Atopic dermatitis is a frustrating skin condition that causes constant itching and affects millions of people worldwide. Scientists are discovering that the bacteria living in our gut and on our skin might be the key to treating this condition better. This review explores exciting new approaches that use beneficial bacteria, special fibers, and other microbiome-based treatments to help calm the immune system and reduce inflammation. These methods appear to work differently than traditional steroid creams and could offer relief with fewer side effects, especially for people with mild to moderate cases of the condition.
The Quick Take
- What they studied: How manipulating the bacteria in our bodies (called the microbiome) might help treat atopic dermatitis, a chronic itchy skin condition
- Who participated: This is a review article that summarizes findings from multiple studies rather than testing people directly. It examines research on various microbiome-based treatments
- Key finding: Several microbiome-based approaches—including probiotics, prebiotics, and fecal microbiota transplantation—show promise in helping control atopic dermatitis by balancing the immune system and reducing inflammation
- What it means for you: If you have mild to moderate atopic dermatitis, microbiome-based treatments may offer an alternative or complement to traditional steroid creams, potentially with fewer side effects. However, more research is needed before these become standard treatments, and you should discuss options with your doctor
The Research Details
This is a review article, which means the authors examined and summarized findings from many different studies rather than conducting their own experiment. They looked at various microbiome manipulation strategies—ways to change the bacteria in and on our bodies—to see how they might help treat atopic dermatitis.
The researchers focused on understanding how these bacterial-based treatments work. They examined approaches like probiotics (good bacteria you consume), prebiotics (food that feeds good bacteria), postbiotics (beneficial substances produced by bacteria), and more advanced techniques like fecal microbiota transplantation (transferring healthy bacteria from one person to another).
By reviewing all this research together, the authors could identify patterns and promising approaches that might help people with atopic dermatitis, particularly those with mild to moderate cases where immune imbalance is a major problem.
This research approach is important because atopic dermatitis is a major health problem affecting millions of people, and current treatments like steroid creams work well for inflammation but can have unwanted side effects with long-term use. By reviewing all available research on microbiome-based approaches, scientists can identify the most promising treatments and understand how they work. This helps guide future research and clinical practice toward safer, more effective options
This is a review article published in a reputable scientific journal (Frontiers in Immunology), which means it has been reviewed by experts. However, because it summarizes other studies rather than conducting original research, the strength of conclusions depends on the quality of the studies reviewed. The authors note that more research is needed, which is appropriate given that many of these microbiome treatments are still being tested. Readers should understand that while the findings are promising, many of these approaches are not yet standard medical treatments
What the Results Show
The review identifies several microbiome-based approaches that show potential for treating atopic dermatitis. Probiotics—beneficial bacteria that you can consume—appear to help by improving the balance of bacteria in the gut and on the skin, which in turn helps calm an overactive immune system. Prebiotics, which are special fibers that feed good bacteria, work in a similar way by promoting the growth of helpful microorganisms.
More advanced approaches like fecal microbiota transplantation (transferring healthy bacteria from a donor to a patient) are being explored for severe cases that don’t respond to other treatments. The research suggests these approaches work by helping to balance the immune system, specifically by adjusting the ratio of different immune cell types that are out of balance in people with atopic dermatitis.
Postbiotics—beneficial substances produced by bacteria—and other innovative approaches like herbal fermentation and phage therapy (using viruses that target bacteria) are also being studied. These methods appear to reduce inflammation through multiple pathways, offering hope for more effective treatment with fewer side effects than traditional steroid medications.
The review highlights that microbiome-based treatments may be particularly effective for mild to moderate atopic dermatitis cases where immune imbalance is a key driver of the disease. The research suggests these approaches can work alongside or potentially reduce the need for steroid creams. Additionally, the review notes that different microbiome manipulation strategies may work through different mechanisms, meaning doctors might eventually be able to choose the best approach for each individual patient based on their specific type of immune imbalance
Traditional treatments for atopic dermatitis have relied heavily on corticosteroid creams and ointments, which effectively reduce inflammation but can cause side effects like skin thinning with long-term use. This review represents a shift toward understanding the underlying causes of the disease—particularly the role of bacteria and immune imbalance—rather than just treating symptoms. While previous research identified that people with atopic dermatitis have different bacterial communities than healthy people, this review synthesizes newer evidence showing that deliberately manipulating these bacterial communities might be therapeutic. This represents an evolution from simply understanding the problem to actively using that understanding to develop new treatments
This is a review article, not original research, so it depends on the quality and design of studies it examines. Many of the microbiome-based treatments discussed are still in early testing stages, with limited human studies. The review notes that more research is needed to determine when and how to best use these therapies. Additionally, most of these approaches are not yet approved as standard medical treatments, and individual results may vary. The review focuses on mild to moderate cases, so findings may not apply equally to severe atopic dermatitis. Finally, the long-term safety and effectiveness of some approaches, particularly fecal microbiota transplantation, are still being studied
The Bottom Line
Based on current evidence, microbiome-based approaches show promise for managing mild to moderate atopic dermatitis, particularly as complementary treatments alongside or potentially reducing the need for steroid creams. Probiotics and prebiotics have the most research support and may be worth discussing with your doctor. More advanced approaches like fecal microbiota transplantation should currently be considered experimental and only pursued under medical supervision for severe cases. Confidence level: Moderate for probiotics/prebiotics; Low to Moderate for newer approaches
People with mild to moderate atopic dermatitis who want to explore alternatives to steroid creams or who experience side effects from traditional treatments should pay attention to this research. Those with severe, treatment-resistant atopic dermatitis might eventually benefit from more advanced microbiome approaches, though these are still being studied. People without atopic dermatitis or those with other skin conditions should not assume these treatments will help them. Anyone considering these treatments should discuss options with their dermatologist or allergist first
If you try probiotic or prebiotic approaches, you should expect to wait several weeks to months to see meaningful improvements in itching and skin inflammation. Some people may notice changes within 4-8 weeks, while others may need 2-3 months. More advanced approaches like fecal microbiota transplantation may show effects more quickly, but these are still experimental. It’s important to maintain consistent use and track your symptoms over time rather than expecting immediate results
Want to Apply This Research?
- Track daily itching intensity (on a scale of 1-10), areas of skin affected, and any visible redness or irritation. Also note which microbiome-based interventions you’re using (specific probiotic strains, prebiotic foods, etc.) and any dietary changes. This creates a clear picture of what works for your individual case
- Start incorporating prebiotic foods (like garlic, onions, bananas, and whole grains) into your diet while potentially adding a probiotic supplement after consulting your doctor. Use the app to log these additions and monitor how your skin responds over the following weeks. This practical step combines dietary change with symptom tracking
- Create a weekly summary view showing your itching scores, skin condition photos, and which interventions you’ve used. Set monthly check-in reminders to assess overall progress and adjust your approach if needed. Share this data with your healthcare provider to help guide treatment decisions and identify which microbiome-based strategies work best for you personally
This review discusses emerging microbiome-based treatments for atopic dermatitis that are still being researched. Many of these approaches are not yet approved as standard medical treatments. This information is educational and should not replace professional medical advice. If you have atopic dermatitis, consult with a dermatologist or allergist before starting any new treatment, including probiotics or other microbiome-based interventions. Some people may experience allergic reactions or other side effects. Do not stop using prescribed medications without medical guidance. Individual results vary, and what works for one person may not work for another.