In 2023, the microbiome will be yet another trending buzzword with a plethora of creams claiming to restore the microbiome to the skin.
I have huge respect for those in the field of microbiology and bacteria, as I contacted colleagues all over the world when it became clear this would be a trend. I think, like true stem cell research for skin, that we are on the tip of a large iceberg. If approached properly, without rushing to get products out to capitalize on popular trends, it will benefit thousands. This may change a large section of the industry in the skin disease arena without medicine.
I have researched a few microbiome products in the industry and sadly found out it was mostly dried yoghurt in cream with a lot of other things. There was nothing bad, but many of the formulations had nothing to do with the skin microbiome. Some of the future products will be pretty good, however, assuming the manufacturer understands the real concept behind skin microflora.
This article will define and explore the microbiome-related terms you need to know as we investigate the future, starting with a basic analysis of skin’s naturally friendly bacteria, most in the gram-positive category. Keep in mind, it is my opinion that this will apply only to skin with a deficit of the naturally occurring Gram-positive colonies, which are normally nestled behind the earlobe and under the orbital bone near the top of the nose.
Chemoorganotrophs
These are organisms that get energy from organic material and convert it into other natural materials that open the door to extracellular enzymes. This can include dead skin cells and organic debris collected on the epidermis. In other words, they turn poop into ice cream, so to speak.
Pre-biotics
These materials can fire up the friendly microbiome colonies located in the aforementioned areas and the reduction of dead keratinocytes. This will allow the healthy bacteria to scatter across the skin, killing off unfriendly (gram-negative) bacterial overloads. It is important to note that advanced skin resurfacing, especially in cases using alpha hydroxy acids (AHAs), uses hygroscopic action to “swell up” the dead keratin on the skin to the point of bursting to then detach from the skin. The epidermis is left like a desert (all the trees and rivers are temporarily gone). In the waiting are hordes of bacteria such as S. Epidermis or S. Aureus. Whoever gets to the landscape first rules the land, for either healthy skin or compromised skin. It is vital to allow the healthy bacteria to take over first and create homeostasis.
Post-biotics
The product of bacteria in the microbiome can include many compounds already used in skincare such as lactic acid. They also help maintain the colonies while warding off further attacks of unfriendly bacteria and fungi.
Probiotics
This is the friendly microflora consisting of live bacteria and fungi that work with our bodily functions to keep our skin and gut functioning properly. Please note that many of the probiotics that are good for the gut, may not necessarily be good for our skin. This should be easy to understand because the function of our gut is nothing like the function of our skin.
Actinobacteria
These Gram-positive bacteria are also found in soil, plant decomposition and hummus. This may explain why children who played a lot outside have stronger immune systems. As a 1950s child, I remember playing outside in the dirt all day, climbing trees, making mud pies, and getting cuts and abrasions all over my arms and legs that were not attended to by my mom until hours later. Children today often get their cuts doused with peroxide, washed with antibacterial soap, and slathered with antibiotic crème with a bandage slapped overall. If there are no ‘good’ bacteria present, homeostasis in the microbiome is negligible and even worse, ‘bad’ bacteria can compromise the natural immunity of the skin. Langerhans cells (the immune defence of the skin) are also weakened, and many problems can arise later in adulthood.
Bacteroides Fragilis
This is normal flora in the colon that is needed at some level as Gram-negative for flora balance but can cause infection if overloaded on surrounding tissue in the blood field, i.e., micro-needling, blading post-surgery, dermatitis, acne, and eczema. Any procedure involving puncturing the skin or “scraping” offsets up a defence mechanism wherein regulatory rhythms of cell proliferation are necessary to ensure a smooth, natural remodelling of tissue on the surface. If the microbiome is deficient, contraindications, even granulomas (especially in the case of micro-needling) can form. People with healthy microbiomes usually escape these contraindications, but there is always a “first one” that alarms everyone. Doctors who have an informed consent form usually get by with just an unhappy patient, but therapists may not be so lucky. If you are so inclined to practice these procedures, ensure your clients have a healthy microbiome and save yourself a lot of trouble in the long run. Actinobacteria are also found in soil, plant decomposition and hummus.
Firmicutes
These Gram-negative bacteria have strong walls. This can be a major part of bacterial homeostasis, serving as an anti-inflammatory and an antibiotic.
Proteobacteria
This is the ultimate predator of Gram-negative bacteria. It can acquire cell nutrients that are present or toxic debris (through nitrogen phagocytosis). It is a double-edged sword that must be carefully formulated with messenger precursors.
Micrococci
This is not common but can be found in people with poor skin habits and contamination such as contact dermatitis.
Streptococci
This type of bacteria is bad and not found on normal skin. Lipids are lethal to this group, such as healthy sebum or a fractioned oil resembling sebum (few oils are ‘comedogenic’ as popularly believed). Micrococci is symbiotic to viruses such as herpes and can start in the mouth and spread to the skin and then to areas of another person’s body.
Malassezia
These fungi are naturally found on the skin and are sometimes misdiagnosed as eczema. It can cause hypo- and hyperpigmentation. This often-misdiagnosed symptom (eczema and melasma are commonly diagnosed) often disappears like a miracle once the right microbiome treatment and regimen are performed. It was stunning to me personally when, at our very first clinical trial, an Asian man who had suffered from this fungus for years had an almost overnight positive change. He was simply misdiagnosed and was given bleaching cremes and antibiotics.
Lactobacillus
Found in fermented foods, lactobacillus limits the amounts of parthenogenic bacteria, parasites (rosacea causing Demodex mites) and viruses.
Bifidobacterium
Found in ‘functional foods’, Bifidobacterium promotes probiotic activities and protects against pathogens.
Caveat: Not for everyone
I will loudly maintain that any results-driven products should be used only in skin conditions that are deficient in the normal microbiome. Selling microbiome-correct products to anyone and everyone of course will be the first wave of the trend, but eventually, therapists will be able to discern who needs this sort of protocol and who does not.
It has taken scientists and bacteriologists worldwide to arrive at the knowledge we have now. I attended many microbiome conferences and listened to many brilliant kids (to my 77 years) strut their stuff and gained an enormous amount of vital information that could lead me to some sort of practical conclusion.
There is nothing wrong with inconclusive research —mostly identifying the ‘what and when’ of things but seldom addressing the ‘how’. Products addressing this are not that easy to compound. Living spores from a variety of sources must be kept inert in a container until used. It is not a piece of cake as everyone may imagine.
More and more ways will be discovered on how to deal with living bacteria practically—and a large part of our industry will be forever changed.
If you have skin related concerns and questions, don’t hesitate to call. You may contact us at 07968777150 or drop an email on enquiries@nu-yu.co.uk
