Probiotics in Psoriasis Management: A Randomized Trial on Disease Severity, Satisfaction, and Quality of Life Publisher



Kheirkhah F ; Babaie H ; Lajevardi V ; Ebrahimpour Koujan S ; Azizpour A
Source: Dermatologic Therapy Published:2026

Abstract

Background: Psoriasis is a chronic systemic disease with an inflammatory process and systemic involvement that affects the quality of life. Recent research indicates that gut microbiota dysbiosis is common in psoriasis cases, and probiotics have been considered as a potential adjunct therapy; however, the current evidence is limited. The aim of this study was to assess the effects of probiotic supplementation on the severity of psoriasis, treatment satisfaction, and quality of life of patients. Methods: Forty-four psoriasis patients between 18 and 70 years old were enrolled in this double-blind, randomized, placebocontrolled trial. They received either topical corticosteroids with a probiotic supplement containing multiple bacterial strains or topical corticosteroids with a placebo for 12 weeks. At the end of the study, changes in the Psoriasis Area and Severity Index (PASI), Dermatology Life Quality Index (DLQI), along with Treatment Satisfaction Questionnaire for Medication (TSQM), and adverse events were assessed. Results: Probiotic supplementation resulted in a greater reduction in PASI scores compared to the control group (46% vs. 15%, p = 0.002). At Week 12, the mean DLQI score was significantly lower in the probiotic group (4.364 ± 5.010) as compared to the control group (8.773 ± 6.015, p < 0.001), with 31.8% of probiotic users reporting no impact on quality of life (DLQI score 0-1) versus 0% in controls. The patient satisfaction with treatment was significantly higher in the probiotic group. No adverse effects were reported. Conclusion: Probiotics can be recommended as a safe and effective adjunct therapy for psoriasis. They can enhance clinical outcomes, quality of life, and patient satisfaction. Further, larger trials are needed. Trial Registration: Iranian Registry of Clinical Trials: IRCT20130108012065N3. Copyright © 2026 Fatemeh Kheirkhah et al. Dermatologic Therapy published by John Wiley & Sons Ltd.