The Skin Microbiome – Bacteria Is The New Black

In recent times, the skin’s barrier function has become a topic of intense discussion amongst Skin Therapists, and for good reason.

The skin is the primary interface between the internal and external environments, providing a barrier against opportunistic pathogens, UV radiation, mechanical and chemical stressors, including toxic substances.

With advancements in and access to a greater range of modalities in clinic, we are able to manage skin concerns like never before.

Do all our treatments support the skin’s barrier function?

The health of the stratum corneum, the uppermost layer of the epidermis has always been considered crucial to healthy skin function. The role of keratinocytes, the major cells of the epidermis, has always been considered to be a protective one, yet recent research has revealed that it is a lot more complex than that. Keratinocytes are involved in communication with host immune networks, producing and releasing an array of hormones, neurotransmitters and cytokines that influence whole body systems.

The acid mantle, that mixture of sweat and sebum, that we were taught about, with a pH of between 4.5 and 5.5, considered as the skin’s first line of defence, repelling opportunistic microbes… well there’s actually more to the story than that…

The skin plays host to a diverse ecosystem of microbes that are directly responsible, along with the body’s innate immunity, for maintaining a healthy barrier, ensuring homeostasis and optimal skin function. Disruption of this delicate microbial balance results in a higher susceptibility to inflammatory conditions.

While more people are becoming familiar with the terms ‘gut health’ and ‘probiotics’, they may not as yet fully understand the impact they both have on health and disease. Conditions such as ulcerative colitis, coeliac disease, rheumatoid arthritis, depression, obesity, psoriasis, eczema, acne and rosacea, to name a few, all have an association with poor gut health. Dietary choices directly influence the trillions of diverse microbes, made up of bacteria, fungi, yeasts and viruses that reside in the gut, impacting both their diversity and numbers. The ‘gut microbiome’ is a term used to describe these microbes, along with their genetic material, that are collectively responsible for determining both health and disease.

The skin microbiome is the new kid on the block and is forcing us to re-think what constitutes the skin’s first line of defence. A fabric of microbes also made up of bacteria, yeast, fungi and viruses, along with their genetic coding, cloak the entire skin’s surface and reside within follicles. It is now recognised that these microbes play a crucial role in the skin’s barrier integrity, influencing hydration levels, pH, ceramide production, and also sebaceous secretions. Disturbances to this intricate balance have been implicated in a host of inflammatory skin conditions.

I describe the skin microbiome as the new black because while it is recognised by some Skin Therapists, there are still huge numbers who have no idea of how integral it is to skin health.

As its influence on dermatological disease management and also skin health become better understood, the interest in the skin microbiome continues to grow exponentially. This has resulted in a large number of players entering the market, from both the Pharma and cosmetic industries, and this will ultimately intensify the competition around microbiome-specific products in the coming years.

I recently attended the 3rd Skin Microbiome Congress 2018 in London, and was excited to see such advancements in both cosmetic and pharmaceutical applications of microbiome-focused product development.

Skin microbiome technology is all about creating an environment where skin microbes can thrive and ultimately promote healthy skin function.

As Skin Therapists we must assess the impact of in-clinic treatments on the skin’s microbial balance. Popular modalities such as microdermabrasion, laser treatments, chemical peels, epidermal blading, to name a few, all impact microbial balance, some to a greater degree than others.

Certain ingredients found in cleansers, exfoliants, serums, moisturisers, even makeup, have been linked to disruption of skin microbial diversity, resulting in increasingly reactive, compromised skin conditions.

A growing consumer awareness of just how dramatically what is applied to our skin can impact skin health is behind the drive to bring products to market that are skin ‘microbiome-friendly’.

In Europe, the United States, and more recently here in Australia, savvy consumers, who are also environmentally aware, seek to have this awareness reflected in their skincare choices too. This growing interest in ‘microbiome-friendly’ products, has led to the increasing popularity of a number of brands in the cosmetic/cosmeceutical  space such as JooMo, Galline, Mother Dirt, Esse and Dermaviduals, not an exhaustive list by any means. With a focus on skin health, and containing no nasties or ingredients linked to the disruption of the skin’s microbial community, such as artificial fragrance, harsh preservatives, harsh surfactants, these products promote the perfect environment for skin microbial balance.

In Pharma, the skin microbiome is also big business, with a focus on the utilisation of probiotic technology in a number applications, such as acne, psoriasis and eczema management as well as in body odour, dandruff control and anti-ageing.

Probiotics are live microbes deemed to confer a health benefit upon their host, and so for a product to be marketed as containing probiotics, it must contain live microbes, which in effect confers drug status upon it.

“I honestly believe that we are heading towards a time when less will indeed be considered more.”

Cosmetic formulations by definition and by law, cannot alter the skin or confer health benefits in any way, and so this raises questions about claims being made by certain cosmetic brands which purport to contain them, and if they do, should they still be considered cosmetics?

The demand for skin microbiome-focused skincare, providing the optimal environment for microbial diversity, will continue to grow as consumers dictate what they want to see in their products and to put on their skin.

The same way ‘fragrance-free’ and the elimination of harsh preservatives have seen cosmetic companies raise the bar, I predict that ‘microbiome-friendly’ skincare will soon become the norm.

The consumer is looking for a simple solution to skincare and I believe as Skin Therapists, this is something we too need to consider. What impact do our in-clinic applications have on the skin’s health in the long run? Is it not time we all turned our focus towards supporting and preserving this complex yet crucial ecosystem? I honestly believe that we are heading towards a time when less will indeed be considered more.

Originally published in Further Education Magazine Professional Beauty and SPA + CLINIC January 2019 Issue

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©2019 Chiza Westcarr