PEARLS 126, November 2008, written by Brian R McAvoy

Clinical question
How effective are probiotics in eczema?

Bottom line
Compared to placebo, probiotics do not reduce eczema symptoms, such as itching, nor do they change the overall severity of eczema judged by patients or their doctors. The results varied between different trials but overall do not suggest that probiotics are an effective treatment for eczema.

Caveat
Probiotic treatment is generally safe; however, it can lead to adverse effects including sepsis and bowel ischaemia. The precise risk of such events is difficult to quantify, but is likely to be very low for most people.

Context
Eczema affects between 5 and 20% of people at some time in their life. People with eczema have different bacteria in their gut to people without eczema, and sometimes they have inflam•mation in their gut. It may be possible to treat eczema symptoms by changing the mix of gut bacteria or by reducing inflammation in the gut. One type of treatment that might achieve this is probiotics - live microorganisms taken by mouth, such as the Lactobacillus bacteria, found in unpasteurised milk and yoghurt.

Cochrane Systematic Review
Boyle R J et al. Probiotics for treating eczema. Cochrane Reviews 2008, Issue 4. Article No. CD006135. DOI: 10.1002/14651858. CD006135.pub2. This review contains 12 trials involving 781 participants.