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The Skin Microbiome and its Significance for Dermatologists

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Abstract

The skin is a physical and immunological barrier to the external environment. Its large surface area is colonized by diverse communities of microorganisms, including bacteria, viruses, fungi, and Demodex species mites. These microorganisms and their genetic material together create the skin microbiome. Physiologic and anatomic properties of skin sites create biogeographical habitats (dry, moist, and sebaceous) where distinct microbiota communities reside. Although, in general, the composition of these habitats is maintained from person to person, the skin microbiome of an individual also has unique microbial features. Dysbiosis occurs when the normal abundance, composition, or location of the microbiota is changed, most notably there is a decrease in flora diversity. Certain skin diseases, including atopic dermatitis, rosacea, and psoriasis are associated with cutaneous dysbiosis, and even disruption of the gut microbiota. Studies have shown that current treatments for these dermatologic conditions can alter/stabilize the skin microbiome, and there is emerging research detailing the impact of prebiotics, probiotics, and postbiotics on these conditions. Although clinical guidelines do not currently exist, clinical studies support the safety and possible benefits of using topical prebiotics and postbiotics and oral probiotics for a variety of skin conditions. Until such guidelines exist, utilizing carefully designed clinical studies to inform clinical practice is recommended.

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  1. Cleo Whiting and Sara Abel Azim contributed equally to this work.

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  1. Department of Dermatology, George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Ave. NW, Suite 2b-430, Washington, DC, 20037, USA

    Cleo Whiting, Sara Abdel Azim & Adam Friedman

  2. Georgetown University School of Medicine, Washington, DC, USA

    Sara Abdel Azim

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Cleo Whiting’s work is supported by an independent fellowship grant from Galderma. Sara Abel Azim’s work is supported by independent fellowship grants from Lilly and Pfizer. There are no financial disclosures, commercial associations, or any other conditions posing a conflict of interest to report for Adam Friedman.

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All authors contributed to the conception and design of the manuscript. The literature search was performed by CW and SAA. The first draft of the manuscript was written by CW and SAA and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Whiting, C., Abdel Azim, S. & Friedman, A. The Skin Microbiome and its Significance for Dermatologists. Am J Clin Dermatol 25, 169–177 (2024). https://doi.org/10.1007/s40257-023-00842-z

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