title: Acne vulgaris, probiotics and the gut-brain-skin axis: from anecdote to translational medicine.
abstract: Acne vulgaris has long been postulated to feature a gastrointestinal mechanism, dating back 80 years to dermatologists John H. Stokes and Donald M. Pillsbury. They hypothesised that emotional states (e.g. depression and anxiety) could alter normal intestinal microbiota, increase intestinal permeability, and contribute to systemic inflammation. They were also among the first to propose the use of probiotic Lactobacillus acidophilus cultures. In recent years, aspects of this gut-brain-skin theory have been further validated via modern scientific investigations. It is evident that gut microbes and oral probiotics could be linked to the skin, and particularly acne severity, by their ability to influence systemic inflammation, oxidative stress, glycaemic control, tissue lipid content, and even mood. This intricate relationship between gut microbiota and the skin may also be influenced by diet, a current area of intense scrutiny by those who study acne. Here we provide a historical background to the gut-brain-skin theory in acne, followed by a summary of contemporary investigations and clinical implications.
authors.affiliation: Department of Dermatology, State University of New York Downstate Medical Center, 450 Clarkson Ave, Brooklyn, NY 11203, USA.
authors.forename: W
authors.initials: W
authors.lastname: Bowe
authors.affiliation: New Jersey Medical School, University of Medicine and Dentistry of New Jersey, 150 Bergen Street, Newark, NJ 07103, USA.
authors.forename: N B
authors.initials: NB
authors.lastname: Patel
authors.affiliation: Genuine Health, 775 East Blithedale Avenue, Suite 364, Mill Valley, CA 94941, USA.
authors.forename: A C
authors.initials: AC
authors.lastname: Logan
mesh_terms: D000152:Acne Vulgaris / Q000209:etiology* / Q000628:therapy; D041981:Gastrointestinal Tract / Q000382:microbiology* / Q000502:physiology*; D009424:Nervous System Physiological Phenomena; D012879:Skin Physiological Phenomena; D057170:Translational Research, Biomedical / Q000639:trends
keywords: acne; anxiety; brain; depression; diet; gastrointestinal tract; gut; microbiota; probiotics; skin