How to Restore Your Skin Microbiome for Healthier Skin - The Science Behind Skin Flora
Table of Contents
Overall Trend for Skin Microbiome
What Exactly Is the Skin Microbiome?
What Does the Science Say about the Skin Microbiome?
Why Is Your Skin Microbiome So Vital for Healthy Skin?
How Can an Unbalanced Skin Microbiome Harm Your Skin?
How To Restore Skin Microbiome Balance with Prebiotics and Probiotics
Signs Your Skin’s Microbiome Needs Restoring
Overall Trend for Skin Microbiome
The skincare world is buzzing about the skin microbiome - the trillions of bacteria, fungi and other microbes inhabiting our skin.
Search interest in this topic has increased by 58% just in the last 3 months alone, and 88% since 2019. Source on image below.
Research reveals this complex skin ecosystem plays integral roles supporting immunity, collagen production, moisture retention and more. So what is the microbiome, how does it impact skin health, and can we nurture it for rejuvenated, balanced skin?
What Exactly Is the Skin Microbiome?
Your skin microbiome comprises all the microscopic flora colonizing the surface of your skin. This includes:
Bacteria: Over 1000 diverse bacterial species including staphylococci, propionibacteria and corynebacteria inhabit skin. Most are harmless or beneficial.
Fungi: Yeasts like malassezia make up part of the skin mycobiome - the collection of fungi living on us.
Viruses and Mites: Microscopic viruses and mites also dwell on the skin.
Research shows location on the body determines which microbes prevail. Fungi dominate moist folds like behind ears while propionibacteria prefer oily zones like the forehead.
This mix of germs forms dynamic, complex communities interfacing with our cells and pivotal to skin function. When in balance, they strengthen immunity, calibrate inflammation and nourish skin. Imbalances manifest as dullness, irritation, acne and sensitivities.
What Does the Science Say about the Skin Microbiome?
Our understanding of the skin microbiome has progressed in the past decade, such that whereas the gut microbiome has been known to play a key role in regulating the health and immune system, the skin microbiome's role is still a rapidly evolving field. Different regions of the body can have a different variation of the microbiome, favoring more of some microbial species. These variations also change depending on the person and their underlying health and exposures.
What we now understand is that the interactions on the surface of the skin between the skin cells, skin flora and other microorganisms, and the immune cells are incredibly important in determine skin health. Disruptions in the delicate interplay between these cells can lead to a number of skin diseases.
Over the last decade, we now realize that acne, rosacea, seborrheic dermatitis, atopic dermatitis, alopecia areata, psoriasis, and even melanoma are intertwined with the skin microbiome. (source)
In 2023 alone, several major scientific studies been published which discuss the implications of the skin microbiome of melanoma, an important disease in dermatology. Chen at al. 2023 put into question the role of a commensal bacteria, staph epidermidis, in modulating responses to melanoma. The authors used an engineered staph epidermidis strain to present tumor antigens to help the body better fight melanoma. While these results were shown in mice, the implications are fascinating especially as distant tumors also appeared to have been affected by the topical application of the engineered bacteria on the mice skin.
Meanwhile, the gut flora continues to be of interest in cutting edge research, with a 2023 study demonstrating that there were important differences between the gut microbiota of early stage vs late stage melanoma. The implications of modulating the skin microbiome to manipulate the immune response is a rapidly evolving field with lots of potential.
For the remainder of this post, we will explore what we know thus far about the science behind the skin microbiome and how restoring or improving your skin microbiome can keep your skin healthy.
Why Is Your Skin Microbiome So Vital for Healthy Skin?
Far from just passive hitchhikers on skin’s surface, researchers are now beginning to recognize the skin microbiome as integral to healthy skin. Our external microbiome confers a number of important benefits:
Bolsters Skin’s Immune Function
Friendly commensal bacteria secrete antimicrobial compounds fending off pathogens like staph aureus. They also interact with local immune cells, fine-tuning defense responses. This fortifies skin’s barrier against germs for resilient, healthy skin.
Wards Off Inflammation
Key microbes produce inflammation-regulating metabolites and train immune cells to suppress excess inflammation implicated in many inflammatory skin diseases. This tempers flare-ups.
Spurs Collagen Production
Studies demonstrate select bacteria spur fibroblasts to ramp up collagen synthesis. This firms and plumps skin minimizing wrinkles.
Assists Wound Healing
Specific microbes activate cell renewal and regeneration processes critical for healing injuries quickly. Others preserve moisture crucial for repair.
And more - the microbiome partakes in pH balance, oil regulation, water retention and vitamin synthesis benefiting skin.
In short, a balanced, thriving microbiome shields from assault, nurtures skin cells and upholds a healthy skin ecosystem. Disrupting this delicate balance can compromise skin.
How Can an Unbalanced Skin Microbiome Harm Your Skin?
Just like an unbalanced gut microbiome causes digestive issues, skin microbiome imbalances manifest as a slew of skin conditions:
Compromised Moisture Barrier
Key microbes signal skin cells to produce ceramides, free fatty acids, cholesterol and proteins essential for an intact protective moisture barrier. Microbiome disruption impairs production of these compounds, degrading barrier function. This sparks water loss and irritation.
Disordered Immune Activity & Inflammation
A thriving microbiome helps resolve acute inflammation. But when dominated by inflammatory Corynebacterium acnes strains, rosacea can erupt. Stress and pathogens also disrupt regulatory pathways, triggering inflammation underlying conditions like eczema, psoriasis and lupus when unchecked. This sparks vicious itch-scratch cycles.
Delayed Healing
Imbalances allow pathogenic bacteria like beta-hemolytic streptococci to prevail and hinder wound closure cellular signals including VEGF production required for prompt healing.
Skin Aging
Inflammation from microbiome shifts degrades supportive collagen over time. And moisture barrier disruption speeds wrinkling. Together this accelerates sagging, dullness and fine lines.
Other Issues - Acne, redness, oiliness, dryness and sensitivity can all stem from microbiome imbalance.
How To Restore Skin Microbiome Balance with Prebiotics and Probiotics
Just like an unbalanced gut, you can restore equilibrium to distressed skin through strategic skincare ingredients:
1. Prebiotics
Prebiotics are fibers that selectively feed good bacteria. They help beneficial bugs prevail to calm inflammation and nurture skin.
Which prebiotics to look for
Fructooligosaccharides (FOS): Boost moisture retention and support immunity (source)
Inulin: Enhances lipid barrier proteins for protection (source)
Lactobacillus: Signals ceramide production to reinforce skin barrier (source)
Reputable Topical Prebiotic Treatments
Each of the products above are great for most skin types, but those with dry and sensitive skin types should integrate them slowly, perhaps at a cadence of one application every 3 days, and increase to nightly as tolerated.
2. Probiotics
Probiotics introduce helpful bacteria strains like lactobacillus directly onto skin to harmonize the ecosystem. They assist good bugs in keeping bad bugs in check. The following are some of the strains that have been backed up by evidence-based studies.
Key probiotic strains
Lactobacillus ferment reinforces skin’s barrier (source)
Bifidobacterium longum alleviates inflammation (source)
Lactobacillus rhamnosus calms reactivity and helps moisturize the skin's barrier (source)
Bacillus coagulans promotes collagen synthesis (source)
3. Avoid Microbiome Disrupters
Conversely, certain common skincare ingredients decimate populations of beneficial flora:
Sodium lauryl sulfate - a harsh detergent that deep cleans but strips moisture barrier lipids and beneficial microbes
Triclosan - an antimicrobial chemical found in cleansers that indiscriminately kills good and bad bacteria alike
Ethanol & SD alcohol - disinfecting alcohols which disrupt microbial membranes and throw off skin pH
Essential oils - potent plant oils which can irritate skin microbiota at certain concentrations
Benzoyl peroxide - an acne treatment with antibacterial effects that strain overall microbe populations when overused
Any antimicrobial or antibiotic treatment (oral or topical) can theoretically disrupt the skin microbiome
Signs Your Skin’s Microbiome Needs Restoring
It is difficult at this stage to quantify this metric without utilizing some advanced microbial tests to measure someone’s individual skin microbiome. The signs below are very much generalizations and they may include:
Increased acne or breakouts
New reactivity and sensitivities
Excess oiliness or dryness
A compromised moisture barrier with tightness, flaking and stinging
Impaired wound healing
An imbalance manifesting as skin conditions like eczema, rosacea or psoriasis
More frequent rashes or inflammatory flare-ups
Accelerated aging like pronounced wrinkles and sagging
If your skin seems stressed and temperamental despite your best skincare efforts, microbiome disruption may be the root cause.
Microbiome Skincare Regimens for Restored, Balanced Skin
If you are thinking that your skincare microbiome may need some bolstering and want to add a prebiotic or probiotic serum to your routine, here is how to fit it in with the rest of your high-impact skincare products:
AM Regimen
Gentle Cleanser
Pre/Probiotic Serum - Smooth on a serum containing skin-beneficial probiotic strains
Moisturizer/SPF - Always follow serums with ample moisture and broad spectrum sun protection
PM Regimen
Oil Cleanser - Gently melt away makeup, debris and sunscreen with an oil cleanser rather than soap
Gentle Cleanser
Retinol Serum - Use retinol 2-3 nights weekly to speed cell turnover which supports a balanced microbiome ecosystem
Moisturizer
Stick with this microbiome-friendly routine for 1-3 months, observing if your:
Skin stays calm and comfortable - less reactive and sensitive
Skin barrier feels reinforced - hydrated with no excessive oiliness or dryness
Breakouts, redness, itching diminish
Skin appears rejuvenated - Bright, smooth and resilient
As studies further reveal our collective understanding of the skin microbiome, specialized pre- and probiotic skincare may be poised to transform dermatology - restoring balance from skin’s surface inward.
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Is the skin microbiome the same as the gut microbiome?
No, the communities of microbes living on the skin versus inside the gut differ but work synergistically to benefit overall health. Taking oral probiotics can indirectly boost skin as well by optimizing gut-skin axis pathways.
How long does it take to repair your skin microbiome?
With consistent application of prebiotic and probiotic skincare formulas for 1-3 months, most start noting improvements in skin comfort, sensitivity, hydration and recalibrated oil production reflecting microbiome rebalancing.
Can I repair my skin microbiome naturally?
Yes! While supplementing with oral and topical pre- and probiotics helps, avoid common disruptors like alcohol and SLS cleansers. And reinforce skin's good bacteria by eating fermented foods like kimchi, kefir and sauerkraut.
Does showering damage your skin microbiome?
Frequent, long, hot showers compromise beneficial flora especially when using stripping cleansers. But brief lukewarm showers with gentle cleansers minimize disruption so skin microbiota can recover.
What is the skin microbiome?
The skin microbiome refers to the diverse community of microorganisms including bacteria and fungi that live on the human skin. These microorganisms play a crucial role in maintaining skin health and have a significant impact on skin immunity.
How does the skin microbiome contribute to skin health?
The skin microbiome is essential for maintaining the homeostasis of the skin and plays a vital role in protecting your skin from harmful pathogens. It also influences the inflammatory skin conditions and overall skin immunity.
What are the factors that can affect the skin microbiome?
Several factors, such as skin care products, skin type, and environmental elements, can impact the living on your skin and may lead to skin concerns if not managed properly.
How can I keep my skin microbiome healthy?
To keep your skin microbiome healthy, it's important to establish a balanced skin care routine, maintain good skin hygiene, and consider the good for your skin food and lifestyle choices that can positively influence skin from the inside.
Is the gut connected to the skin microbiome?
Yes, there is a strong connection between the gut and skin. A healthy microbiome in the gut can have a positive effect on the skin microbiome and overall skin health.
What are some common skin conditions related to the skin microbiome?
Some common skin conditions such as eczema, acne, and rosacea are closely related to the skin microbiome. The presence of beneficial bacteria on the skin can help in managing and preventing these conditions.
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We are a group of dermatology residents and attending physicians based in Boston, MA. Our team of Ivy League-trained dermatologists is demystifying the cosmeceutical industry by offering unbiased, scientifically supported reviews of skincare products. We are extremely passionate about skincare and making it accessible to all through education. We value integrity, practicality, and inclusivity. No sponsorships were received for the products prior to testing; we feel strongly about providing un-biased reviews. After blogs are published, following the links in this blog post may result in commission.
Dr. David Li is a recent graduate from the Harvard Combined Dermatology Residency Program. He is now in private practice as a procedural dermatologist in Downtown Boston where he offers skin cancer screenings, skin cancer surgeries, and laser and cosmetic rejuvenation. He has published more than 25 peer-reviewed research articles, is active as an advisor for multiple early-stage companies, and is an angel investor in the healthcare technology space. In his free time, he enjoys running to stay fit, cooking, and playing with his Australian shepherd, Laika.
Dr. Jacqueline Stevens is currently a resident in the Harvard Combined Dermatology Program. She completed her undergraduate studies and MD-PhD at the University of Virginia with a PhD in microbiology, immunology, and infectious disease. Jacqueline has interest in cutaneous oncology, melanoma, and dermatologic surgery. She has published work on the basic science of inflammation at skin barriers, dermatologic diseases, and systems used to classify squamous cell skin cancer. In her free time, she enjoys skiing, hanging with her rescue pup, and the outdoors.
Dr. Nelson Ugwu is a dermatology resident at the Harvard Combined Dermatology Residency Program. His clinical interests include general dermatology, skin of color and skin cancer prevention. Nelson has discovered mutations that cause skin diseases, as well as new treatments for skin conditions. In his free time, Nelson enjoys weightlifting, playing soccer and trying new recipes.
Dr. Arash Mostaghimi is an associate professor of dermatology at Harvard Medical School, the director of the inpatient dermatology consult service, and co-director of the Complex Medical Dermatology Fellowship at Brigham & Women’s Hospital. He is also the principal investigator of the Mostaghimi Lab, where he leads a diverse group of physicians and researchers to study alopecia areata, an autoimmune hair loss condition which afflicts his daughter. In addition to his research, he is an advisor to multiple companies and is an associate editor of JAMA Dermatology.
