The Skin Microbiome – the Key to Good Skin Health

 
 We’ve all heard about the gut microbiome (population of bacteria) but did you know that your skin had its own microbiome? 
 
We now know that that skin microbiome is implicated in several skin health conditions including Atopic Dermatitis (AD) but also acne, rosacea, and psoriasis. 
 
Research has shown that the skin and intestinal microbiomes are similar in a number of ways: 

• A good variety of ‘good’ bacteria is key for balance, rather than abundant single strains. 
• The skin microbiome population changes depending on age and life-stage. This is why acne can develop with the changing flora at puberty.


• For those with AD, research has identified that there is a skin microbiome imbalance (dysbiosis) with a skew to an overgrown population staphylococcus epidermidis and staphylococcus aureus) (1,2).

 
Treatment usually focuses on antimicrobial and antibiotic creams and current research is looking into crems that target the over abundant staphylococcus strains specifically. 
 
How to support your skin microbiome
Your skin and gut microbiomes are closely linked, so here are my top tips for maintaining a healthy skin microbiome: 

1. Keep your skin clean, but not too clean.  Whilst washing to remove a lot of dirt can prevent infections, constantly washing and applying potentially harsh cleansers can harm the skin’s natural barrier and microbiome. 
2. Keep a food and symptom diary to identify any foods that trigger an acne or eczema flare. My clinical experience in skin health has shown time and time again that whilst some foods appear to trigger reactions, it is often simply because the immune system is hyper-activated and is reacting disproportionately. Often removing the worst triggers for a short amount of time to allow the immune system to ‘stand down’, will be enough. Please note that removing foods from a child’s diet should only be done under the supervision of a medical or nutrition practitioner. 
3. Foods that support your gut microbiome also support your skin microbiome  and the possible link between both skin and intestinal dysbiosis (3). Foods that feed your good bacteria are important (prebiotics) such apple, asparagus, banana, burdock, cacao, dandelion leaves, aubergine, endive, flaxseed, garlic, honey, Jerusalem artichoke, konjac, leek, legumes, onion, and peas.   Consider introducing some foods which contain the good bacteria themselves (probiotics) foods such as aged cheese, cottage cheese, kefir, yogurt, fermented meats, fermented kimchi, kombucha, miso, sauerkraut, tempeh
4. Make sure that you are eating a varied diet.  Our skin needs a wide range of vitamins (A, C, D, E) and minerals (zinc) for good health.  We all tend to stick a small selection of foods for conveniency, but your body needs the variety to be able to fulfil all of its functions. 
5. Get out in nature. The more your skin has contact with the natural world, the more varied is its microbiome. 

References
 
1.         Szari S, Quinn JA. Supporting a Healthy Microbiome for the Primary Prevention of Eczema. Clin Rev Allergy Immunol. 2019;57(2):286–93. 
2.        Martinez KB, Leone V, Chang EB. Western diets, gut dysbiosis, and metabolic diseases: Are they linked? Gut Microbes [Internet]. 2017;8(2):130–42. Available from: http://dx.doi.org/10.1080/19490976.2016.1270811
3.        Nakatsuji T, Gallo RL. The role of the skin microbiome in atopic dermatitis. Ann Allergy, Asthma Immunol [Internet]. 2019;122(3):263–9. Available from: https://doi.org/10.1016/j.anai.2018.12.003