July 15, 2025Open Access

Probiotics supplements for the prevention of atopic dermatitis in children: an umbrella review

LZLing ZhongUniversity of Electronic Science and Technology of China JSJia SuNingbo University Affiliated Hospital XZXiyuan ZhouUniversity of Electronic Science and Technology of China

Key Points

Probiotics supplementation is associated with a reduced risk of atopic dermatitis (AD) in children.
The umbrella review analyzed 126 meta-analyses and found strong evidence for probiotics' protective effect.
Both prenatal and postnatal supplementation, particularly multi-strain probiotics, are most beneficial.
Future research is needed for randomized controlled trials to solidify evidence-based guidelines for probiotics use.

Abstract

Introduction Previous meta-analyses of multiple studies have suggested that probiotics supplementation plays a role in reducing the risk of atopic dermatitis (AD). However, the conclusions of these studies remain controversial. Methods We conducted an umbrella review of meta-analyses to comprehensively analyze and evaluate the evidence regarding the association between probiotics and AD. We searched PubMed, Web of Science, Embase, Spous, and Cochrane Library databases for meta-analyses and systematic reviews up to October 2024. Our selection criteria encompassed meta-analyses of cohort studies, case–control studies, and randomized controlled clinical trials investigating the associations between probiotics and the risk of AD. We also assessed the levels of evidence for these associations using the AMSTAR 2 criteria. Results A total of 32 eligible articles, including 126 meta-analyses, were included for qualitative synthesis in this umbrella review. The results indicate that probiotics supplementation is associated with a reduced risk of AD. The subgroup analysis indicates that supplementation with Lactobacillus spp., single-strain, and multi-strain probiotics is associated with a reduced risk of AD, with multi-strain formulations potentially demonstrating more pronounced effects. Furthermore, both combined prenatal and postnatal supplementation, as well as postnatal supplementation alone, contribute to a reduction in AD risk. Discussion Probiotics supplementation may help reduce the risk of AD, with early-life administration playing a key role. Future research should focus on well-designed randomized controlled trials that account for potential sources of bias in order to provide evidence-based public health recommendations. Systematic review registration PROSPERO (International00 Prospective Register of Systematic Reviews) under the registration number CRD42024599789. The publicly accessible registration record is available at: https://www.crd.york.ac.uk/PROSPERO/view/CRD42024599789 .

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