Dysbiosis means imbalance of the normal gut bacteria (microbiome).
In simple words:
Good bacteria ↓ and bad bacteria ↑ inside the intestine.
This imbalance creates inflammation in the body and can trigger many diseases, including chronic urticaria, acidity, bloating, IBS, autoimmune problems, and skin issues.
✅ Scientific Definition
Dysbiosis =
Alteration in the quantity, diversity, or function of normal gut microbiota, leading to impaired immunity and increased inflammation.
✅ Why does dysbiosis happen?
Most common causes:
- Repeated antibiotics (most important)
- Gastroenteritis (E. coli, viral diarrhea)
- Stress, poor sleep
- Junk food, high sugar diet
- Prolonged fasting or irregular meals
- Age-related reduction in gut bacteria
- PPIs like pantoprazole for long duration
- Low-fiber diet
✅ Symptoms of dysbiosis
(Not all present in every patient)
- Gas, bloating
- IBS-like symptoms
- Acid reflux / LPR
- Irregular stools
- Excess mucus
- Food intolerance
- Fatigue
- Skin flare-ups (urticaria, eczema, acne)
✅ How dysbiosis causes chronic urticaria
- Gut imbalance →
- Increased permeability (“leaky gut”) →
- Bacterial toxins (LPS) enter bloodstream →
- Trigger mast cells →
- Histamine release →
- Urticaria, itching, flushing
This is why many urticaria patients improve after probiotics or after treating diarrhea.
✅ How to correct dysbiosis
- Probiotics
- High-fiber diet (fruits, oats, vegetables)
- Avoid unnecessary antibiotics
- Avoid excess sugar and packaged food
- Regular mealtime
- Buttermilk (daytime only)
- Occasional curd
- Good hydration
ડિસબાયઓસિસ એટલે આંતરડામાં રહેલા સારાં બેક્ટેરિયા ઓછા અને ખરાબ બેક્ટેરિયા વધારે થઈ જવું.
डिस्बायोसिस मतलब आँतों के अच्छे बैक्टीरिया कम और खराब बैक्टीरिया ज्यादा होना।
Dysbiosis means imbalance of gut bacteria—good bacteria decrease and harmful bacteria increase.
🔵 Probiotics used safely in
Chronic urticaria
Atopic dermatitis (probiotics reduce flares)
Seborrheic dermatitis
Acne patients after multiple antibiotics
Psoriasis (mild systemic benefit)
lichen planus
vitiligo
dysbiosis has a meaningful role in both vitiligo and lichen planus — but the mechanism and clinical importance are different in each disease.
Below is a clear, evidence-based and dermatologist-friendly explanation.
⭐ 1. Dysbiosis in Vitiligo – Clear Connection
✅ Strong scientific evidence (Level 2–B)
Recent studies show that vitiligo patients commonly have:
- Reduced Lactobacillus and Bifidobacterium
- Increased pro-inflammatory gut bacteria
- Higher levels of LPS (endotoxin) in blood
- Altered T-cell and dendritic cell activity
These changes cause:
- ↑ IFN-γ
- ↑ CXCL9, CXCL10
- ↑ oxidative stress
- ↑ melanocyte apoptosis
👉 This explains why gut dysbiosis may worsen vitiligo progression.
🔬 Clinical impact
- Many vitiligo patients worsen after:
- Repeated antibiotics
- GI infections
- Severe constipation
- Chronic acid reflux
- Some patients show stabilization with:
- Probiotics
- Diet correction
- Anti-inflammatory gut therapy
⭐ So in vitiligo:
- Dysbiosis = important aggravating factor
- Probiotics = adjunctive therapy, not primary treatment
- Helps especially in:
- Active disease
- Vitiligo with IBS / acidity
- Post-antibiotic flare vitiligo
⭐ 2. Dysbiosis in Lichen Planus (LP) – Moderate Connection
🔬 Current understanding
Lichen planus is primarily a T-cell mediated autoimmune disorder.
But recent microbiome studies show:
- Altered gut flora
- Increased inflammatory cytokines
- Modified mucosal immunity
- Possible triggering by oral/gut infections
🧪 LP subtypes where dysbiosis has more role:
- Lichen planus pigmentosus
- Oral lichen planus
- Cutaneous LP with chronic GI acidity or constipation
- LP patients with metabolic syndrome or NAFLD
⭐ Mechanism
Dysbiosis → ↑ IL-17, IL-23 axis → ↑ Th1/Th17 response → keratinocyte apoptosis → LP flares
This pathway is similar to psoriasis and vitiligo but less dominant.
📌 So in LP:
- Dysbiosis = secondary contributor
- It does NOT cure LP, but may reduce inflammation and help control chronic disease
- Patients with concurrent GI issues improve more with probiotics
🟢 3. Can probiotics help in Vitiligo & LP?
✔ Vitiligo
YES – beneficial as adjunct.
May help in:
- Reducing oxidative stress
- Lowering IFN-γ mediated inflammation
- Improving nutrient absorption (B12, folates)
- Stabilizing active disease
May help your vitiligo patients who have:
- Recent diarrhea
- Acid reflux
- IBS
- Antibiotic-induced flare
- Stress-triggered worsening
✔ Lichen Planus
Possible benefit but mild to moderate.
Use in:
- OLP
- LPP
- Chronic recurrences
- Patients with gut symptoms or constipation
- LP with metabolic syndrome
✔ Safety
Probiotics are safe in both diseases unless patient is severely immunocompromised.
When to add Preventic in Vitiligo?
- Active spreading phase
- History of GI infection
- Post-antibiotic use
- Vitiligo + IBS / constipation
- Vitiligo + autoimmune thyroiditis (helps inflammation)
When to add in Lichen Planus?
- OLP with burning
- LPP patients with chronic dysbiosis
- LP with bloating / gas / acidity
- Long-term immunosuppressant use (methotrexate, azathioprine)
- Lichen planus recurrences every 3–6 months
When probiotic will NOT make big difference?
- Stable vitiligo
- LP purely drug-induced
- LP purely Koebner phenomenon
- When no GI symptoms ever present
🧠 5. Summary (Short & Clear)
| Disease | Role of Dysbiosis | Benefit of Probiotics (Preventic) |
|---|---|---|
| Vitiligo | Strong role (immune imbalance, oxidative stress) | Moderate benefit, may slow progression and stabilize |
| Lichen Planus | Moderate role (Th17 activation) | Mild benefit, useful when GI issues coexist |
| Chronic Urticaria | Very strong role | High benefit (your personal improvement is classic example) |