Healthy Skin is a Reflection of a Balanced + Diverse Microbiome

Between Kristina Holey’s practice and my experience with customers, we’ve seen a major surge of inflammatory conditions like acne, rosacea and dermatitis over the last few years. In fact, it’s reached epidemic proportions in Kristina’s female clients in their 30s and 40s.

Needless to say, this has become a significant point of focus for us, and our working hypothesis has been that problems begin with disruptions in the skin microbiome and extend to epidermal barrier impairment. Now, research is supporting this premise with studies showing that the skin microbiome plays a critical role in maintaining skin health, and commensal microbial communities are your immune system’s first line of defense against invading pathogens. Healthy skin is a reflection of a balanced, widely diverse microbiome, but skin disorders like atopic dermatitis (AD) — which affects 10–20% of the general population and is increasing (especially in industrialized nations and among children) [1] — reflects underlying problems with epidermal barrier impairment and disturbances in the skin microbiome. [2]

So how do you treat a compromised skin microbiome? Let’s start with a general overview of how it all works.  

A Macro View of the Microbiome

The skin, our largest organ, supports an astonishingly wide variety of habitats: approximately one trillion microorganisms of around one thousand different species, including bacteria, fungi, viruses and mites. Most of the microorganisms that inhabit our microbiomes are commensal (harmless), and those that are symbiotic work tirelessly to keep us, their beloved Hosts, healthy.

Each one of us has a unique skin microbiome. Yours differs from that of your relatives by intrinsic factors such as gender and age. It differs from your that of your neighbors by extrinsic factors like diet and lifestyle, and from that of your long-distance friends by factors like climate, nutrition, pollution levels and regional geography. A recent study showed that in family members residing in the same home, skin commensal bacteria was much more similar than between strangers; furthermore, pet owners showed strikingly similar bacterial communities as those present on their pets. [3]

Diversity is Essential

The skin microbiome is dynamic, and it changes over time. Imagine an ecosystem composed of various and distinct habitats populated by organisms who have adapted to life there. A slightly warmer or more alkaline environment could alter the make-up of the usual commensal populations who may yield their territory to less desirable species. Such a population shift could have drastic consequences.

Research shows that in around 90% of AD cases, the skin becomes colonized by Staphylococcus aureus—50% of which produce toxins. The toxins, Staphylococci exoproteins and superantigens, activate the host inflammasomes, and evoke inflammatory reactions. As S. aureus multiplies, so does its cousin, Staphylococcus epidermidis, a “good” or symbiotic microbe that produces antimicrobial peptides and bacteriocins in response to invading pathogens. [4] But no matter how hard S. epidermidis is working, when warring species drive out other species (such as Propionibacterium, Corynebacterium and Streptococcus), it results in severe loss of biodiversity and increased barrier dysfunction. [5]

Rebalance Your Microbiome for Healthy Skin

Not surprisingly, external factors like hygiene, topical treatments and skin care products affect resident skin bacteria, and there are simple measures you can take to achieve healthier skin. If you already suffer from dermatitis (and there are growing numbers of you), follow these guidelines.

Avoid

1. Over-cleansing can be worse than no cleansing. Antibacterial soaps disrupt microbial balance, and over-exfoliation weakens the barrier layer, leaving skin vulnerable to pathogenic assault. 
2. Essential oils are volatile organic compounds with antiseptic properties. They can disrupt microbiome balance and should be used in moderation. 
3. Microcidal preservative systems kill indiscriminately, and in doing so disrupt microbial balance of the skin. Even microcidal preservatives regarded as ‘natural’ and ‘non-toxic’ like phenoxyethanol and phenethyl alcohol are associated with a high incidence of skin irritation, probably because they create microbial dysbiosis.  

Embrace

1. Topical yoghurt containing live Lactobacilli species. Cleanse, exfoliate and moisturize with this pro-bacterial option—and be sure to pick one in which Streptococcus thermophilus appears on the list of live bacteria. This age-delaying dynamo increases ceramide levels in the skin and improves barrier function. [6]  To cleanse, smooth ¼ tsp full-fat yoghurt over the face and rinse. To exfoliate, smooth ¼ tsp over the face and leave on for 15-30 minutes, then rinse. To moisturize, smooth a thin layer onto the skin after your regular nighttime ritual and leave it on all night.  
2. Microstatic (where colonies don’t increase in size) preservatives like leuconostoc radish root ferment may be doubly beneficial to the skin. The preservative activity of products like Leucidal™ Liquid, approved by ECOcert, comes from a peptide secreted from the process of fermenting radishes with Leuconostoc kimchii, a probiotic lactic acid bacteria (LAB). Skin irritation is minimized because microbial balance is maintained. But beyond microstatic preservation, recent studies suggest there are many skin health benefits to be derived from these tiny LAB creatures, including “antioxidative and antiaging properties.” All of our products are preserved using microstatic preservative systems. [7]
3. Topicals that contain synbiotics (e.g. Pre + Probiotic Daily Mist and Balancing HypoTonic). You’ve heard of probiotics (live bacteria and yeasts) and prebiotics (carbohydrates that serve as food for probiotics). Synbiotics refer to the use of pre and probiotics in the same product, where microbial additions (probiotics) are deliberately selected to work in conjunction with specific substrates (prebiotics). [8] For example, oligiosaccharides are readily available for fermentation and improve survival of bifidobacterial strains. [9]
4. Barrier enhancing topicals (e.g. Barrier Restore Serum and Barrier Lipid Complex) containing components of the barrier layer that are needed for good task performance, such as ceramides, amino acids, natural moisturizing factor, and the like. The skin microbiome includes the top layer of the epidermis, the stratum corneum, so addressing this can make a difference.  

We practice what we preach, so if this seems a bit overwhelming, rest assured that all of our products are microbe tolerant.   Our advice can be boiled down to the simple maxim: “everything in moderation.” Less is more. Be kind to the tiny creatures who are looking out for you. In return, your microbiome will thank you with healthy, glowing skin.