Probiotics and Prebiotics in Dermatology: Regulating the Skin Microbiome and Influencing Mental Health

Background: The skin and gut microbiomes are complex ecosystems critical to human health, with their interplay mediated through the gut-skin-brain axis.Probiotics and prebiotics offer promising interventions to modulate these microbial communities, impacting dermatological conditions and mental health outcomes.This review synthesizes current scientific understanding of their mechanisms, clinical efficacy, and emerging therapeutic strategies in dermatology.Methods: A systematic literature search was conducted across PubMed, Embase, Web of Science, and ClinicalTrials.gov,using keywords such as "probiotics," "prebiotics," "skin microbiome," and "gut-skin axis."Studies from 2015-2025, including peer-reviewed articles, systematic reviews, meta-analyses, and clinical trials, were prioritized, with a focus on human subjects, supplemented by relevant animal or in vitro studies.Data were extracted on study design, interventions, and outcomes, and synthesized thematically to evaluate probiotics and prebiotics in dermatological conditions and mental health.Results: Probiotics and prebiotics modulate the skin and gut microbiomes through competitive inhibition, immunomodulation, and barrier enhancement, showing efficacy in atopic dermatitis, acne vulgaris, psoriasis, rosacea, and wound healing.Clinical trials demonstrate strain-specific benefits, such as reduced SCORAD scores in atopic dermatitis and improved PASI scores in psoriasis.Emerging strategies like microbiome transplantation, bacteriophage therapy, antimicrobial peptides, and CRISPR-based engineering highlight personalized approaches.Microbiome modulation also improves mental health outcomes, reducing anxiety, depression, and enhancing quality of life in dermatological patients.Conclusions: Probiotics and prebiotics offer significant therapeutic potential in dermatology by restoring microbial balance and alleviating psychological comorbidities via the gut-skin-brain axis.However, strain specificity, administration routes, and patient variability necessitate further research to optimize personalized interventions.Knowledge gaps in long-term efficacy and novel therapies underscore the need for advanced clinical trials.