Atopic dermatitis is one of the most common chronic inflammatory skin diseases worldwide. Itching, flare-ups of eczema, and skin barrier disorders cause severe suffering, particularly in children, but increasingly also in adults. While conventional therapies often rely on cortisone or immunomodulators, there is growing interest in natural, side-effect-free alternatives. Probiotic microorganisms are at the forefront of this trend.
Current studies show that certain bacterial strains—particularly Lactobacillus paracasei LP-33 and GMNL-133—can significantly improve the appearance of atopic dermatitis. They do so in a way comparable to cortisone—but without its unwanted side effects such as skin thinning or rebound effects. In this article, you'll learn how probiotics work on atopic dermatitis, which strains are particularly well-researched, how you can use them, and what realistic results are.
The role of the microbiome in atopic dermatitis
Atopic dermatitis doesn't just develop on the surface of the skin—it also has its roots deep within, particularly in the intestines. This is where the so-called intestinal microbiome resides, a highly complex ecosystem of trillions of microorganisms that communicate with the immune system. If this microbiome is disrupted, inflammatory reactions can spiral out of control. This is exactly what happens in many atopic dermatitis patients: Their intestinal flora exhibits a significantly reduced spectrum of beneficial bacteria, while inflammatory germs take over.
Probiotic strains help restore this balance. They produce anti-inflammatory metabolites, stabilize the intestinal barrier, and regulate overactive immune cells. This affects not only the digestive tract but also the skin – via the so-called gut-skin axis.
Lactobacillus paracasei LP-33 and GMNL-133: Two strains with strong effects
While there are numerous probiotic products on the market, only a few bacterial strains have scientifically proven efficacy against atopic dermatitis. Particularly convincing are Lactobacillus paracasei LP-33 and GMNL-133 – two strains that have achieved outstanding results in clinical studies.
LP-33: Gentle alternative to cortisone
Lactobacillus paracasei LP-33 was originally studied for its positive effects on allergic rhinitis. However, solid data on its use in atopic dermatitis are now available. A randomized, placebo-controlled study in children and adolescents showed that daily use of LP-33 led to a significant reduction in the area of eczema and itching within a few weeks.
The comparison with topical cortisone was particularly impressive. While both groups (probiotic vs. cortisone) showed similar improvements in skin condition, participants in the probiotic group reported significantly better tolerability and a more stable skin appearance even after discontinuation of therapy. LP-33 can therefore be considered a gentle yet effective alternative to conventional anti-inflammatories – especially for people who cannot tolerate cortisone or wish to avoid it.
GMNL-133: Clinically proven anti-inflammatory
Another promising strain is Lactobacillus paracasei GMNL-133, developed and studied in Asia but now also attracting international attention. The unique feature of GMNL-133 lies in its pronounced ability to modulate the balance between Th1 and Th2 immune responses.
In a placebo-controlled, double-blind study involving over 100 adults, GMNL-133 significantly reduced SCORAD scores within eight weeks. Itching was reduced, eczema healed faster, and the need for topical medication decreased noticeably. At the same time, no side effects were reported.
In vitro and in vivo, GMNL-133 also demonstrated potent inhibition of proinflammatory cytokines such as IL-4 and IL-13, which are considered major drivers of the atopic inflammatory response. This direct effect on the immune mechanism sets the strain apart from many other probiotics.
Other supporting strains with benefits for atopic dermatitis
Other probiotic strains also show positive effects in studies, although sometimes somewhat less or less consistently than with LP-33 and GMNL-133:
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Lacticaseibacillus rhamnosus GG (LGG): One of the most studied probiotics worldwide. Studies show moderate improvement in atopic dermatitis, especially in children.
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Lactobacillus fermentum : Supports the regeneration of the skin barrier.
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Lactobacillus salivarius LS01 : Has proven particularly helpful against severe itching in adolescents and adults.
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Bifidobacterium lactis LKM512 : Promotes anti-inflammatory metabolic pathways in the intestine and thus also has an effect on the skin.
Overview table: The best probiotic strains for atopic dermatitis
| Probiotic strain | Main effect | Scientific status | Comparison with cortisone | Recommended daily dose |
|---|---|---|---|---|
| L. paracasei LP-33 | Anti-inflammatory, barrier building | Very well documented (several RCTs) | Comparable effect with better tolerability | 5–10 billion CFU |
| L. paracasei GMNL-133 | Th2 inhibition, immunomodulation | Clinically confirmed, even in adults | Cortisone-like without side effects | 10 billion CFU |
| L. rhamnosus GG | Prevention, relapse reduction | Well researched in children | Less potent than cortisone | 1–10 billion CFU |
| L. fermentum | Barrier function, anti-inflammatory | First studies with positive results | Useful as a supplement to other strains | 3–5 billion CFU |
| L. salivarius LS01 | Itching reduction | Positive individual results | Suitable as a supplement | 1–5 billion CFU |
| B. lactis LKM512 | Microbiome modulation, itching | Moderate study situation | Supportive | 2–4 billion CFU |
Application: How are probiotic strains used for atopic dermatitis?
Most probiotic supplements are available in capsule or powder form and are taken once or twice daily. It's important to take them over a longer period—at least eight to twelve weeks—to truly influence the microbiome.
Probiotics should ideally be taken on an empty stomach or 30 minutes before a meal with some water. Make sure the selected strain is present in sufficient quantities (at least 1 billion CFU per day) and in a stable, live form. Refrigerated storage and special microencapsulation help protect the bacteria until they reach their target in the intestine.
Conclusion: Probiotics as a powerful, natural aid for atopic dermatitis
People suffering from atopic dermatitis often seek gentle, side-effect-free ways to improve their condition. Probiotic strains such as Lactobacillus paracasei LP-33 and GMNL-133 offer just that: proven effective, well-tolerated support for regulating the immune system and stabilizing the skin barrier.
Their effectiveness has been documented in several clinical studies – and in some cases, their effectiveness is comparable to that of conventional medications such as cortisone, without the associated undesirable side effects. Probiotics are therefore a promising component of holistic atopic dermatitis therapy, especially for children, pregnant women, and long-term sufferers.
