Atopic dermatitis is a chronic inflammatory skin condition characterized by dry, itchy, and irritated skin. Treatment often relies on cortisone preparations, which, while effective, can also cause undesirable side effects. Especially when used long-term, cortisone can damage the skin and pose other health risks. Therefore, more and more sufferers are looking for alternatives.
In recent years, probiotics – live microorganisms that promote health – have received increasing attention. The lactic acid bacteria strain Lactobacillus paracasei , with its variants LP-33 and GMNL-133, has shown particular promise in studies. Both strains modulate the immune system and strengthen the skin barrier, which can help relieve atopic dermatitis symptoms. In some studies, they are even comparable in effectiveness to cortisone – but without its side effects.
How Lactobacillus paracasei LP-33 and GMNL-133 work in atopic dermatitis
Atopic dermatitis is caused, among other things, by a dysregulation of the immune system and a weakened skin barrier, which increases moisture loss and promotes inflammation. Lactobacillus paracasei can intervene positively on several levels:
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Immunomodulation: The LP-33 and GMNL-133 strains regulate pro-inflammatory messengers (cytokines) such as IL-4, TNF-α, and CCL17, which play a central role in atopic dermatitis. They thereby reduce inflammatory reactions and allergic hypersensitivity.
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Strengthening the skin barrier: By promoting the production of skin lipids and improving cell networking, they reduce transepidermal water loss, which makes the skin more supple and reduces itching.
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Gut-skin axis: As part of the intestinal flora, they support a healthy balance of microorganisms, which has a positive effect on skin health.
Study situation: LP-33 and GMNL-133 at a glance
The efficacy of Lactobacillus paracasei in atopic diseases has been demonstrated in several clinical studies. While LP-33 was primarily studied in allergic rhinitis, results show symptomatic improvement, which is also useful for atopic dermatitis. GMNL-133 was specifically tested in children with atopic dermatitis, demonstrating significant improvements in the SCORAD index.
| feature | Lactobacillus paracasei LP-33 | Lactobacillus paracasei GMNL-133 | Cortisone (topical) |
|---|---|---|---|
| Mechanism of action | Immune modulation, anti-inflammatory | Immunomodulation, skin barrier strengthening | Strong anti-inflammatory effect |
| Proven effect | Symptom improvement of allergies, itching relief | Reduction of SCORAD index, long-term improvement of atopic dermatitis | Fast reduction of inflammation and itching |
| Side effects | Very well tolerated, mild digestive discomfort possible | Very well tolerated, no skin damage | Skin thinning, possible systemic effects |
| Recommended intake | 1–2 billion CFU daily, for at least 8 weeks | 2 billion CFU daily, for at least 12 weeks | Short-term use recommended |
| Onset of action | After a few weeks | After 4–8 weeks, effect even after discontinuation | Within a few days |
| Cortisone-sparing effect | Proven possible in combination therapy | Studies show reduced cortisone requirements | Not applicable |
Comparison of effectiveness: probiotics vs. cortisone
Cortisone is known for its rapid and potent anti-inflammatory effect. However, studies on Lactobacillus paracasei show that the GMNL-133 strain in particular is capable of reducing the severity of atopic dermatitis—measured by the SCORAD index—to a comparable extent. What's remarkable about this is that the effect sometimes lasts for several months even after discontinuation of probiotics.
The advantages of probiotics are clearly their safety and low risk of side effects. While long-term use of cortisone can damage the skin and impair the immune system, LP-33 and GMNL-133 have an immune-regulating effect without these risks. This makes them an ideal complement or even alternative to cortisone therapy.
There is also evidence that probiotics in combination with cortisone can reduce the so-called “cortisone requirement”, which allows for a lower dose and thus a lower rate of side effects.
Application and dosage
For a sustained effect, probiotics containing Lactobacillus paracasei LP-33 or GMNL-133 should be taken regularly for at least 8 to 12 weeks. The usual dosage is approximately 2 billion colony-forming units (CFU) daily. Especially for children, lower doses may be sufficient as long as they are taken consistently.
Accompanying skincare with moisturizing, fragrance-free products supports the effect by strengthening the skin barrier and preserving moisture. Continuous use is recommended, as the positive effects often increase over time and remain stable.
Safety and tolerability
Taking LP-33 and GMNL-133 is considered safe and very well tolerated. Unlike cortisone, there are no side effects such as skin thinning or immunosuppression. In rare cases, mild digestive discomfort may occur initially, which usually disappear after a short time.
Especially for children and sensitive individuals, the application is a gentle, side-effect-free therapy option.
Outlook and perspectives
Research on Lactobacillus paracasei in the treatment of atopic dermatitis is promising, but not yet complete. Larger studies with more participants are needed to definitively determine the optimal dosage and duration of effect. Combining different probiotic strains and developing new, personalized therapies are other exciting areas of research.
Conclusion
Lactobacillus paracasei LP-33 and GMNL-133 offer an effective and low-side-effect treatment for atopic dermatitis. Their ability to strengthen the skin barrier and reduce inflammation makes them a natural alternative or supplement to cortisone. Studies show that these probiotics can be similarly effective to cortisone without its side effects.
For those affected, regular use for at least three months, combined with good skin care, is recommended. This can significantly improve quality of life and reduce the need for cortisone.
