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Your Microbiome – Skin, Gut and Harmony – A Dermatologist’s Perspective

Did you know that every square centimeter of our skin is covered by a collection of over a billion bacteria, viruses, and fungi? All of these living organisms make up the skin microbiome. Like a fingerprint, every individual’s skin microbiome is different, and even various areas on the body of an individual are unique. All this variety is the result of a complex interplay between age, diet, lifestyle, location, genetics and climate, friction, heat, sweat, and oil production. While it may seem gross to think about all these organisms living on the skin, a diverse microbiome helps protect our skin and bodies from harmful organisms and promotes a healthy skin barrier.

The microbiome and skin barrier should live in harmony. Healthy skin is supple, well-hydrated, and promotes and maintains a diverse microbiome, and these organisms, in turn, reinforce a healthy skin barrier, which further supports the microbiome. Alterations to the skin microbiome contribute to acne, rosacea, atopic dermatitis, psoriasis, and collagen breakdown, leading to an aged appearance of the skin. Support your skin microbiome by keeping skin moisturized, selecting cleansers appropriate for pH-balanced skin types, and careful exfoliation. Avoid excessive cleansing, use of antibacterial soaps, and aggressive exfoliation, especially with physical exfoliants, such as brushes.

Some skin care brands are now incorporating ingredients in their products to support our skin microbiome. These ingredients are generally characterized as prebiotics, probiotics, and postbiotics. Prebiotics act as food for good bacteria and are usually plant sugars. Probiotics are live bacteria that add to the population of good bacteria. Postbiotics are molecules produced by probiotics that may be beneficial to the skin, such as peptides and fatty acids. While the idea of including these ingredients in skincare products sounds reasonable and potentially beneficial, do keep in mind that microbe supportive claims are not regulated by the FDA.

“Like a fingerprint, every individual’s skin microbiome is different, and even various areas on the body of an individual are unique.”

Our gut has a microbiome too, and keeping it healthy and diverse also affects the microbiome of the skin. Eating inflammatory foods (think sugar, high fat, red meat, trans fats, and possibly gluten) leads to the release of pro-inflammatory mediators which make their way to the skin. These mediators negatively affect the skin barrier by making it less hospitable to the good microbes. Keep the gut happy by eating anti-inflammatory foods, such as fruits, veggies, fish, nuts, whole grains, and beans. Many of these also act as prebiotics for our good gut bacteria. Be sure to have plenty of good bacteria to feed by including probiotic-rich foods in the diet (such as sauerkraut or yogurt with live cultures) or take a probiotic supplement.

We are entering a new era of approaches to skincare, dermatologic care, and overall health and wellness as we discover and harness the power of our microbiomes.

The full extent of the role our microbiome plays in our overall health and wellness remains to be elucidated, but the evidence is clear that a role is played. The effects of our body-wide microbiomes on the skin are well documented.

The microbiomes physically present on the surface of our skin are affected by the pH of the skin, hydration status of the skin, and oil production. Disruption to this delicate balance of the skin microbiome can contribute to an aged skin appearance, acne or eczema. Alterations to the skin microbiome occur with use of products that are drying to the skin, or physical scrubbing of the skin with brushes or physical exfoliants. Using products that are not pH balanced and not keeping the skin moisturized are other contributors to an altered skin microbiome that can lead to an undesirable skin appearance.

But it is not only the microbiome physically present on the skin that influences skin appearance and health; it is also our gut microbiome. Through the gut-skin axis, the health of our gut influences the health of our skin. Inflammation in our gut from eating inflammatory foods leads to the release of pro-inflammatory mediators into our brain and skin. These mediators contribute to acne and rosacea, and also contribute to collagen breakdown in the skin, resulting in wrinkles and loss of elasticity to the skin.

Eating for healthy, beautiful skin focuses on colorful fruits and vegetables, and minimizing pro-inflammatory foods in the gut, such as sugar, meat, dairy, and processed foods. To keep our surface skin microbes happy, minimize physical exfoliants, keep skin moisturized, use pH-balanced products and keep your body well hydrated.

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