Did you know that your child’s gut health can affect their skin? Kids with eczema often have fewer “good” bacteria like Lactobacillus Rhamnosus GG, and more harmful bacteria in their intestines. This imbalance, called gut dysbiosis, can over-activate the immune system and trigger skin inflammation. Supporting gut health with the right probiotics like lactobacillus probiotics may help calm eczema from the inside out!
How Gut Health Affects Your Child’s Skin
Your child’s gut plays a key role in skin health. In kids with eczema, the balance of gut bacteria is often disrupted, a condition called gut dysbiosis. This means there are fewer beneficial bacteria, like Lactobacillus, and more inflammatory bacteria.
When this balance is off, the gut lining can become “leaky,” letting substances enter the bloodstream that trigger systemic inflammation. This inflammation can worsen eczema flares. In short, a healthy gut helps regulate the immune system and keeps the skin calm, while an unhealthy gut can make eczema worse.
What Are Lactobacillus Probiotics
Lactobacillus probiotics are beneficial bacteria that naturally live in the gut. They produce short-chain fatty acids (SCFAs), such as butyrate, which strengthen the gut lining and support immune cells called regulatory T cells (Tregs).
Tregs help prevent the immune system from overreacting, a key factor in eczema. By improving gut health, Lactobacillus probiotics can reduce inflammation, support the skin barrier, and make eczema flare-ups less frequent and severe.
How Lactobacilli Help the Skin
Lactobacilli work by maintaining the gut barrier and producing metabolites that calm the immune system. When these beneficial bacteria are reduced, the gut becomes more permeable, allowing inflammatory substances to reach the bloodstream. This can trigger the Th2-skewed immune response and high IgE levels commonly seen in eczema.
Put simply: fewer Lactobacilli in the gut = more sensitive skin and more frequent eczema flares.
The Effect of Lactobacillus Strains in Children With Atopic Dermatitis
Since 2003, there has been a lot of research backing the use of Lacto rhamnosus GG. In 2003, a group of researchers found that children ranging from 1 to 13 years old who took a combination of Lactobacillus Rhamnosus and Lactobacillus Reuteri showed decreased levels of Eosinophil Cationic Protein (ECP).
This indicates a reduction in allergic inflammation and improvement in disease severity.
Among the many strains studied, LGG stands out as one of the most extensively researched probiotics in relation to childhood eczema.
In a pivotal study by Wickens et al. (2008), supplementation with LGG significantly reduced the number of children who developed eczema by the age of two. Importantly, this reduction occurred without a corresponding decrease in allergic sensitisation (atopy), suggesting that LGG primarily influences pathways related to skin inflammation, immune regulation, and barrier function rather than permanently altering allergic predisposition.
Over the years, researchers kept zooming in on Lactobacillus rhamnosus GG (LGG).
Research has also been done on Bifidobacteria and Lactobacillus salivarius LSO1, which we will cover below.
Can Bifidobacteria Probiotics Help My Children’s Atopic Eczema?
The same research paper (quoted above) published by Wickens et al. (2008) concludes: Bifidobacterium animalis subsp. lactis showed no significant benefit for either eczema prevention or atopy. 🤷
Please continue reading. I will try to explain why.
Why Is Chinese Doc Writing About Probiotics For Children?
At our clinic, parents bring in their children, mostly toddlers, even infants, who are flaring with eczema. The child is in excruciating pain, the parents don’t know what to do, and they often are told to give their children probiotics.
This article on probiotics is the result of parents bringing in their children for treatment of childhood eczema — one consistent question is: should we use probiotics, and which one? This article was created for that parent.
In 2025, a more recent study explored the effects of Bifidobacteria in the development of atopic eczema. It demonstrated that Bifidobacteria are two-faced – let us explain.
Different types of bifidobacteria are more abundant at different ages in infancy. This makes it difficult to supplement bifidobacteria in a targeted way.
More specifically, researchers found that certain Bifidobacterium types present around 2 months of age were linked to a lower risk of eczema.
However, this protective effect did not last! Between 2 and 12 months, the mix of bifidobacteria in the gut changed rapidly. New types appeared, while the earlier beneficial bifidobacteria faded or stopped being protective.
By 12 months, Bifidobacterium was no longer protective. Some of the later-appearing, more “adult-like” types were even linked to a higher risk of eczema later in childhood!
This is why the evidence for Bifidobacterium is more complex and less consistent than for LGG.
Conclusion: It may not be as effective or safe to supplement with bifidobacterium probiotic for your kid.
Lactobacillus Salivarius LSO1 is Also Good for Your Child’s Atopic Eczema!
Research by PubMed on the probiotic strain Lactobacillus salivarius LS01 (also called Ligilactobacillus salivarius LS01) shows measurable effects on atopic eczema in controlled clinical settings. A preliminary clinical trial involving 43 children aged 0 to 11 with atopic dermatitis found that oral supplementation with L. salivarius LS01 resulted in significant improvements in both objective severity scores (SCORAD) and itch intensity during and after the probiotic period. Improvements continued after the supplementation ended, suggesting a lasting clinical effect within the study period. This outcome was interpreted as an enhancement in quality of life for those children affected by eczema.
Another research approach examined a synbiotic combination of L. salivarius with a prebiotic (fructo-oligosaccharide) in children with moderate to severe atopic dermatitis. In this double-blind, randomized study, patients receiving the combination had significantly lower eczema severity scores after eight weeks compared with a control group that received the prebiotic alone. The trial also reported that the treatment group had a greater proportion of children with mild disease status by the end of the period, along with reduction in medication use and inflammatory markers.
Clinical evidence from adult studies further supports strain-specific effects on atopic dermatitis severity. In a randomized, double-blind, placebo-controlled trial of adults, L. salivarius LS01 supplementation for 16 weeks led to a significant reduction in SCORAD scores and improvements in dermatology life quality scores compared with placebo. In this study, the probiotic was well tolerated and associated with changes in immune response indicators and a decrease in intestinal staphylococcal populations.
Broader analyses of multiple clinical trials suggest that strain selection is critical when evaluating probiotics for atopic dermatitis. A systematic review and meta-analysis that included several trials reported that probiotics had a beneficial impact on severity scores in adults, with L. salivarius among the strains showing the largest effect size. The review noted greater statistical improvements in moderate to severe disease compared with mild cases.
Mechanistic research and clinical observations together hint at how L. salivarius LS01 might exert effects in atopic eczema. The strain appears to influence immune regulation pathways, for example by modulating Th2-type cytokine activity while maintaining Th1 cytokine levels, and by affecting gut microbiota composition including reductions in certain bacterial groups associated with inflammation. These immune and microbiota changes align with clinical improvements in severity scores in both pediatric and adult participants.
Now that we have finished covering Lactobacillus salivarius LSO1, let’s go back to lactoGG and dive deeper in.
LGG Supplementation Benefits for Kids Up to 18 Years
In 2023, Wang and colleagues analyzed multiple studies in meta-analysis on Lactobacillus rhamnosus (the probiotic strain in LactoGG) and its effects on children with eczema, from infants up to 18 years old.
The researchers found that children who took Lactobacillus rhamnosus experienced less severe eczema symptoms compared with children who did not take the probiotic. This suggests that giving this probiotic may help manage eczema severity across a wide age range.
If You’re Pregnant, Lactobacillus Probiotic (LGG) May Prevent Baby Eczema!
Interestingly, the authors also concluded that if the pregnant mother took LactoGG probiotics before and after delivery, it could significantly prevent the incidence of atopic dermatitis in her baby. So this suggests that eczema can be prevented in children using probiotics especially when given BOTH pre-natally and post-natally!
Should My Child Take LactoGG Every Day for Life? What’s the Right Dose?
Currently, the studies show that LGG works best in pregnancy, infancy, and early toddler years (up to 1–3 years old). It helps reduce the chance or severity of eczema expression, but it does not permanently change allergy risk.
Of course, there are also studies that include children up to 18 years of age.
There are products out there like the famous LGG in green packaging. Each capsule contains about 20 billion live cells of Lactobacillus rhamnosus GG.
However, it is important for all consumers to know that this is way more than the typical dosages used in clinical studies which only range from about 1 to 5 billion CFU (colony forming units).
After early childhood, it’s still important to focus on good skin barrier care, a diverse, fibre-rich diet, and avoiding unnecessary antibiotics.
Can LGG Work Better with Other Supplements?
There is one study done in 2020, on combining LGG with vitamin D3 and zinc, and feeding it to children less than 2 years of age. The dosage was 1 billion CFU of LGG, with 0.01mg of vitamin D3 and 0.6mg zinc. The probiotic/micronutrient group had a significant SCORAD reduction and used less topical treatment and antihistamines over 2 years.
LGG + Vitamin D3 + Zinc: A Powerful Combo Against Eczema?
Let’s look at the science.
LGG primarily acts through the gut–immune–skin axis. It helps restore gut microbial balance, strengthens the intestinal barrier, and promotes regulatory immune responses. LGG increases the production of short-chain fatty acids and supports regulatory T cells, which reduce excessive Th2-driven inflammation commonly seen in eczema. By lowering systemic inflammation originating from the gut, LGG reduces immune activation that would otherwise manifest in the skin.
Vitamin D3 plays a key role in immune modulation and skin barrier integrity. It promotes immune tolerance by suppressing excessive Th2 responses while enhancing regulatory immune pathways. Vitamin D also supports the production of antimicrobial peptides in the skin, which improve barrier defense and reduce secondary infections that often worsen eczema. In young children, vitamin D deficiency is common, and correcting this deficiency may reduce baseline skin inflammation and improve treatment response.
Zinc contributes directly to skin barrier repair and immune balance. It is essential for keratinocyte proliferation, wound healing, and maintaining tight junctions in the skin. Zinc deficiency is associated with increased skin permeability, delayed healing, and heightened inflammatory responses. In eczema, adequate zinc helps reduce oozing, crusting, and prolonged inflammation, while also supporting normal immune cell function.
When used together, LGG, vitamin D3 and zinc create a synergistic effect. LGG reduces inflammatory signaling from the gut, vitamin D3 recalibrates immune responses and strengthens antimicrobial defense, and zinc supports physical skin repair and inflammation control. This multi-level approach explains why children receiving the combination showed greater reductions in SCORAD scores and required less topical medication and antihistamines over time.
In this section, we will link to another page that recommends certain products that are likely safer
Since LGG Is a Probiotic, Should My Child Take a Prebiotic Too?
Since LGG is a probiotic, it naturally raises the question of whether giving a prebiotic alongside it would help. Prebiotics are non-digestible fibers that act as food for beneficial gut bacteria, potentially helping probiotics like LGG survive and colonise the gut more effectively.
In theory, combining LGG probiotic with a prebiotic — hence making a synbiotic — could enhance its effects on the gut microbiome and immune system. There is one study done in Russia that looked at the effectiveness of both LGG and prebiotics in children with eczema, and the results supported its use. The study did not mention exactly which prebiotics though.
How to Give Prebiotics for Kids with Eczema
Fructo-oligosaccharides (FOS), galacto-oligosaccharides (GOS), and trans-galacto-oligosaccharides (TOS) are the most common prebiotics.
But generally, you can just let your kid have whole foods that contain these prebiotics.
Foods high in prebiotics are primarily fiber-rich plant foods that feed beneficial gut bacteria, including chicory root, Jerusalem artichoke, garlic, onions, leeks, asparagus, bananas, oats, and flaxseeds. These foods support digestion and immune health by promoting healthy bacteria in the colon.
So you don’t have to actively look for a supplement that combines LGG and a prebiotic, in case you were wondering.
More importantly, there are prebiotics that can flare up your child’s eczema → link to inulin prebiotic article.
Practical Tips for Choosing a Safe Probiotic Product
Choosing the right probiotic for your child can feel overwhelming with so many options on the market. Here are some tips to keep it safe and effective:
- Check the strain. Look for probiotics that list specific strains, such as Lactobacillus rhamnosus GG (LGG) or Lactobacillus salivarius LS01, which have research backing for eczema.
- Check the dose. Clinical studies often use 1–5 billion CFU per day for children. Avoid products that don’t specify the amount of live bacteria.
- Look for quality certifications. Choose products that are tested for purity and safety. Third-party testing or GMP certification is ideal.
- Consider form and storage: Probiotics come in capsules, powders, or chewables. Some require refrigeration. Follow the instructions to ensure the bacteria stay alive.
We also reviewed popular probiotic products, including which ones may contain strains that aren’t helpful or could even worsen eczema.
Check out this article for a detailed product review and recommendations.
Conclusion: Probiotics Are An Effective Option for Atopic Dermatitis!
According to Emokpae et al. (2025), research into the gut microbiome’s influence on skin immunity has intensified, and probiotic therapy has emerged as a potential alternative for atopic dermatitis (AD).
The authors note that while probiotics can modulate gut microbial diversity and have shown promise in conditions like antibiotic‑associated diarrhea and irritable bowel syndrome, their role in AD has not been as extensively studied. They emphasise that Lactobacillus species, as major components of many probiotic supplements, are promising candidates for AD management due to their immunomodulatory properties, but outcomes vary widely depending on the specific strain used.
Who Am I?
Dr. Mark uses Chinese Herbs to reduce inflammation and tweak the immune system. At Chinese Doc Singapore, he treats allergic asthma, allergic rhinitis and atopic dermatitis. His PhD is on Steroid-dependent Eczema, and he has been treating TSW in children and adults for over a decade.
To Learn More About TCM Treatment For Eczema, fill out the form below.
Frequently Asked Questions
Should I give my child probiotics for eczema?
It depends — but there is a reasonable case for trying it, particularly in younger children. The research suggests probiotics are more useful as a preventive tool than a cure. If your child already has eczema, probiotics may help reduce flare frequency and severity by calming the gut–immune–skin axis, but they are unlikely to eliminate eczema on their own. Think of them as one tool among several, alongside skin barrier care, diet, and — where needed — TCM or medical treatment.
Which strains should I look for?
The two strains with the most relevant evidence for children with eczema are Lactobacillus rhamnosus GG (LGG) and Lactobacillus salivarius LS01. LGG has the largest body of research behind it across infants and children up to 18 years old. L. salivarius LS01 has shown meaningful reductions in SCORAD scores in both children and adults, and appears to work well in combination with a prebiotic. Bifidobacterium strains are more complicated — some are protective in very early infancy, but this effect does not reliably persist, and some later-appearing types may even be associated with higher eczema risk. For this reason, I tend to be more cautious about recommending Bifidobacterium supplementation as a standalone approach.
How long should my child take it?
Most clinical studies run for 12 to 16 weeks, which is a reasonable trial period to assess whether your child is responding. The evidence is strongest for early intervention — ideally starting in pregnancy, continuing through infancy, and into the early toddler years. That said, there are studies including children up to 18 years old that still show benefit. If your child is older, a 3-month trial at a sensible dose is worth considering. There is no strong evidence for lifelong supplementation — after early childhood, dietary fiber, food diversity, and avoiding unnecessary antibiotics may do more for long-term gut health than a daily probiotic capsule.
What does this mean for parents, practically?
Three things to keep in mind. First, the strain name on the label matters enormously — “Lactobacillus rhamnosus” and “Lactobacillus rhamnosus GG” are not the same thing. Always look for the full strain designation. Second, dose matters less than you might think — clinical studies typically used 1 to 10 billion CFU daily, and many products exceed this significantly without adding proportional benefit. Third, not every probiotic marketed for children is appropriate for children with eczema — some contain histamine-producing strains that may quietly worsen symptoms in sensitive children. If you are unsure where to start, LGG in a single-strain product, without unnecessary additives, is currently my most straightforward recommendation for this age group.
