EXPERT OPINION. Problem skin microbiome

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Five percent of a person’s weight is … microorganisms. The same microbiome that affects literally everything in our lives – from mood to the state of immunity and skin. It turned out that with problematic skin, there is an imbalance in the microbiome. So, it makes sense to choose care taking into account these features. We understand with the help of an expert how acne and the microbiome are connected and what to do with it all.

Acne and microbiome imbalances – what is the cause and what is the effect?

Scientific knowledge is accumulating, and new research is helping to better understand the causes of acne. Today, four main mechanisms of its development are distinguished, which include the formation of colonies and biofilms of Cutibacterium acnes (C. acnes).

Moreover, C. acnes also differ and affect the manifestations of acne in different ways, being mainly responsible for comedones (black dots) or pustular rashes. Sebum, the breakdown products of cells, is a suitable medium for the reproduction of these microbes. The fatter the skin, the more favorable conditions for them. At the same time, C. acnes is able to trigger other mechanisms of acne development.

But it all starts with an increased sensitivity of the receptors of the cells of the sebaceous hair follicle to the sex hormones androgens. As a result, sebum production increases, microcomedones form in the skin, inflammation occurs and colonization by microorganisms increases.

What are the characteristics of the microbiome of skin prone to imperfections?

C. acnes is an important factor in acne, but for most people this microorganism is a commensal, that is, it does not cause harm by its presence. It lives on the surface of the skin, as well as in the mouths of sebaceous hair follicles. In general, it has been found that the skin microbiome in acne is different from normal: the number of C. acnes and other microorganisms increases at the expense of the rest. Some microbes are known to be able to suppress inflammation and affect C. acnes. Based on new research, new methods are being developed to get rid of acne.

What features of skin care products does this dictate, does their composition, application technique, care routine change?

Perhaps “transplanting” the skin microbiome is one of the options for getting rid of acne in the future. But today we can already influence the microbiome with the help of products that contain prebiotics. These products help to maintain the balance of beneficial bacteria on the skin.

Often, owners of problem skin are overly actively struggling with manifestations of oiliness and imperfections, using aggressive products. Acne-prone skin needs an effective yet gentle cleansing. Therefore, it makes sense to use special tools, do not abuse cleaning devices (rags, brushes, mittens). And, most importantly, do not neglect hydration.

To cleanse problematic skin, both men and women require special products that help control acne and not overdry the skin.

How can skin with imperfections be sensitive at the same time? Indeed, sensitivity is traditionally associated with the insufficiency of the stratum corneum, and with acne, the opposite is true.

The thing is that one of the mechanisms of acne development is inflammation, which triggers a whole cascade of various reactions in the skin, which makes it sensitive. Therefore, with acne, we always talk about oily, but sensitive skin. Microbiome imbalance is also a factor in sensitivity.

Traditionally, anti-blemish products contain active ingredients to dry and exfoliate the skin. How is this effect combined with calming and restoring?

Indeed, many active ingredients in acne-prone skin products can have a drying effect. Therefore, special care is needed for oily, but overdried skin.

In the care of sensitive oily skin, moisturizing and soothing care is no less important than acne treatments themselves.

Research on the microbiome and its influence on the development of various skin conditions, including acne, has led to the emergence of skin care products that promote balance. This is a new approach that will be improved in the near future.

How do skin care products combine those ingredients that fight acne and those that restore the skin microbiome?

When developing formulas and textures, the necessary effects and compatibility of ingredients are taken into account, since not all substances are “friendly” with each other. Funds can act in a complex way and solve several problems.

Should everyone with imperfections use products that act on the microbiome, or in certain cases they are not necessary?

We have already discussed that with acne, the balance of the microbiome is bound to change. You also need to remember that 20% of the state of the microbiome depends on environmental factors. Care products are external factors, therefore, they affect the skin. Proper care helps to reduce its sensitivity.

Is it possible to influence the skin microbiome from the inside, through nutrition?

“You are what you eat!” — this phrase is also relevant for the microbiome. Approximately 60% of it depends on genetics, 20% on the external factors of the environment in which a person lives, and the remaining 20% are dietary habits. Eating a large amount of easily digestible carbohydrates, dairy products, saturated fats negatively affects the microbiome. Fermented foods (sauerkraut, kimchi, kombucha, pickles, kefir, miso, apple cider vinegar), on the contrary, contribute to its improvement.

Sour-milk (but not milk!) and fermented foods can have a beneficial effect on the acne microbiome.

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We have written a lot about the care of problem skin and suitable products for this.

Special care for acne-prone skin is, in our opinion, an essential part of a comprehensive approach. Special products take into account the needs of such skin – oily, but overdried by drug treatment. An example is the Effaclar H Isobiome range of products from the La Roche-Posay dermatological laboratory. It includes a cleansing cream-gel and a revitalizing treatment to help restore comfort to the skin. The peculiarity of the La Roche-Posay brand is its special attention to the skin microbiome. Formulated with soothing panthenol and niacinamide, annatto extract to help fight imperfections, and the exclusive Filiformis Aqua Pose probiotic to benefit the skin microbiome.

On the one hand, this combination allows you to control imperfections, on the other hand, it moisturizes the skin, makes it softer and reduces the manifestations of sensitivity.