is a chronic inflammatory skin condition characterized by severe itching and scaly sores due to intense allergic reaction50. It is characterized by increased count of Staphylococcus aureus56. Scientists have found out that Roseomonas mucosa can be used as symptomatic prophylaxis against eczema as these bacteria can restore the lipid component into the skin57. 5% extract of Vitreoscilla filiformis was able to relieve AD symptoms when incorporated into an emollient58. Topical probiotics can accelerate wound healing by regulation of release of inflammatory mediators51. Application of Lactobacillus promotes re-epithelisation of damaged skin and improves the wound healing. This bacterium was found to be effective against the infection caused by Pseudomonas aureginosa59. A gel was formulated by incorporating the stabilised extract of Lactobacillus casei as an anti-dermatophytic agent to treat fungal infections60.  A cosmetic ointment containing Lactiplantibacillus plantarum was investigated for anti-aging property61. Fermented plant extract of Lactobacillus buchneri improved the production of elastin, collagen and could be used as an anti-wrinkling agent29. Lactiplantibacillus plantarum, identified in fermented cabbages, was found to inhibit the growth of microbes such as Porphyromonas, Fusobacterium and Aggregatibacter. This bacterium showed ability to treat periodontal diseases62. Psoriasis is a chronic autoimmune skin disorder. The pathogenesis of psoriasis is yet to be completely understood18. It is cause due to the mutation of CARD14 and could be worsened in the presence of allergens63. Efficacy of topical probiotics against psoriasis is yet to be proved.

Challenges And Limitations

Despite having several benefits, there is a need to throw light upon the existing drawbacks of the topical probiotics. The current section discusses the challenges and limitations to be addressed regarding topical probiotics. The topical probiotics involves incorporation of microorganisms as a part of the formulation. Further research on the skin microbiota is essential to identify the types of microbes that could be introduced into the skin. There is a need to understand and establish the endogenous and exogenous factors affecting the skin microbiota. Further scientific backing is required to highlight the efficacy of the product in treating dermatological diseases. Efforts have to be made in developing topical probiotics as prophylactic interventions. Also, there is a need to simplify the dosage form such that the user can conveniently include it as a part of their skin care routine. During pre-formulation studies, the drug- excipients interaction and excipient- microbial strains interaction should be analysed and kind of incompatibility should be addressed. Excipients such as preservatives, antioxidants, buffers, surfactants or emulsifiers should not alter the viability and activity of the microbial strains.

It is necessary that the properties of the formulation align with normal skin conditions and probiotic strains incorporated in it. Physicochemical properties like pH, viscosity, particle size, rheological properties, optimum level of moisture content etc. are of utmost importance to be taken care during formulation. It is crucial to determine the appropriate concentration of these microorganisms to ensure the stability of the formulation64. Factors such as viability of the microbial cells, number of colony forming units (CFUs), stability, shelf life and storage conditions are critical and should be carefully optimised. Novel drug delivery systems such as nanoparticles, nanogels, nanoemulsions, hydrogels, and microencapsulation can be developed to incorporate lipophilic drugs along with the probiotics. It is essential to develop methods that preserve the viability of live microbes and maintain the activity of the formulation. Table 2 has also helped in identification of herbal ingredients and nutraceuticals that could be incorporated to improve the formulation activity. Biopolymers such as collagen peptide, hyaluronic acid, chitosan, carragenan, pectin and starch can be explored to provide unique properties to topical formulations45. The packaging material should not degrade the efficacy of the probiotics and the ingredients. The packaging material should be resistant to heat and light. It should be impervious to moisture or air. Processes like leaching, phase separation or loss of solvent can deteriorate the product. The storage conditions, preferably low or sub-zero, should be taken care by proper cold chain supply. The dosage form should be cost effective. Strategies have to be planned and executed to enable cost optimisation of the product.

Unknown mechanisms of action of probiotics and their potential adverse effects have limited the prospect of clinical research regarding topical probiotics. This uncertainty complicates the identification of biomarkers needed for personalized therapeutic interventions. Large-scale clinical trials are essential to establish the quality, safety, and efficacy of probiotics.

Several regulatory gaps such as approval and classification of topical probiotic products by the United States Food and Drug Administration (USFDA) exist. Currently, there are no topical probiotic products approved by USFDA. There is a need for an agency and guidelines for regulating topical probiotics. Although topical probiotics are showing significant positive results, there is a need to establish data regarding long term safety profile for intended use3, 65. Increased microbial load makes it difficult for the classification and testing of topical probiotics18. Efforts should be made to establish definite product safety and efficacy guidelines for topical skin probiotics50,52.

CONCLUSION

Topical probiotics holds promising potential for advancing skincare and dermatological treatments. Further research is essential to fully understand the complexities of the skin microbiota and identification of specific strains of beneficial microbes that can effectively address various skin conditions. Innovations in formulation and delivery systems will be crucial in overcoming current limitations. Additionally, exploring personalized skincare approaches based on individual microbiota profiles could lead to more effective and customized treatments. While several promising topical probiotic products are already in the market, they face limitations that require adherence to defined regulatory aspects. By addressing these challenges, we can harness the full benefits of topical probiotics for effective and targeted treatments for various skin conditions.

ACKNOWLEDGEMENT

We gratefully acknowledge the contribution made by all the authors for this review article.

Author Contributions

Conceptualization: AHR, YC, P SF; Methodology: AHR, YC ; Data Curation: AHR, YC, P, SF; Writing (Original Draft): YC; Writing (Review & Editing): AHR, YC; Visualisation: YC, P, SF; Supervision: AHR.

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  47. Haghshenas B, Nami Y, Almasi A, Abdullah N, Radiah D, Rosli R, et al. Isolation and characterization of probiotics from dairies. Iran J Microbiol. 2017 Aug;9(4):234–43.
  48. Admin P. How Everyday Lifestyle Habits Impact Skin Health and Appearance [Internet]. Dr Nathan Holt. 2023 [cited 2024 Aug 4]. Available from: https://cambridgelaserclinic.com/how-everyday-lifestyle-habits-impact-skin-health-and-appearance/
  49. Cleveland Clinic [Internet]. [cited 2024 Aug 4]. Skin Diseases: Types of, Symptoms, Treatment & Prevention. Available from: https://my.clevelandclinic.org/health/diseases/21573-skin-diseases
  50. França K. Topical Probiotics in Dermatological Therapy and Skincare: A Concise Review. Dermatol Ther (Heidelb). 2020 Dec 19;11(1):71–7.
  51. Knackstedt R, Knackstedt T, Gatherwright J. The role of topical probiotics on wound healing: A review of animal and human studies. Int Wound J. 2020 Aug 31;17(6):1687–94.
  52. Lee GR, Maarouf M, Hendricks AJ, Lee DE, Shi VY. Topical probiotics: the unknowns behind their rising popularity. Dermatology online journal [Internet]. 2019 [cited 2024 Jul 25];25(5). Available from: https://escholarship.org/uc/item/2v83r5wk
  53. Dapkevicius I, Romualdo V, Marques AC, Lopes CM, Amaral MH. Acne Vulgaris Topical Therapies: Application of Probiotics as a New Prevention Strategy. Cosmetics. 2023 Jun;10(3):77.
  54. Lebeer S, Oerlemans EFM, Claes I, Henkens T, Delanghe L, Wuyts S, et al. Selective targeting of skin pathobionts and inflammation with topically applied lactobacilli. Cell Rep Med. 2022 Feb 15;3(2):100521.
  55. Cha H, Kim SK, Kook M, Yi TH. Lactobacillus paraplantarum THG-G10 as a potential anti-acne agent with anti-bacterial and anti-inflammatory activities. Anaerobe. 2020 Aug 1;64:102243.
  56. Herbert S, Haughton R, Nava J, Ji-Xu A, Le ST, Maverakis E. A review of topical probiotic therapy for atopic dermatitis. Clinical and Experimental Dermatology. 2023 Apr 1;48(4):319–24.
  57. NIAID Discovery Leads to Novel Probiotic for Eczema | NIAID: National Institute of Allergy and Infectious Diseases [Internet]. 2024 [cited 2024 Aug 11]. Available from: https://www.niaid.nih.gov/news-events/niaid-discovery-leads-novel-probiotic-eczema
  58. (PDF) Improvement of atopic dermatitis skin symptoms by Vitreoscilla filiformis bacterial extract [Internet]. [cited 2024 Aug 11]. Available from: https://www.researchgate.net/publication/6852367_Improvement_of_atopic_dermatitis_skin_symptoms_by_Vitreoscilla_filiformis_bacterial_extract
  59. Li Z, Zhang S, Zuber F, Altenried S, Jaklenec A, Langer R, et al. Topical application of Lactobacilli successfully eradicates Pseudomonas aeruginosa biofilms and promotes wound healing in chronic wounds. Microbes and Infection. 2023 Nov 1;25(8):105176.
  60. Mehdi-Alamdarloo S, Ameri A, Moghimipour E, Gholipour S, Saadatzadeh A. Formulation Development of a Topical Probiotic Gel for Antidermatophytosis Effect. Jundishapur J Nat Pharm Prod [Internet]. 2016 [cited 2024 Jul 25];11(3). Available from: https://brieflands.com/articles/jjnpp-18464#abstract
  61. Falholt Elvebakken H, Bruntse AB, Vedel C, Kjærulff S. Topical Lactiplantibacillus plantarum LB244R® ointment alleviates skin aging: An exploratory trial. Journal of Cosmetic Dermatology. 2023;22(6):1911–8.
  62. Zhang J, Duan Z. Identification of a new probiotic strain, Lactiplantibacillus plantarum VHProbi® V38, and its use as an oral health agent. Front Microbiol [Internet]. 2022 Dec 12 [cited 2024 Aug 4];13. Available from: https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2022.1000309/full
  63. Psoriasis: What’s the Genetic Link? [Internet]. [cited 2024 Aug 11]. Available from: https://www.healthline.com/health/psoriasis/is-psoriasis-hereditary#takeaway
  64. Wallen-Russell C, Wallen-Russell S. Topical Probiotics Do Not Satisfy New Criteria for Effective Use Due to Insufficient Skin Microbiota Knowledge. Cosmetics. 2021 Sep;8(3):90.
  65. Gowda V, Sarkar R, Verma D, Das A. Probiotics in Dermatology: An Evidence-based Approach. Indian Dermatology Online Journal. 2024 Aug;15(4):571

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  53. Dapkevicius I, Romualdo V, Marques AC, Lopes CM, Amaral MH. Acne Vulgaris Topical Therapies: Application of Probiotics as a New Prevention Strategy. Cosmetics. 2023 Jun;10(3):77.
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  59. Li Z, Zhang S, Zuber F, Altenried S, Jaklenec A, Langer R, et al. Topical application of Lactobacilli successfully eradicates Pseudomonas aeruginosa biofilms and promotes wound healing in chronic wounds. Microbes and Infection. 2023 Nov 1;25(8):105176.
  60. Mehdi-Alamdarloo S, Ameri A, Moghimipour E, Gholipour S, Saadatzadeh A. Formulation Development of a Topical Probiotic Gel for Antidermatophytosis Effect. Jundishapur J Nat Pharm Prod [Internet]. 2016 [cited 2024 Jul 25];11(3). Available from: https://brieflands.com/articles/jjnpp-18464#abstract
  61. Falholt Elvebakken H, Bruntse AB, Vedel C, Kjærulff S. Topical Lactiplantibacillus plantarum LB244R® ointment alleviates skin aging: An exploratory trial. Journal of Cosmetic Dermatology. 2023;22(6):1911–8.
  62. Zhang J, Duan Z. Identification of a new probiotic strain, Lactiplantibacillus plantarum VHProbi® V38, and its use as an oral health agent. Front Microbiol [Internet]. 2022 Dec 12 [cited 2024 Aug 4];13. Available from: https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2022.1000309/full
  63. Psoriasis: What’s the Genetic Link? [Internet]. [cited 2024 Aug 11]. Available from: https://www.healthline.com/health/psoriasis/is-psoriasis-hereditary#takeaway
  64. Wallen-Russell C, Wallen-Russell S. Topical Probiotics Do Not Satisfy New Criteria for Effective Use Due to Insufficient Skin Microbiota Knowledge. Cosmetics. 2021 Sep;8(3):90.
  65. Gowda V, Sarkar R, Verma D, Das A. Probiotics in Dermatology: An Evidence-based Approach. Indian Dermatology Online Journal. 2024 Aug;15(4):571

Photo
Dr. Ambujakshi H. R.
Corresponding author

Acharya & BM Reddy College of Pharmacy, Bengaluru, Karnataka, India

Photo
Yashaschandra
Co-author

Acharya & BM Reddy College of Pharmacy, Bengaluru, Karnataka, India

Photo
Prajwal
Co-author

Acharya & BM Reddy College of Pharmacy, Bengaluru, Karnataka, India

Photo
Sidra Fatima
Co-author

Acharya & BM Reddy College of Pharmacy, Bengaluru, Karnataka, India

Yashaschandra, Prajwal, Sidra Fatima, Dr. Ambujakshi H. R., Topical Probiotics: A Review on Current Status and Challenges, Int. J. of Pharm. Sci., 2024, Vol 2, Issue 12, 2268-2279. https://doi.org/10.5281/zenodo.14500086

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