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ABSTRACT
Postbiotics, non‐viable microbial components or metabolites derived from probiotics, represent a promising new class of therapeutic agents in dermatological and wound‐healing science. This review highlights the bioactive potential of postbiotics in modulating inflammation, enhancing tissue regeneration, and restoring microbiota balance in skin wounds. Through analysis of recent experimental and clinical studies, postbiotics were found to accelerate wound closure, stimulate collagen synthesis, and improve barrier integrity while providing antimicrobial and immunomodulatory benefits. Their incorporation into topical formulations and wound dressings has shown to regulate moisture, prevent infection, and support optimal healing conditions. In contrast to live probiotics, postbiotics are stable, safe, and free from viability‐related limitations, making them ideal for cosmetic and medical use. Overall, postbiotics represent an innovative, next‐generation strategy for skin regeneration and wound management.
Introduction
Traditional wound healing methods, deeply rooted in various cultures, continue to be utilized alongside modern medical practices. A study in Turkey found that while a majority of participants employed modern first aid techniques for burns and wounds, a significant number still relied on traditional remedies learned from family elders [1]. Common traditional treatments include the application of
Despite their benefits, the use of live probiotics in dermatological formulations remains limited due to stability and regulatory challenges. This review therefore focuses on postbiotics, non-viable microbial derivatives with potent therapeutic effects, highlighting their mechanisms and clinical applications in skin wound healing.
Methodology
This review followed a structured literature search and synthesis process. Articles were retrieved from PubMed, Scopus, and Web of Science databases using the keywords ‘postbiotics’, ‘probiotics’, ‘skin wound healing’, ‘dermatology’, ‘topical application’, and ‘microbiota’. Publications from 2010 to 2025 were included.
Inclusion criteria: Peer-reviewed English-language studies reporting experimental, clinical, or mechanistic data on postbiotics or probiotics with dermatological or wound-healing relevance.
Exclusion criteria: Studies focusing solely on gut or oral probiotic effects without dermatological context.
Extracted data included study design, type of microbial product, formulation, biological mechanism, and clinical outcomes. We also emphasize that data on topical probiotics remain limited, with many findings derived from oral or animal models. This limitation reinforces the rationale for the present focus on postbiotics as next-generation dermatological bioactives.
Probiotics
Probiotics have garnered significant attention in dermatology due to their beneficial effects on skin health and potential to alleviate various skin disorders. By modulating the skin's microbiota and enhancing the immune response, probiotics play a vital role in maintaining skin homeostasis and treating conditions such as acne, eczema, and rosacea [7]. The influence of probiotics on human microbiota extends beyond gastrointestinal benefits, shaping systemic immune and metabolic responses. Recent studies have demonstrated that microbial metabolites, particularly short-chain fatty acids such as butyrate, act as signaling molecules modulating host metabolism and inflammation [8]. Similarly, probiotics have been shown to regulate the gut–brain axis and psychological conditions through neurochemical pathways [9], while others modulate obesity and metabolic syndromes through microbiota–host interactions [10].
They have been studied for their potential role in wound healing, and several specific strains have shown promising effects. Here is a breakdown of the role of some commonly studied probiotic strains, including
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From Probiotics to Postbiotics
Probiotics are living microorganisms, primarily bacteria, that provide health benefits when used in adequate amounts. These microorganisms are similar to beneficial microorganisms that are found naturally in the human gut. Probiotics are often found in fermented foods such as kefir, yogurt, sauerkraut, and kimchi, as well as in dietary supplements. They work by colonizing the gut with beneficial bacteria, which can help maintain a healthy balance of gut microbiota. In addition, they are associated with various health benefits, such as improving digestion, improving immune function, and perhaps even mental health benefits. On the other hand, postbiotics are metabolic by-products or components produced by probiotic microorganisms during fermentation or growth. Unlike probiotics, postbiotics do not contain live microorganisms. Instead, they consist of substances such as short-chain fatty acids, organic acids, peptides, polysaccharides, and other bioactive compounds. They can be found in fermented foods such as yogurt and dietary supplements, but are also being studied and developed for specific health-promoting purposes. They are believed to exert beneficial effects on the host by regulating the gut microbiota, supporting the growth of beneficial bacteria, and influencing various physiological processes. Consequently, they are gaining attention for their potential health benefits, including antioxidant, immunomodulatory, and metabolic effects.
The progression to postbiotics in therapeutic applications stems from the foundational concepts of prebiotics and probiotics. Initially, prebiotics were identified as non-digestible food ingredients promoting the growth of beneficial gut microorganisms. The discovery of probiotics followed, highlighting live microorganisms that confer health benefits when ingested. This understanding led to the exploration of postbiotics, which are non-viable bacterial products or metabolic by-products of probiotics, including short-chain fatty acids, organic acids, peptides, and polysaccharides. Advances in biotechnology and microbial fermentation have enabled the production of purified postbiotics, offering therapeutic benefits without the challenges associated with live microorganisms. This shift underscores the potential of postbiotics in applications such as wound healing and skin therapy, addressing limitations of traditional probiotics [27, 28] (Figure 2).
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Postbiotics
Prebiotics, probiotics and postbiotics are all related to gut health and have different roles in the body [29]. Although both terms share similarities, such as their relationship to gut health and potential benefits for the human body, they represent different concepts. In summary, probiotics are living microorganisms that provide health benefits, while postbiotics are nonliving compounds produced by probiotics that also offer health benefits. Both play crucial roles in maintaining gut health and overall well-being. Briefly, postbiotics are bioactive compounds that are produced by probiotic bacteria during fermentation [30, 31]. They are not living, although they still contain helpful chemicals released from bacteria that live in your gut when they feed on fibre molecules [32]. They even contain the metabolites that probiotics produce [31, 33] and can be found in foods such as sauerkraut, fermented soybean soup, soft cheeses, slow-fermented bread, and buttermilk [30, 31]. They have several uses, including accelerating wound healing, stimulating the growth of beneficial bacteria, hindering the growth of harmful bacteria, stimulating the immune system, improving the production of components of the skin barrier, and modulating skin inflammation [30, 33, 34]. In contrast, probiotics are live bacteria culture and yeast [31]. They are found in functional foods such as yogurt and can also be consumed in supplement form [31, 34] and can help with digestive health, such as compensatory diarrhoea associated with antibiotic use, and immune health [31, 34] (Figure 3).
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Postbiotics have shown some promising characteristics. They can enhance wound healing [35], play an anti-inflammatory agent [36], protect against environmental damage [37], manage skin disorders [38], and regulate microbiota [39]. However, the main focus of the current literature is its wound healing capacity, which has been shown in several studies [38, 40, 41]. As the research results in various studies show, they have emerged as promising agents to improve the healing process of wounds. The study of post-biotic therapies in wound healing is based on understanding the role of the microbiome in skin health and tissue repair. Mechanically, postbiotics demonstrate stimulation of cell proliferation, angiogenesis, tissue remodelling, collagen synthesis, and repair. Studies have elucidated the immunomodulatory properties of postbiotics, which contribute to their ability to modulate inflammatory responses and promote a favourable environment for wound healing. Furthermore, postbiotics have been found to enhance the production of cytokines and growth factors involved in the wound healing process. Collectively, previous findings underscore the potential of postbiotics as novel therapeutic agents to promote wound healing and tissue regeneration [36, 38, 40, 41].
The skin microbiome plays an essential role in maintaining skin health and serves as an important barrier to pathogens and environmental stresses. Comprising diverse communities of bacteria, fungi, viruses, and other microorganisms, the skin microbiome interacts dynamically with the host immune system to regulate inflammation, protect against pathogens, and promote tissue repair. Moreover, research has shown that increased skin microbiome composition, known as dysbiosis, is correlated with various skin conditions such as acne, eczema, and psoriasis. Finding the correlation between the skin microbiome and host factors is essential for developing strategies to promote skin health and effectively manage dermatological disorders effectively [42–45]. In addition, postbiotics can target the skin microbiome to advance wound healing by modulating the microenvironment and promoting favourable conditions for tissue repair. The impairment of wound healing refers to the delayed or compromised healing process, which can be the result of various factors such as infection, chronic inflammation, or underlying health conditions. Using the advantages of postbiotics, such as their anti-inflammatory and immunomodulatory effects, researchers aim to address these impediments and accelerate wound closure [46, 47]. Additionally, postbiotics can influence the skin microbiome by promoting the growth of beneficial bacteria, suppressing pathogen proliferation, and restoring microbial balance in the wound bed. Additionally, postbiotics can interact directly with host cells and immune components to stimulate tissue regeneration and repair mechanisms. By improving the innate defence mechanisms of the skin and promoting a healthy microbiome, postbiotics are potent wound healing agents and can reduce the risk of complications such as infection and chronic wounds [48, 49].
Moreover, postbiotics significantly affect skin tissue engineering and regenerative medicine by maintaining a supportive microenvironment for tissue repair and regeneration. Postbiotics can be incorporated into tissue engineering scaffolds to enhance their biocompatibility and promote cell adhesion, proliferation, and differentiation. By creating a favourable microenvironment, postbiotics facilitate cell colonisation within the scaffold and support tissue regeneration processes [50]. Postbiotics have anti-inflammatory effects that can help mitigate inflammation-associated tissue damage and promote a regenerative environment. By regulating immune responses, postbiotics can reduce excessive inflammation, prevent fibrosis, and facilitate tissue remodelling [51]. Postbiotics have been shown to promote angiogenesis, the formation of new blood vessels, which is crucial for supplying nutrients and oxygen to regenerating tissues. By enhancing angiogenesis, postbiotics support tissue viability and accelerate the healing process in engineered skin constructs [52]. Postbiotics can modulate scaffold degradation kinetics, ensuring that the scaffold provides structural support during tissue regeneration while allowing gradual replacement by newly formed tissue. This controlled degradation is crucial for maintaining mechanical integrity and promoting functional integration of the engineered tissue [53].
Production and Classification
Postbiotics are nonviable microbial products or metabolic byproducts generated during the fermentation process of probiotics or the breakdown of dietary fibres by the gut microbiota. They encompass a diverse range of components, including short-chain fatty acids (SCFAs), organic acids, polysaccharides, bacteriocins, peptides, and other bioactive molecules. SCFAs such as acetate, propionate, and butyrate are produced through fermentation of dietary fibres by the gut microbiota, particularly bacteria like Bifidobacterium and Lactobacillus [54]. Various organic acids, including lactic acid, acetic acid, and formic acid, are produced by lactic acid bacteria (LAB) such as Lactobacillus during fermentation. These acids contribute to the acidic environment of the gut, inhibiting the growth of pathogenic bacteria [55]. Certain probiotic bacteria, including Bifidobacterium and Lactobacillus species, produce polysaccharides with prebiotic properties during fermentation. These polysaccharides can selectively stimulate the growth of beneficial gut bacteria [56].
Postbiotics and Antibacterial Dressings: Benefits, Challenges, and Emergence
In the field of wound care, the emergence of postbiotic and antibacterial dressings represents a significant advance. Postbiotics are bacterial products or metabolic by-products that are not viable during fermentation and are beneficial to the host's health. Antibacterial dressings, on the other hand, are materials applied to wounds to prevent or treat infection. Together, they offer a promising approach to wound healing, addressing both microbial control and tissue regeneration [57].
There are some benefits in using postbiotics, including modulating the immune response, promoting angiogenesis, and accelerating wound closure. In addition, antibacterial dressings effectively inhibit the growth of pathogenic bacteria, reducing the risk of infection and promoting wound sterilisation. Furthermore, postbiotics possess anti-inflammatory properties, which can alleviate wound-related inflammation, minimise tissue damage, and enhance overall healing outcomes. Finally, by fostering a favourable microenvironment, postbiotic and antibacterial dressings support tissue regeneration, leading to improved wound closure and reduced scarring [58, 59].
However, there are some serious challenges. First, there is a lack of standardised protocols for the production and application of postbiotics and antibacterial dressings, which poses challenges to ensure consistency and efficacy in different formulations. Furthermore, determining the most effective combination of postbiotic, carrier, and delivery systems for wound healing applications remains an ongoing challenge, requiring further research and optimization. There may be potential risks associated with the use of postbiotics and antibacterial dressings, such as allergic reactions or adverse interactions with existing medications. Meanwhile, the development and production of postbiotic and antibacterial dressings may incur higher costs compared to conventional wound care modalities, raising concerns regarding accessibility and affordability [53, 60]. The emergence of postbiotics represents a paradigm shift in wound care, capitalising on the therapeutic potential of microbial metabolites. With the growing recognition of the intricate interplay between the microbiome and host health, there has been growing interest in harnessing the beneficial properties of postbiotics for various medical applications, including wound healing. Advances in biotechnology and microbial fermentation techniques have facilitated the production of highly purified and standardised postbiotic preparations, paving the way for their integration into clinical practice. Furthermore, the arrival of multidrug resistant pathogens and the decreasing efficacy of conventional antibiotics have underscored the urgent need for alternative antimicrobial strategies.
The skin microbiota is a crucial focus for therapeutic interventions, as it not only serves as a physical barrier against pathogenic bacteria but also aids in modulating the immune system and reducing inflammation, thereby playing a significant role in various dermatological conditions [61]. In this regard, postbiotics offer a promising solution, offering targeted antimicrobial activity against pathogens while preserving the indigenous microbiota and minimising the risk of resistance development. As our understanding of the interactions between microbial communities and host physiology continues to deepen, the therapeutic potential of postbiotics is poised to expand further, heralding a new era in wound care and beyond. Recently, significant steps have been taken toward the development of novel wound dressings that are designed to improve wound healing outcomes. These dressings use innovative materials and technologies to provide a conducive environment for tissue regeneration while addressing various challenges associated with traditional wound care modalities. Some prominent types of novel wound dressings include hydrogels, sponges, and electrospinning fibres [62–64]. Hydrogels are three-dimensional networks of water-absorbing polymers that can retain large amounts of water. They are highly biocompatible and help keep wounds moist, which supports healing. Hydrogel wound dressings can be modified to release beneficial agents like growth factors or antimicrobial substances to enhance their effectiveness [65–68]. Electrospinning is a method to create nanofibrous materials with adjustable properties. These fibres can mimic the extracellular matrix, helping with cell growth and healing while also preventing infections [69–71] (Figure 4).
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Applications of Postbiotics in the Treatment of Different Skin Lesions
Postbiotics have shown promising applications in the treatment of various skin conditions due to their diverse biological activities, including anti-inflammatory, antimicrobial, and immunomodulatory effects. The most prevalent dermatological conditions that postbiotics can address encompass Atopic Dermatitis, Acne, Anti-aging, and Wound Healing and Dressing. Postbiotics have been studied for their potential benefits in various skin conditions. In atopic dermatitis, they may help improve the skin barrier, reduce inflammation, and enhance the quality of life for patients. For acne, postbiotics can inhibit acne-causing bacteria, decrease oil production, and lessen inflammation, which may lead to fewer breakouts [72]. In terms of anti-aging effects, postbiotics may promote collagen production, reduce oxidative stress, and improve the skin barrier, helping to delay signs of aging like wrinkles and sagging. Regarding wound healing, research indicates that postbiotics can speed up the closure of wounds, support collagen synthesis, and lower inflammation, benefiting patients with both acute and chronic wounds [73]. Integrating postbiotics into wound dressings presents a new method for wound care. These dressings can enhance healing and help prevent infection due to the anti-inflammatory and antimicrobial properties of postbiotics. They create an environment that reduces inflammation, promotes tissue regeneration, and protects against harmful pathogens, which can speed up the healing process. Postbiotics also show effectiveness against various pathogens, including antibiotic-resistant strains, thus improving infection control [60]. Moreover, wound dressings with postbiotics maintain proper moisture levels, which are important for healing, by supporting cell movement and tissue repair. Their anti-inflammatory effects can minimise tissue damage from excessive inflammation, promoting a better healing environment. Postbiotics also encourage angiogenesis, helping form new blood vessels that provide essential oxygen and nutrients to injury sites, thus supporting regeneration and closure of hard-to-heal wounds [74–80] (Figure 5).
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Postbiotics are bioactive compounds produced by probiotic bacteria during fermentation and have beneficial effects on general human health. Recent studies have shown that postbiotics can be used to improve wound healing [60, 62, 81, 82]. Postbiotics can be formulated in creams or dressings and applied topically to the wound site [60, 62]. They have been shown to accelerate wound healing by promoting the growth of beneficial bacteria and inhibiting the growth of harmful bacteria [60, 62, 81, 82]. Postbiotics can also stimulate the immune system, increase the production of components of the skin barrier, and regulate skin inflammation, all of which are crucial for maintaining healthy skin [53]. In a study conducted in diabetic mice, topical application of a postbiotic heat-killed
TABLE 1 Experimental and clinical studies on postbiotic applications in dermatological and wound-healing.
| Study | Design | Biotic name and its administration | Findings and conclusion | References |
| Oral and topical probiotics and postbiotics in skincare and dermatology | Review of clinical studies | Various probiotic and postbiotic formulations for oral and topical use | Probiotics and postbiotics improve skin barrier function, reduce inflammation, and treat acne and eczema effectively. | [61] |
| Cosmeceuticals: a review of clinical studies claiming to contain probiotics or postbiotics | Review of 14 clinical trials | Cosmetic products containing well-characterised probiotic or postbiotic strains | Application of probiotic/postbiotic-based cosmetics showed positive outcomes in skin hydration, elasticity, and reduction of acne. | [86] |
| Potential clinical applications of the postbiotic butyrate in human skin diseases | Various in vitro and in vivo studies on human skin diseases | Topical and oral application of sodium butyrate | Enhanced skin health, reduced inflammation, improved wound healing, effective antibacterial dressings. | [87] |
| Multi-omic approach to decipher the impact of skincare products with pre/postbiotics on the skin microbiome | Experimental study | Skincare products with prebiotics and postbiotics | Prebiotics/postbiotics improved skin hydration by modulating the skin microbiome and associated metabolic pathways. | [88] |
| A pilot study on the efficacy of topical lotion containing anti-acne postbiotic in the treatment of mild to moderate acne | Randomised clinical trial | Topical lotion containing anti-acne postbiotic | Improved skin moisturization, controlled pH, and reduced acne severity. | [89] |
| Efficacy of a yeast postbiotic on cold/flu symptoms in healthy children | Randomised controlled trial | Yeast-derived postbiotic, oral administration | Yeast postbiotic significantly reduced the duration and severity of cold/flu symptoms, enhancing immune response in children. | [90] |
| Rice flour fermented with |
Randomised, double-blind, placebo-controlled trial | Reduced eczema severity in infants with atopic dermatitis, highlighting the protective effects of |
[91] | |
| Randomised controlled trial | Improved clinical symptoms and reduced inflammatory markers in patients with atopic dermatitis. | [92] | ||
| Oral administration of a heat-treated |
Randomised, double-blind, placebo-controlled trial | Heat-treated |
Significant improvement in eczema symptoms, particularly when used alongside topical corticosteroids. | [93] |
| Efficacy of prolonged ingestion of |
Randomised controlled trial | Long-term use of |
[94] | |
| Oral administration of live and dead cells of |
Randomised, double-blind, placebo-controlled study | Live and dead |
Both live and dead cells alleviated symptoms of atopic dermatitis, with significant immune modulation effects. | [95] |
| Effects of oral administration of |
Double-blind, randomised clinical trial | Reduced inflammatory cytokines and improved skin symptoms in adults with atopic dermatitis. | [96] |
Future Market Trends and Clinical Applications
Postbiotics offer potential health benefits without the need to consume live bacteria, making them more stable and suitable for various applications. Several potential market trends can be executed, including increasing consumer awareness, expanding product offerings, focusing on research and development, integration into personalised nutrition, regulatory considerations, partnerships and collaborations, increased investment, emerging markets, technological advances, and sustainable and environmentally friendly practices.
Future clinical applications of postbiotics hold significant promise in various fields of medicine and healthcare. Some potential areas where postbiotics could have clinical applications in the future are gastrointestinal health, immune support, metabolic health, dermatological conditions, neurological disorders, women's health, allergy and autoimmune disorders, cancer support care, cardiovascular health, and aging and longevity.
Discussion and Conclusion
This review synthesises the current understanding of postbiotics as innovative agents in skin regeneration and wound healing. Postbiotics have demonstrated the capacity to modulate inflammation, stimulate collagen and elastin synthesis, and accelerate tissue repair while maintaining microbial balance. Their advantages over live probiotics, including improved stability, safety, and regulatory acceptance, make them particularly suitable for dermatological formulations. Importantly, postbiotics, through their bioactive components such as cell-wall fragments, peptides, and metabolites, can reproduce the beneficial effects of probiotics without the risks associated with live organisms. This evolution from probiotics to postbiotics represents a major translational step in modern dermatological biotechnology. In summary, postbiotics are by-products of probiotics, while probiotics are cultured live bacteria and yeast. Postbiotics have several uses, including accelerating wound healing, upregulating beneficial bacteria growth, downregulating harmful bacteria growth, stimulating the immune system, improving the production of components of the skin barrier and modulating skin inflammation. On the basis of our observation, it can be said that by harnessing the multifaceted properties of postbiotics, innovative strategies are developed to improve the regenerative potential of engineered skin constructs and improve outcomes in tissue engineering and regenerative medicine applications.
In this study, multiple aspects of postbiotics were discussed. Since postbiotics do not contain live microorganisms, they are unlikely to cause infection during the wound healing process. Postbiotics have been studied for their potential to promote wound healing and reduce the risk of infection by modulating the skin microbiome and improving the immune response. However, it is essential to ensure the safety and quality of postbiotic products used in wound care to prevent any risk of contamination or adverse effects. Contaminated or improperly processed postbiotic formulations could potentially introduce harmful pathogens or toxins, leading to infection or other complications. Therefore, it is crucial to follow appropriate manufacturing and handling procedures to minimise the risk of contamination and ensure the safety of postbiotic-based wound care products. In general, when used appropriately, postbiotics are unlikely to cause infection during the wound healing process and may contribute to improved healing outcomes by promoting a healthy wound environment and supporting the body's natural defence mechanisms.
Therefore, the substantial difference between probiotics and postbiotics lies in their composition and nature. Probiotics are live microorganisms, while postbiotics are nonliving metabolic by-products of probiotic microorganisms. Probiotics work by directly colonising the intestinal tract with beneficial bacteria, while postbiotics exert their effects through the compounds they produce or contain. Although both probiotics and postbiotics can contribute to intestinal health, they can have different mechanisms of action and potentially different health benefits. Probiotics are more commonly found in fermented foods and supplements, whereas postbiotics are often found in fermented foods but are also being developed as specific supplements for health purposes. In summary, probiotics such as
Importantly, the therapeutic promise of postbiotics is deeply rooted in the fundamental role of the human microbiota in health. The microbiota contributes to immune homeostasis, epithelial integrity, and tissue repair. Leveraging this relationship allows postbiotics to act as safe, non-living modulators of host–microbiome communication, providing targeted benefits in skin and wound care.
In conclusion, postbiotics represent a clinically relevant and mechanistically sound advancement in wound healing research. Their multifunctional roles, anti-inflammatory, antimicrobial, and immunomodulatory, make them promising candidates for topical and regenerative therapies. Future studies should focus on clinical validation, formulation optimization, and elucidation of molecular pathways involved in postbiotic-mediated skin repair. The continued exploration of microbiota-derived therapeutics will further establish postbiotics as safe, effective agents in modern dermatological care.
Funding
This research did not receive any specific grants from funding agencies in the public, commercial, or not-for-profit sectors.
Ethics Statement
All ethical considerations were followed.
Conflicts of Interest
The authors declare no conflicts of interest.
Data Availability Statement
The data that support the findings of this study are available from the corresponding author upon reasonable request.
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