Probiotics in Atopic Dermatitis: Does Gut Microbiome Modulation Enhance Skin Condition?

Atopic dermatitis (AD) is a chronic condition driven by epidermal barrier disruption and multiphasic immune dysregulation involving type 2, Th1, Th17, and Th22 pathways. Beyond local cutaneous pathology, systemic interactions mediated by the bidirectional gut–skin axis play an integral role, in which intestinal dysbiosis, depletion of short-chain fatty acid–producing taxa, and compromised epithelial integrity exacerbate cutaneous symptoms. This review evaluates the therapeutic potential and mechanistic pathways of targeted probiotic administration to restore microenvironmental equilibrium and alleviate cutaneous pathology. The underlying biological mechanisms-encompassing epithelial junction reinforcement, short-chain fatty acid biosynthesis, and cytokine rebalancing-are examined alongside current clinical evidence. Therapeutic interventions utilizing selected bacterial strains have been shown to significantly reduce SCORAD indices, indicating that probiotic supplementation represents a viable, safe adjunctive strategy for managing disease severity in both pediatric and adult populations