Synbiotics Supplement May Improve Melasma Severity

The effects of a synbiotics supplement (TS6) on improving melasma were investigated.

Oral synbiotics supplementation for 12 weeks can improve the severity of melasma, according to study findings published in the Journal of Cosmetic Dermatology.

The prospective, double-blind, randomized controlled trial investigated the effects of a synbiotics supplement (TS6) on improving melasma, according to the Modified Melasma Area and Severity Index (mMASI) score. TS6 (Tensall Bio-Tech Co, Ltd; Taiwan) is a combination of 50 billion colony-forming units of 6 probiotics strains.

A total of 57 women (aged 30-50 years) were categorized into 1 of 2 treatment groups—29 were in the oral synbiotics group and 28 were in the placebo group. The patients had Fitzpatrick skin type III to VI, with facial melasma on both sides of the face, and presented to a hospital in Bangkok, Thailand, from January to December 2019.

The participants were randomly treated with oral synbiotics or placebo, 1 sachet daily for 12 weeks. The study authors evaluated melasma severity and skin health at baseline and at weeks 4, 8, and 12.

In the synbiotics-treated group, the severity of melasma score per the mMASI was 7.54 ± 0.79, 7.36 ± 0.80, 7.16 ± 0.73, and 6.98 ± 0.72 at baseline and at weeks 4, 8, and 12, respectively. In the placebo group, the mMASI score was 7.51 ± 0.86, 7.52 ± 0.88, 7.54 ± 0.86, and 7.54 ± 0.89 at baseline and at weeks 4, 8, and 12, respectively.

At week 12, the melasma score in the synbiotics supplement group was significantly lower than that in the placebo group (P = .008).

“The melasma severity evaluated by mMASI score of our volunteers gradually improved significantly (P < .001) on every visit (week 4, week 8, and week 12),” stated the researchers.

Using the Mexameter MX 18, the study authors also found that melanin and erythema indices improved. Both indices for crow’s feet and under-eye wrinkles decreased significantly compared with the baseline values since week 4, except for the melanin index of crow’s feet, which improved significantly at week 8, the investigators noted.

The researchers recorded that no significant differences were observed between the 2 treatment groups regarding underlying disease, medication and supplement, photo sensitivity, facial product allergy, history of following treatment, sun exposure, and mean dietary intake.


Piyavatin P, Chaichalotornkul S, Nararatwanchai T, Bumrungpert A, Saiwichai T. Synbiotics supplement is effective for Melasma improvement. J Cosmet Dermatol. Published online January 21, 2021. doi: 10.1111/jocd.13955