Topical Probiotics Decrease the Severity of Atopic Dermatitis. A Systematic Review and Meta-Analysis of Double-Blind, Randomized, Placebo Control Trials

Elliot Flint, Nabeel Ahmad, Kevin Rowland, Charles Hildebolt, David M Raskin. medRxiv 2024.07.30.24311221; doi: https://doi.org/10.1101/2024.07.30.24311221

Percent Change from baseline in SCORAD vs time.
A) Percent change in SCORAD vs time for probiotics for all studies.
B) Percent change in SCORAD vs time for placebo for all studies.
C) Difference in percent change in SCORAD between groups vs time for all studies. 

Abstract

Atopic Dermatitis (AD) is a chronic skin disease that commonly appears during childhood but can present at any age. There are many reports showing that probiotics relieve AD symptoms in children. This systematic review and meta-analysis sought to determine the efficacy of topical probiotic treatment for AD in adult populations. A database search was conducted of peer-reviewed, double-blind clinical trials, and studies underwent a systematic exclusion and inclusion process, yielding four that met the criteria. Disease severity, as measured by a standardized scoring tool (SCORAD), was collected, and compared to placebo at two-week and four-week time points.

All studies showed improvement in SCORAD in the treatment groups compared to baseline at all time points. Two showed significant decreases in SCORAD after two weeks of treatment, and three studies showed long-lasting improvement after four weeks of treatment. Interestingly, while each study showed a reduction in severity of AD at the two- and four-week time points, a pooled meta-analysis did not show a statistically significant difference between treatment and control at four weeks of treatment. Clinically, there may be benefits to topical probiotic usage as evidenced by the individual studies, more studies need to be performed including adults to show statistical significance.

PDF