The skin is the primary interface between the internal and external environments, providing a barrier against opportunistic pathogens, UV radiation, mechanical and chemical stressors, including toxic substances.
In recent times, the skin’s barrier function has become a topic of intense discussion amongst skin therapists, and for good reason. With advancements in and access to a greater range of modalities in clinic, we are able to manage skin concerns like never before. Do all our treatments support the skin’s barrier function?
The health of the stratum corneum, the uppermost layer of the epidermis has always been considered crucial to healthy skin function. The role of keratinocytes, the major cells of the epidermis, has always been considered to be a protective one, yet recent research has revealed that it is a lot more complex than that. Keratinocytes are involved in communication with host immune networks, producing and releasing an array of hormones, neurotransmitters and cytokines that influence whole body systems.
The acid mantle, that mixture of sweat and sebum that we were taught about, having a pH of between 4.5 and 5.5 has always been considered the skin’s first line of defense, repelling opportunistic microbes, but there’s actually more to the story than that; the skin plays host to a diverse ecosystem of microbes that are directly responsible, along with the body’s innate immunity, for maintaining a healthy barrier, ensuring homeostasis and optimal skin function. Disruption of this delicate microbial balance results in a higher susceptibility to inflammatory conditions.
While more people are becoming familiar with the terms ‘gut health’ and ‘probiotics’, they may not as yet fully understand the impact they both have on health and disease. Conditions such as ulcerative colitis, coeliac disease, rheumatoid arthritis, depression, obesity, psoriasis and eczema, to name a few, all have an association with poor gut health. Dietary choices directly influence the trillions of diverse microbes, made up of bacteria, fungi, yeasts and viruses that reside in the gut, impacting both their diversity and numbers. The gut microbiome is a term used to describe the microbes that inhabit the gut, along with their genetic material, that are collectively responsible for determining both health and disease.
The skin microbiome is the new kid on the block, and is forcing us to re-think what constitutes the skin’s first line of defense. The fabric of microbes made up of bacteria, yeast, fungi and viruses that cloak the entire skin’s surface and reside within follicles, is now recognised as determining the skin’s barrier function, influencing the skin’s hydration levels, pH levels, ceramide production, and also sebaceous secretions. Disturbances to this intricate balance have been implicated in inflammatory skin conditions such as psoriasis, eczema, acne and rosacea.
I describe the skin microbiome as the new black because while it is recognised by some skin therapists, there are still huge numbers who have no idea of how integral it is to skin health. As its influence on dermatological disease management and also skin health are becoming better understood, the interest in the skin microbiome continues to grow exponentially. This has resulted in a large number of players entering into the market from both Pharma and cosmetic industries, which will ultimately intensify the competition around microbiome-specific products in the coming years.
I have only very recently returned from the 3rd Skin Microbiome Congress 2018 in London and was excited to see such advancements in both cosmetic and pharmaceutical applications of microbiome-focused product development.
Skin microbiome technology is all about creating an environment where skin microbes can thrive and ultimately promote healthy skin. As skin therapists we have to assess the impact of in-clinic treatments on the skin’s microbial balance. Popular modalities such as microdermabrasion, laser treatments, chemical peels, epidermal blading, to name a few all alter the microbial balance. Is there more that can be done to address skin concerns while being mindful of the skin microbiome?
A growing consumer awareness of just how dramatically what we apply to our skin can impact skin health is behind the drive to bring products to market that are skin ‘microbiome-friendly’. Certain ingredients found in cleansers, exfoliants, serums, moisturisers, even makeup, have been linked to disruption of the skin microbial diversity, resulting in increasingly reactive, compromised skin conditions.
In Europe and the United States, (and more recently here in Australia), consumers are becoming a lot more savvy and environmentally aware, and they are continuously seeking to have this reflected in their skincare choices, fuelling the growing interest in products that are ‘microbiome-friendly’. This has led to the emergence and increased popularity of a growing number of product brands in the cosmetic/cosmeceutical space such as JooMo, Galline, Mother Dirt, Esse and Dermaviduals, not an exhaustive list by any means, that all have a focus on skin health, containing no artificial fragrance, little to no preservatives, no harsh surfactants or stripping cleansing agents which have all been linked to the disruption of the microbial diversity on the skin’s surface, but instead, creating the perfect environment for skin microbial balance.
In Pharma, the skin microbiome is also big business, with a big focus on the utilisation of probiotic technology in a number applications, such as acne, psoriasis and eczema management as well as in body odour, dandruff control and anti-ageing.
Probiotics are live microbes that are deemed to confer a health benefit upon their host and so in order for a product to be marketed as containing probiotics, it must be found to contain live microbes, which in effect confers drug status upon the product.
Cosmetic formulations are not allowed, by law to alter the skin in any way, and so therefore are not permitted to contain probiotics. This is the sole domain of Pharma and therefore raises questions about claims being made by certain cosmetic brands which purport to contain them.
Skin microbiome-focused skincare is going to continue to grow in awareness and demand as consumers continue to dictate what they want to see in their products and to put on their skin. The same way ‘fragrance-free’ and the elimination of harsh preservatives have seen cosmetic companies raise the bar, I predict that ‘microbiome-friendly’ skincare will soon become the norm. The consumer is looking for a simple solution to skincare and I believe as skin therapists this is something we too need to consider. What impact are our applications having on the skin’s health in the long run?
I honestly believe that we are heading towards a time when less will indeed be considered more.
- Chiza will present ‘Beauty from the Inside Out’ at Beauty & Spa Insiders in Sydney on May 21. For more information click here.