The Skin Microbiome, Probiotics & Healthy Skin
What is Skin Microbiome?
Microbiome, also known as microbiota or Skin flora, is a term for the bacteria, viruses, fungi, and microscopic things that coexist in your gut & on your skin.
There are two important microbiomes. The gut microbiome is well known and researched and includes probiotics and “friendly bacteria” However, it turns out there is another microbiome on the outer skin. Together these microbiomes act like a major organ in your body and the health of your microbiome is essential for healthy skin.
In this article, we are going to look at how the gut and skin microbiomes work together.
Why is the Skin Microbiome Important?
You just can’t replicate all the good your microbiota  does for your skin with creams and vitamins.
They may be the secret to curing or managing skin problems long thought to be almost impossible to cure. Most importantly, both your gut and skin microbiome directly affect the appearance and health of your skin.
So, to protect your microbiome you will need to look at both your stomach and skin microbiota.
Dry Skin, Aging & Intestinal Disease Protection
.. gut microbiome
In a 2014 study rats were given Lactobacillus brevis there was a significant decrease in transepidermal water loss. 
In 2014 a 12-week study was conducted on humans to test the effects of bacteria L. brevis SBC8803 supplements. At the end of the study, they found that participants had significantly decreased skin water loss.
Separate studies also found there were big improvements in the skin barrier function. Test subjects who took supplements of Lactobacillus paracasei over a 2 month period had reduced skin sensitivity and water loss. 
Test on bacteria L. helveticus also had very positive effects on skin moisturisation levels.
An article, published in Science Translational Medicine presented a study where the gut microbiota of older mice was transferred into the gut of younger mice. 
The reseach revealed that this produced an increase in brain neuron growth and altered aging. There was also an increase in levels of butyrate, a fatty acid produced in the gut. This is significant because butyrate is suspected to be very important in the protection against intestinal and extraintestinal diseases. 
What Does the Skin Microbiome Do?
A healthy skin microbiome is a protective barrier against skin infections and other common skin problems.
It maintains an acidic environment on the skin which controls the spread of bacteria such as Staphylococcus epidermidis which is at the root of many cause many skin problems. In addition, a healthy microbiome is central to maintaining skin hydration and healing skin damage.
This is why it you need to look after the microbiota in your gut and on the outer layers of your skin.
How to Repair & Heal Your Microbiome
If you suspect your skin microbiome is damaged and want to heal it you will need a comprehensive plan that covers both how you eat and how you look after your skin.
As we discussed above look at your gut microbiota and review the products that you use on your skin.
How to Protect Your Gut Microbiome
To improve your gut microbiome look at your diet and supplements with prebiotics and probiotics.
- Eat prebiotic foods 
- Make sure you have fiber in your diet
- Eat a wide range of foods
- Gut flora love polyphenol-rich foods 
- Eat some fermented foods such as Kefir, Live Yogurts Apple Cider Vinegar 
- Avoid artificial sweeteners
- Be careful to take some preventative action when taking antibiotics
How to Protect Your Skin Microbiome
To improve your skin microbiome look carefully at what you are putting on your skin and your cleaning regimen.
- Avoid Anti-bacterial washes or soaps! No 1
- Avoid overwashing & Exfoliating
- Remember your skin should be slightly acidic. Consider PH balanced cleansers & Moisturisers
- Maintain Hydration Levels ( Drink 2 – 3 litres of water per day )
- Choose clothes/material to allow your skin to breath not sweat
To put it simply, if your skin flora is not happy, then your skin will not be healthy.
Common Skin Problems & the Skin Microbiome
… the gut microbiome
Rosacea is a chronic inflammatory skin condition.
It is hard to treat because it does not respond well to most know skin treatments. A study of 50,000 Danish patients with rosacea, showed that many types of intestinal disturbances were higher in patients with Rosacea.  Furthermore studies found an improvement in rosacea symptoms occurred after eliminating a bacteria known as H. pylori 
One important conclusion of the research was that people with gastrointestinal problems who also suffered from rosacea should be referred for an investigation into Helicobacter pylori infection (HPI), small intestinal bacterial overgrowth.
… the skin microbiome
In patients suffering from rosacea, the balance of microbiota in the skin has been disturbed.
This imbalance allows otherwise harmless microbes, such as the Demodex mite, to multiply out of control.  In fact, it has been found that inflammation of the skin in rosacea closely correlates with the density of mites on the skin.  The Demodex mites may also exacerbate the situation by making the skin more susceptible to common causes of inflammation like sunlight, alcohol, hormones, and other bacteria.
It has been shown that regular washing with alkaline soap reduced the Demodex mite population.
.. gut microbiome
The root causes of this life-long problem are rooted in infancy and early childhood.
Not only is eczema closely connected to the correct microbiome development but research is now seeing how it influences other organs, such as the lung, brain, and skin. Possibly uncovering the common link between Eczema and Asthma which often occur together.
Studies found that treatment of the gut with certain lactobacilli in mice significantly changes their overall skin phenotypes – a discovery that may well explain the results of studies into Staphylococcus aureus and Eczema ( see below ).  Other observations of patients with Atopic Eczema found a correlation between high levels of gut bacteria – Clostridia, Clostridium difficile, Escherichia coli, and Staphylococcus aureus and lower than normal levels of Bifidobacteria, Bacteroidetes, and Bacteroides. 
… skin microbiome
Research in the U.S. uncovered a direct connection between Eczema flare-ups and a skin microbiome imbalance of bacteria Staphylococcus aureus.
They noticed that this bacteria was found in higher than normal concentrations on skin affected by Eczema. They also noted that there were lower concentrations of the cells that assist in building up skin barriers.
By increasing levels of other bacteria on the skin, the levels of Staphylococcus aureus were controlled which prevented flareups. 
.. gut microbiome
Studies found that people who have psoriasis of the skin or psoriatic arthritis have a less diverse range of intestinal bacteria.
This also appears to be linked to a higher chance of getting irritable bowel syndrome and gut inflammation. A number of important bacterial types were present in lower than expected levels including – Coprococcus spp. Akkermansia, Ruminococcus, and Pseudobutyrivibrio. 
To test these observations a supplement based therapy using Bifidobacterium infantis 35624 was made on psoriasis patients over an eight week period. 
The results of the study showed an increase in:
- C-reactive protein – produced in blood plasma in response to inflammation
- TNF-alpha – a cell-signaling protein involved in systemic inflammation
- IL-6 – an anti-inflammatory small protein
.. gut microbiome
It is more than 70 years since dermatologists John H. Stokes and Donald M. Pillsbury suggested the connection between the gut microbiome, emotional states, and acne.
A study was made of 13,000 teenagers suffering from acne. Researchers noticed that those with gastrointestinal symptoms and abdominal bloating were 37% more likely to have acne and other skin problems . The initial observations noted that 40% of those with acne have hypochlorhydria an excess production of hydrochloric acid in the stomach.  This increased acidity level affects the environment in which beneficial bacteria can flourish.
Unhealthy stomach acid production can lead to “small intestine bacterial overgrowth” [ SIBO]. Specific studies into SIBO and acne vulgaris have not yet been made. However, other studies have shown that patients with acne rosacea are 10 times more likely to have SIBO.
As a treatment for acne, they proposed the use of organisms such as Lactobacillus acidophilus c and Bacillus acidophilus with cod liver oil – a probiotic.
.. skin microbiome
Disturbed bacterial colonies in the skin are thought to be the main cause of acne. 
A study of the skin microbiome in healthy patients and patients with acne was made. They found that although the levels of the Propionibacterium acnes were similar in healthy and acne skin that certain “variant strains” were closely associated with acne skin and others with healthy skin.
A strain is a “genetic variant or subtype of a microorganism “.
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 Egeberg A, Weinstock LB, Thyssen EP, Gislason GH, Thyssen JP. Rosacea and gastrointestinal disorders: a population-based cohort study. Br J Dermatol. 2017https://pubmed.ncbi.nlm.nih.gov/27501017/
 Tüzün Y, Keskin S, Kote E. The role of helicobacter pylori infection in skin diseases: Facts and controversies. Clin Dermatol. 2010;
 Horii Y., Kaneda H., Fujisaki Y., Fuyuki R., Nakakita Y., Shigyo T., et al. (2014). Effect of heat-killed Lactobacillus brevis SBC8803 on cutaneous arterial sympathetic nerve activity, cutaneous blood flow, and transepidermal water loss in rats. J. Appl. Microbiol. 116 1274–1281.
 Zhang H, Liao W, Chao W, Chen Q, Zeng H, Wu C. et al.Risk factors for sebaceous gland diseases and their relationship to gastrointestinal dysfunction in Han adolescents. J Dermatol. 2008;35:555–61. doi: 10.1111/j.1346-8138.2008.00523.x  Scher JU, Ubeda C, Artacho A, Attur M, Isaac S, Reddy SM, Marmon S, Neimann A, Brusca S, Patel T. Decreased bacterial diversity characterizes the altered gut microbiota in patients with psoriatic arthritis, resembling dysbiosis in inflammatory bowel disease. Arthritis Rheumatol. 2015
 Groeger D, O’Mahony L, Murphy EF, Bourke JF, Dinan TG, Kiely B, Shanahan F, Quigley EM. Bifidobacterium infantis 35624 modulates host inflammatory processes beyond the gut. Gut Microbes. 2013
 Gao Z, et al. Substantial alterations of the cutaneous bacterial biota in psoriatic lesions. PloS one. 2008
 62. Georgala S, et al. Increased density of Demodex folliculorum and evidence of delayed hypersensitivity reaction in subjects with papulopustular rosacea. Journal of the European Academy of Dermatology and Venereology: JEADV. 2001
 Bojar RA, Holland KT. Acne and Propionibacterium acnes. Clinics in dermatology. 2004