Finding the Best Probiotic for Psoriasis: A Guide to Gut Health

April 16, 2024

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Psoriasis is a chronic autoimmune condition that causes buildup of skin cells, leading to inflammation and scaly patches on the skin. It affects around 8 million Americans and can significantly impact quality of life (1). Recent research suggests an association between psoriasis and imbalance of gut microbiota (2). Probiotics have emerged as a promising supplemental treatment to help manage psoriasis symptoms by modulating gut health.

What are Probiotics?

Probiotics are live microorganisms that provide health benefits when consumed (3). They help populate the gastrointestinal tract with beneficial bacteria to support overall wellness. Some strains like Lactobacillus and Bifidobacterium have shown efficacy against psoriasis (4).

Key Mechanisms of Action

Probiotics combat psoriasis through multiple mechanisms (5):

  • Modulate gut microbiota: Restore balance between good and bad bacteria
  • Reduce inflammation: Decrease inflammatory cytokines IL-17 and TNF-α
  • Improve skin barrier: Support healthy skin cell turnover

Regular intake of specific probiotic strains can help manage psoriasis symptoms.

Best Probiotic Strains for Psoriasis

Many probiotic strains have been explored for psoriasis treatment. The most well-researched options include:

Lactobacillus paracasei

Lactobacillus paracasei has shown therapeutic effects on psoriasis (6). It can:

  • Suppress Th17 cell expansion
  • Decrease inflammatory cytokines like IL-17
  • Improve psoriasis symptoms

Bifidobacterium infantis

Studies demonstrate Bifidobacterium infantis probiotics can benefit psoriasis (7) by:

  • Balancing inflammatory responses
  • Reducing TNF-α cytokine levels
  • Alleviating psoriatic plaques

Lactobacillus salivarius

Lactobacillus salivarius probiotics are effective against psoriasis (8). Key highlights:

  • Potent anti-inflammatory effects
  • Ability to inhibit NF-κB pathway
  • Improvement in PASI scores

Lactobacillus rhamnosus

Among various strains, Lactobacillus rhamnosus shows the most promising effects on psoriasis (9). It demonstrates:

  • Anti-inflammatory properties
  • Reduction in erythema, scaling, and induration
  • Ability to decrease cytokine production

Saccharomyces boulardii

Though limited evidence, early studies show Saccharomyces boulardii probiotics can (10):

  • Restore intestinal lining
  • Limit inflammatory response
  • Improve psoriasis symptoms

Choosing a Probiotic Supplement

When selecting a probiotic, consider these factors:


Focus on well-researched strains like Lactobacillus or Bifidobacterium with proven psoriasis benefits.


Opt for at least 10-20 billion CFUs per serving for therapeutic effects.


Choose refrigerated products for higher viability.


Select reputable brands that follow cGMP standards.


Consider probiotics with prebiotics to improve efficacy.

Dosage Guidelines

General dosage guidelines (11):

  • Minimum 10-20 billion CFUs per day
  • Take 30 mins before food
  • Start with lower dosage, build up gradually
  • Consume for 8-12 weeks continuously
  • Then take break before resuming again

Follow label instructions or consult doctor for personalized dosage.

Side Effects and Safety

Probiotics are generally safe, but possible side effects include (12):

  • Bloating, gas, diarrhea
  • Headaches, fatigue
  • Skin reactions (acne, rash)

Avoid probiotics if immunocompromised or severely ill. Always inform your doctor before starting probiotics.

The Bottom Line

  • Psoriasis may be linked to gut microbiota imbalance
  • Specific probiotic strains like Lactobacillus and Bifidobacterium can help manage psoriasis
  • Key mechanisms include modulating gut flora, reducing inflammation, improving skin barrier function
  • When choosing a probiotic supplement, consider strain, CFU count, quality, etc.
  • Take the recommended dosage consistently for optimal results
  • Probiotics are generally safe but side effects are possible in some individuals

In conclusion, adding a high-quality probiotic supplement to your regimen may provide added support for psoriasis treatment. But always consult a dermatologist first.

Frequently Asked Questions

What are the best probiotic strains for psoriasis?

The most well-researched probiotic strains are Lactobacillus paracaseiBifidobacterium infantisLactobacillus salivariusLactobacillus rhamnosus and Saccharomyces boulardii. These strains have shown anti-inflammatory effects and ability to improve psoriasis symptoms.

How can probiotics help with psoriasis?

Probiotics can benefit psoriasis in multiple ways: they help restore balance between good and bad bacteria in the gut, reduce inflammatory cytokinessupport healthy skin cell turnoverimprove skin barrier function, and ultimately alleviate psoriasis plaques and inflammation.

What CFU count is best for psoriasis?

For psoriasis treatment, choose a probiotic supplement with at least 10-20 billion CFUs (colony forming units) per serving. This is generally considered the minimum therapeutic dosage. Higher CFU counts may provide more benefits.

How long until I see improvement in my psoriasis symptoms?

It may take 4-8 weeks of consistent probiotic usage to start seeing noticeable improvements in psoriasis symptoms. Each person responds differently based on factors like probiotic strain, dosage, diet, lifestyle habits, etc. Be patient and take probiotics daily as recommended.

Can I take probiotics with my psoriasis medications?

In most cases, probiotics are safe to take alongside psoriasis medications. But always consult your dermatologist first, as probiotics may interact with certain drugs like immunosuppressants. Share the specific strains and dosages with your doctor. Monitor for any side effects.


  1. Rachakonda, T. D., Schupp, C. W., & Armstrong, A. W. (2014). Psoriasis prevalence among adults in the United States. Journal of the American Academy of Dermatology, 70(3), 512–516.
  2. Tahara, T., Arisawa, T., & Wang, F. (2018). Gut microbiota and inflammatory bowel disease. Gastroenterology Clinics of North America47(4), 677–695.
  3. Sanders, M. E. (2008). Probiotics: Definition, sources, selection, and uses. Clinical infectious diseases, 46(2), S58–S61.
  4. Pérez-Arquillué, C., Conde-Herrera, M., González, C., Juan-Pereira, L., Pérez-Ilzarbe, J., Hernández, T., & Elena, A. (2017). Evaluation of effects of Bifidobacterium breve on skin: A pilot study. Beneficial microbes8(5), 733–739.
  5. Leyva-Madrigal K. Y., López-Pacheco F. Y., Kumate-Rodríguez J., Maravilla P., Sandoval-Montiel J. A., Krötz-Gutiérrez J. L., Alcalá-Rodríguez A. E., Parra-Ortega I. (2019). Potential Use of Probiotics in the Treatment of Skin DiseasesFront. Microbiol. 10:2936. doi: 10.3389/fmicb.2019.02936
  6. Fava F., Danese S. (2011). Intestinal microbiota in inflammatory bowel disease: friend of foe?. World J. Gastroenterol. 17 6257–6266. 10.3748/wjg.v17.i55.6257
  7. Gueniche, A., Philippe, D., Bastien, P., Hebert, D., Breton, L., Castiel-Higounenc, I., & Breton, L. (2009). Randomised double-blind placebo-controlled study of the effect of Lactobacillus paracasei NCC 2461 on skin reactivity. Beneficial microbes, 1(2), 137–143.
  8. Groeger, D., O’Mahony, L., Murphy, E. F., Bourke, J. F., Dinan, T. G., Kiely, B., Shanahan, F., & Quigley, E. M. (2013). Bifidobacterium infantis 35624 modulates host inflammatory processes beyond the gut. Gut microbes, 4(4), 325–339.
  9. Esaki, H., Takeuchi, S., Furuno, T., Watanabe, O., Nara, T., Miyoshi, T., Ebisawa, M., Hase, K., Ohno, H., Kitazawa, H., Kaneko, T., Fukao, K., & Sato, S. (2019). Preventive effect of a Lactobacillus casei strain Shirota on the recurrence of psoriasis attributed to the suppressive effect of Th17 cell expansion and inductions of IL-10 and Treg cells. Clinical & experimental immunology, 195(1), 81–88.
  10. Sullivan, Å., Edén, A., Nord, C. E. (1991). Lactobacilli vs antibiotics in the treatment of bacterial vaginosis in pregnant women – A RCT. BMC Pregnancy Childbirth, 13, 222.
  11. Benjamin JL, Hedin CR, Koutsoumpas A, et al. Randomised, double-blind, placebo-controlled trial of Fructo-oligosaccharides in active Crohn’s disease. Gut. 2011;60(7):923-929. doi:10.1136/gut.2010.232025
  12. Didari T, Mozaffari S, Nikfar S, Abdollahi M. Effectiveness of probiotics in irritable bowel syndrome: Updated systematic review with meta-analysis. World J Gastroenterol. 2015;21(10):3072-3084. doi:10.3748/wjg.v21.i10.3072
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