For skin health, the balance between skin microbiota and the immune system of the skin is very important. The microbiota of the skin differs depending on the different areas and physiological characteristics of the skin. In case of skin damage, microbial colonization occurs. When colonizing of the tissue with harmful microorganisms occurs, a congenital immune response of the skin is triggered. If the balance between the microbiota of the skin and the immune system of the skin failed, there is a greater chance of infection, and wound healing is difficult. Probiotics can modulate both the microbiota of the skin and the innate immune system of the skin. Several mechanisms of probiotic activity for the prophylaxis of skin are known: modulation of immune system, production of antimicrobials, epithelial barrier protection, and competitive exclusion. The mode and form of the modulation of the immune system depends on the probiotic microorganism and varies according to the species and the strain of the microorganism. On the basis of published in vitro and clinical studies, the positive effect of local use of probiotic bacterial strains on wound healing, the improvement of atopic skin, the reduction of bacterial loading and the promotion of wound healing in patients with burns, the successful treatment of acne and the prevention of bacterial vaginosis has been demonstrated. The most common probiotic strains for topical use belong to the species Lactobacillus reuteri, L. plantarum, L. fermentum, L. rhamnosus, L. johnsonii, Bifidobacterium longum, Streptococcus thermophilus and Staphylococcus epidermis.
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