What is the skin microbiome?

Did you know that there is a whole community of microorganisms living on your skin? These are the good guys that protect your skin from the infection-causing germs and microbes - a.k.a the bad guys! These good microorganisms include bacteria, viruses, fungi, and other microorganisms that interact with each other and with the skin cells. The skin microbiome plays a crucial role in maintaining the health of the skin by protecting it from harmful pathogens, regulating the immune system, and maintaining the skin's natural barrier function.

How does a damaged skin barrier affect the skin microbiome?

The skin barrier is an essential protective layer that acts as a barrier between the outside environment and the body. It is comprised of various components, including the outermost layer of skin (the stratum corneum), lipids, and other molecules that help to maintain the barrier function.

Damage to the skin barrier can disrupt the balance of the skin microbiome by altering the skin's pH, moisture levels, and overall environment. Dr Samujjala Deb, MD says " There's a recent trend towards excessive cleaning of the skin. People are just scrubbing away their skin barrier without realising the harm being caused to the skin. In the long run, even minor cuts, scrapes and bruises can open up passages for harmful bacteria to not just enter but colonise the deeper structures of the skin leading to chronic eczema and frequent infections."

Dr Samujjala also adds that overwashing can also lead to a worsening of skin conditions like acne and eczema. This is because damage to the skin barrier can lead to inflammation, which can further alter the skin's environment and promote the growth of certain types of bacteria. This can result in an imbalance of the skin microbiome, leading to skin conditions such as acne, eczema, or psoriasis.

Which diseases can occur as a result of a change in the skin microbiome and skin barrier? 

The skin microbiome can change in ways that are not always helpful to the body. This is often called 'dysbiosis'. The reason for this change is still unknown, but it can result in several diseases:

1. Eczema

2. Atopic Dermatitis

3. Psoriasis

4. Acne Vulgaris

5. Rosacea

6. Non-Healing Wounds

How does a change in skin microbiome affect our overall health? 

Some of the ways that a change in the skin microbiome can affect our overall health include:

1. Immune system function: The skin microbiome interacts with the immune system, and thus, a change in the skin microbiome can affect the immune system function.

2. Skin disorders: Disruptions to the skin microbiome can lead to the development of skin disorders such as acne, eczema, and psoriasis, which can deteriorate the quality of life.

3. Infections: A disruption to the skin microbiome can increase the risk of infections, as harmful microorganisms may be able to colonize the skin more easily.

4. Allergic reactions: A change in the skin microbiome can increase the risk of allergic reactions to environmental allergens.

5. Mental health: Disruptions to the skin microbiome have been linked to conditions such as depression and anxiety.

What is the relation between the skin microbiome and the gut-skin axis?

The gut-skin axis is a complex and dynamic interaction between the gut microbiome, the immune system, and the skin.

The gut microbiome refers to the collection of microorganisms that live in the digestive tract, while the skin microbiome refers to the microorganisms that live on the skin. Research has shown that there is a close relationship between the gut and skin microbiomes and that they can influence each other in a variety of ways and changes in either can affect the other. For example, some gut bacteria produce metabolites that influence the skin's immune response and affect the development of skin conditions such as acne, eczema, and psoriasis while an overgrowth of certain fungi on the skin (Candida leads to worsened gut issues (ulcerative colitis and Crohn's disease).

How to restore the skin microbiome and maintain it? 

"How can I restore my skin's microbiome?" Is this question on your mind? Here are some steps that you can follow to restore and maintain a healthy skin microbiome:

1. Use of gentle skin care products: Avoid using harsh soaps or cleansing products that can strip the skin of its natural oils and damage the skin barrier and the skin microbiome. A good choice would be the Dermdoc 4% Niacinamide Face Wash which helps to gently remove oil from the skin and yet does not disrupt the skin microbiome. Also, the Avoid over-cleansing: Over-cleansing the skin can disrupt the skin microbiome. Limit cleansing to once or twice a day, and avoid using hot water or harsh scrubbing motions.

3. Moisturize regularly: Moisturizers help to maintain the skin barrier by preventing water loss from the skin. Choose a moisturizer that is appropriate for your skin type and contains ingredients such as ceramides, hyaluronic acid, and glycerin. Regularly moisturizing the skin can help to repair the damage to the skin's barrier function and support a healthy skin microbiome. A good skin barrier repair cream would be the DermDoc by Purplle 2% Salicylic Acid Face Wash for Acne is good for reducing the bacteria on the skin leading to a reduction in acne by restoring the skin microbiome.

4. Avoid over-exfoliating: Over-exfoliating can damage the skin barrier and disrupt the skin microbiome. Limit exfoliation to once or twice a week and use gentle exfoliants.

5. Use probiotics: Probiotics contain beneficial bacteria that can help to restore the skin microbiome. Look for skincare products that contain probiotics or use a probiotic supplement.

6. Eat a healthy diet: A healthy diet that is rich in fruits, vegetables, and whole grains can help to support a healthy skin microbiome and skin barrier.

7. Limit exposure to irritants: Exposure to irritants such as pollution, chemicals, and UV radiation can damage the skin barrier and disrupt the skin microbiome. Wear protective clothing and use sunscreen to minimize exposure.

8. Manage stress: Stress can disrupt the skin microbiome and compromise the skin barrier. Manage stress through practices such as meditation, yoga, or exercise.

9. Eat a healthy diet: A healthy diet that is rich in fruits, vegetables, and whole grains can help to support and restore a healthy skin microbiome.

So How Do The Microbes On Our Skin Affect Our Health - The Indian Perspective 

The skin microbiome plays an important role in maintaining skin health in the Indian context, as in any other context. However, several unique factors can affect the skin microbiome in India.

Some of the most important factors are -

1. Humidity - This leads to increased sweating, which can lead to the growth of certain types of microorganisms on the skin and increase the risk of skin infections and other skin disorders.

2. Skin Microbiome - Studies have shown that the skin microbiome of Indians is different from that of individuals from other parts of the world. For example, the skin microbiome of Indians is dominated by the bacteria Staphylococcus and Corynebacterium, while the rest of the world has a more diverse microbiome with a higher abundance of Propionibacterium. So Indians are more prone to developing recurrent bacterial infections like impetigo, folliculitis etc.

3. Traditional Practices - use of ayurvedic herbs and oils can also impact the skin microbiome.

4. Excessive Cleansing - While natural cleansers like reetha, shikakai or soap nut are gentle cleansers, many Indians use harsh soap along with vigorous scrubbing with pumice stones, scrubbers and abrasives to clean their skin. This can damage the skin barrier in the long run.

5. Diet - The Indian diet is rich in spices like turmeric, pepper, ginger, curd etc. which are anti-inflammatory and antimicrobial and support a healthy gut-skin axis.

In conclusion, a healthy skin barrier is essential not just for healthy skin but for maintaining good health overall. Dr Samujjala Deb, MD shares a few personal tips to ensure a healthy skin barrier - "Use a gentle skin cleanser, both for the face and the body. Squeaky clean often means loss of the protective natural lipid barrier, so stay away from any cleanser that gives you that feeling. Next always remember to seal in your skin barrier with a good moisturiser post-cleansing. This is non-negotiable!! Use a ceramide-based cream or lotion for maximum benefits. And lastly, eat healthily. A healthy gut leads to healthy skin. Our Indian diet is loaded with superfoods like yoghurt, turmeric, spices etc. Make full use of these to ensure a healthy gut and healthy skin."