From Probiotic to Prebiotic Using Thermal Spring Water openaccess articles

June 2018 | Volume 17 | Issue 6 | Original Article | 657 | Copyright © 2018

Joshua Zeichner MDa and Sophie Seite PhDb

aMount Sinai Hospital, New York, NY bLa Roche-Posay Dermatological Laboratories, Levallois-Perret, France

figure6LRP-TSW may be considered a probiotic, as it naturally contains a low concentration of bacteria, with a high microbial diversity and more Gram-negative than Gram-positive bacteria. Clinical studies indicate that balneotherapy with probiotic LRP-TSW stimulates the growth of Gram-negative bacteria, particularly on Xanthomonadaceae, at the expense of Gram-positive bacteria at the skin surface improving microbial diversity associated with decreased severity of inflammatory skin conditions.12-14 Without the use of an antibiotic, LRP-TSW can modify the microbiota on human skin. Decreases in Staphylococci sp. have been observed along with increases in Gram-negative Xanthomonadaceae levels, even after topical application of LRP-TSW.12-14 Moreover, these improvements in microbiota have been correlated to clinical improvement of the skin in conditions like AD. Although the therapeutic mechanisms of balneotherapy are not completely understood, in addition to a probiotic effect LRP-TSW may have anti-inflammatory effects as well. Finally, it exhibits a prebiotic effect on Gram-negative bacteria and on the Xanthomonadaceae family, as patients treated with prebiotic demonstrate improvements in dryness and skin barrier function.7


Skin microbiome studies are challenging and costly. Currently results are a discussion of in-vivo data that demonstrated microbiome alterations correlated with skin condition improvement when using balneotherapy at the source with probiotic LRP-TSW, topical filtered LRP-TSW, and skincare containing more than 50% LRP-TSW. More comparative studies using TSW with different mineral compositions are needed to better understand the mechanism(s) of action.


LRP-TSW exhibits both prebiotic for its mineral composition and probiotic properties for its bacterial diversity. LRP balneotherapy has been shown to effectively treat inflammatory skin conditions including AD and psoriasis. An abnormal microbiota is associated with skin disease and improvements in microbial diversity correlated with clinical improvements in the severity of the skin disease itself. LRP-TSW has been shown in clinical studies to improve skin microbiome diversity as well as the decreased severity of active lesions in skin diseases like AD, psoriasis, and general dryness in otherwise healthy skin. The concentration of minerals and non-pathogenic microbes likely explain its therapeutic benefit and make it an attractive option for treating inflammatory skin diseases.


Joshua Zeichner has served as an advisory board member and consultant to La Roche Posay. Sophie Seité is an employee of La Roche-Posay, France.


The author would like to thank Dr. Andriessen of RBC Consultants for writing assistance. Her support was funded by La Roche-Posay Dermatological Laboratories, France.


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Joshua Zeichner MD


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