#intestinal #flora #influences #acne #adolescents
Acne remains one of the most common dermatological conditions in adolescents, with not only an aesthetic but also a psychosocial impact. Although the local mechanisms (sebum, comedones, inflammation, infection with Cutibacterium acnes) are well known, in recent years there has been increased interest in the role of the intestinal microbiome in influencing skin inflammation, immunity and hormonal balance.
1. Why does acne occur in teenagers?
Acne vulgara is a chronic inflammatory condition of the pilosebaceous unit, and its onset in adolescence is usually due to a combination of factors:
- Hormonal changes: puberty brings an increase in the level of androgens (male sex hormones, present in both boys and girls), which stimulate the activity of the sebaceous glands and the increase in sebum production.
- Excess sebum: sebum in an increased amount, together with dead cells that do not come off properly, block the pores. This environment is ideal for the proliferation of the bacterium Cutibacterium acnes, thus leading to the appearance of acne lesions.
- Genetic predisposition: if one or both parents had severe acne, the chances that the teenager will also face this problem are higher.
- Lifestyle: diet rich in sugars, refined carbohydrates and ultra-processed products; overweight / obesity; chronic stress; insufficient sleep; inadequate hygiene (mechanical friction, physical aggression on the skin); prolonged use of antibiotics; the use of comedogenic cosmetics – all these factors influence the appearance of acne.
These factors do not act in isolation, but together: hormonal fluctuations increase sebum production, genetic predisposition determines a local response (inflammation, hyperkeratosis) and lifestyle can aggravate systemic or local imbalances.
2. The connection between the intestine and the skin: the gut-skin axis
Although at first glance they seem completely separate, the intestine and the skin communicate constantly. This bidirectional channel is called the gut-skin axis.
The intestine is responsible for the absorption of nutrients and the elimination of toxins. The skin, being the largest organ, is a faithful mirror of what happens inside. When the intestine is healthy and functioning optimally, the skin receives all the nutrients it needs and is protected from inflammation. When the intestinal balance is disturbed, the alarm signals reach the skin in the form of inflammation, redness and, of course, acne.
At the same time, there is scientific evidence that shows that adolescents with acne have an imbalance of intestinal flora – fewer good bacteria and a lower microbial diversity than those who do not have acne.
3. What is intestinal dysbiosis and how does it manifest itself?
Our intestine hosts trillions of microorganisms (bacteria, fungi, viruses) that form the intestinal flora or the intestinal microbiome. A healthy flora (eubiosis) is diverse and balanced.
Intestinal dysbiosis represents an imbalance of the bacterial flora, that is, a decrease in “good” (symbiotic) bacteria in favor of “bad” (pathogenic) ones and a reduction in microbial diversity.
Causes of dysbiosis:
• Repeated use of oral antibiotics: destroys pathogenic bacteria, but, unfortunately, also kills a large part of beneficial bacteria.
• Diet rich in sugars, refined carbohydrates, ultra-processed foods, saturated fats: feeds pro-inflammatory bacteria and reduces the number of beneficial ones.
• Reduced consumption of fibers (prebiotics): fibers are “food” for good bacteria, and a diet poor in vegetables and fruits directly affects the health of the microbiome.
• Chronic stress: releases hormones that affect intestinal motility and weaken the mucosal barrier of the intestine.
• Latent intestinal inflammations (eg irritable bowel syndrome), gastrointestinal or parasitic infections.
• Sedentary lifestyle, insufficient sleep.
Dysbiosis is manifested by digestive symptoms (bloating, gas, constipation/diarrhea), sensitivity to certain foods, but also by systemic problems, including skin problems.
4. How does dysbiosis contribute to acne?
Microbial imbalance contributes to the appearance and persistence of acne through 2 main mechanisms:
A. Leaky gut
Dysbiosis weakens the integrity of the intestinal wall, creating what we call “leaky gut”. Toxins, fragments of undigested food and products of bacterial metabolism pass directly into the blood.
B. Systemic inflammation
The immune system perceives these substances as threats and triggers a systemic inflammatory response (at the level of the whole body). This chronic and low-intensity inflammation also reaches the skin level, where: it aggravates the inflammation of the sebaceous glands, increases sebum production and facilitates the development of Cutibacterium acnes, turning the simple pimple into an inflamed, red and painful lesion.
Therefore, an inflamed gut leads to inflamed skin, and intestinal dysbiosis can be a factor in “maintaining” or exacerbating acne.
5. The role of probiotics in the fight against adolescent acne
If dysbiosis is the cause of the inflammation, the solution is to restore the microbial balance. This is where probiotics come in – live microorganisms that, administered in adequate amounts, confer a benefit on the host’s health.
Why are probiotics anti-acne allies?
- Reduce systemic inflammation: certain probiotic strains (such as Lactobacillus and Bifidobacterium) help seal the permeable gut and modulate the immune response, reducing the inflammation that fuels acne.
- They produce short-chain fatty acids: good bacteria ferment the fibers and produce short-chain fatty acids (ex: butyrate), which are essential for gut health and have a strong anti-inflammatory effect at a systemic level.
For the management of acne in adolescents, a supplement that provides not only quantity, but also diversity and viability of the strains is crucial.
ProbioBalance is an excellent choice in this context. This supplement combines 3 key probiotic strains, incl lactobacillus acidophilus and bifidobacterium longumoffering a wide spectrum of action. A major benefit is the association with prebiotics (FOS – Fructo-oligosaccharides). This symbiotic formula (probiotics + prebiotics) provides the necessary food for good bacteria to establish and proliferate effectively, thus maximizing the chances of: ameliorating dysbiosis, reducing the general inflammation of the body, improving the barrier function of the intestine and, implicitly, of the skin.
In medical practice, ProbioBalance it can be used as additional support in addition to the usual dermatological treatments, especially in adolescents with signs of dysbiosis (disturbed digestion, gastrointestinal symptoms, chronic stress). It is essential that the choice of probiotics be made individually, preferably together with a gastroenterologist/nutritionist, and that the supplements be seen as an aid, not as a substitute for standard dermatological treatment.
6. Diet and lifestyle for healthy skin
Supplementation with probiotics must always be supported by changes at the base level. Here are some practical tips:
Food:
• Increase the intake of prebiotic fibers (vegetables, fruits, whole grains, legumes) – they feed the good bacteria;
• Reduce sugar and ultra-processed foods (sweets, fast food and carbonated drinks) – they aggravate acne;
• Consume fermented foods (yogurt, kefir, pickles) if they are well tolerated.
• Ensure an adequate supply of omega-3 essential fatty acids from fatty fish, flax seeds, chia;
• Avoid excess dairy products, if you notice a correlation between consumption and worsening of acne;
• Drink enough water – hydration is also important for the skin;
• Avoid the abuse of oral antibiotics, especially if they are not necessary.
Lifestyle:
• Regular and sufficient sleep – lack of sleep increases stress and inflammation;
• Regular physical activity — stimulates circulation and metabolic balance;
• Delicate facial hygiene with mild products, without attacking the skin;
• Regular dermatological monitoring.
These measures, combined with standard dermatological therapy (topicals, retinoids, dermatological procedures), can optimize the chances of acne remission and prevent recurrences.
Conclusion
Acne in teenagers has many causes: hormones, genetic factors and lifestyle. But more and more research shows that the balance of the intestinal flora also plays an important role. When dysbiosis occurs – that is, an imbalance of the microbiota – inflammation in the body increases and maintains acne lesions. Therefore, acne is not only a skin problem, but a signal that the whole body needs balance.
An approach that combines intestinal care with dermatological treatments can bring teenagers not only cleaner skin, but also better health.
This article was written by…
Dr. Madalina Nastasa
Dermato-venerology specialist doctor
With over 7 years of experience in the diagnosis and treatment of skin, hair and nail conditions, a graduate of the “Gr. T. Popa” University of Medicine and Pharmacy in Iasi, I work at the Arcadia clinic in Iasi.
I am passionate about the complexity and diversity of dermatology, and my goal is to offer each patient a personalized approach, based on the latest guidelines and medical technologies.
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