A Review of Probiotic Supplementation and Feasibility of Topical Application for the Treatment of Pediatric Atopic Dermatitis

Atopic dermatitis is a chronic inflammatory skin disease that commonly occurs in early childhood. To date, the pharmacological treatment of atopic dermatitis is far from ideal, poses several limitations, and constantly requires novel approaches. The theory that appropriate colonization of gut bacteria during infancy influences the development of the immune system has prompted numerous clinical trials that have evaluated the effectiveness of probiotic supplementation for the prevention and treatment of atopic eczema in children. In addition, topical application of probiotics has been demonstrated to improve the skin's barrier function, which might contribute to reduce the severity of atopic dermatitis. In this article, we review the literature and data regarding the use of probiotics, both by oral administration and topical application, for the treatment of atopic dermatitis. We also summarize the knowledge on the potential mechanisms by which probiotics influence the gut and exert their skin effects. Probiotic supplementation seems to be an attractive strategy to prevent and treat pediatric atopic dermatitis. However, to enable the treatment to be fully effective, the period of supplementation should be considered. Moreover, in future studies, a combination of probiotic supplementation and simultaneous topical application of creams containing probiotics might also be considered.