When you think about bacteria on the skin, “clean” probably isn’t the first word that comes to mind. Yet we’ve come to actively embrace foods specifically for their microbes — yogurt, kombucha, probiotic supplements — as part of a “clean” diet. These differing perceptions show our shifting relationship with the microbial world, one that’s growing by the day.
Bacteria have become an important new area of focus in the medical community. We’re even creating drugs based exclusively on microbes to treat challenging intestinal diseases, like C. diff and IBS. Even though there’s much left to learn, we’ve accepted the idea that a healthy microbial ecosystem is a cornerstone of internal health.
But externally, on the skin, we’re still at war with the microbial world.
The belief that bacteria on the skin is bad has shaped the general public's ideas on dermatology, personal care, and beauty. Our obsession with “clean” is apparent in our daily routines. The intentions have been good; we only really hear about the bad bacteria out there, so we assume a bacteria-free world (and body) would be healthy.
But the data suggests otherwise.
More than half of all women and men claim to have sensitive skin, and the products marketed to them are taking up more and more space on store shelves. More than 50 million Americans suffer from acne (it's not just for teenagers anymore). Eczema cases have tripled in the last three decades in children alone. We’re seeing more skin allergies and other inflammatory issues like psoriasis, rosacea, keratosis pilaris, and staph/MRSA. Even celebrities like Kim Kardashian and Cara Delevingne are speaking out about their ongoing struggle with psoriasis.
There’s no shortage of products or information on all of these conditions, but despite the ever-expanding roster of cleansers, toners, creams, gels, masks, peels, and scrubs, our skin issues not only persist, but they grow. Perhaps it's time to start over and revisit what we assume to be true.
The tremendous insights we’re gaining on the gut microbiome have triggered drastic changes in all our judgments about bacteria, even those on the skin. Here’s what we’ve learned so far, and why you should care about your skin microbiome:
Our Skin Is an Ecosystem, Just Like Our Gut
One of the most important things to remember, though, is that the bacteria on the skin communicates with our immune system. Studies show that this ecosystem on our skin serves as a first responder when something is wrong and exerts influence on immune response. But in order for this communication to happen, that good bacteria needs to stay on our skin.
This is made somewhat difficult by the fact that these good bacteria are sensitive: Some of the microbes that have been identified as “peacekeepers” are easily washed away by basic soap (even a homemade version). Additionally, "bad" bacteria aren't always bad and don't necessarily deserve the rap they get. Their presence only becomes a problem when the microbial community fails to keep them in check.
Just like an ecosystem in nature, there needs to be a balance of both kinds of bacteria for optimal health. And we shape this topical ecosystem all day, every day. Everything from how we’re born to the time we spend outdoors to the products we use shape this ecosystem.
Our Microbes Aren't What They Used to Be
Modern humans have lost important microbes in the last 50 to 100 years. Our diminished interaction with nature, the advent of modern chemistry, our growing hygiene routines, and our changing lifestyles have eliminated key species of microbes from our skin.
What's interesting, however, is to note that the Third World and tribal communities — those without easy access to modern self-care and antibacterial products — have vastly different skin bacteria. In fact, an isolated Amazonian tribe has the most diverse microbiome ever documented in humans, meaning that despite never having been exposed to commercial antimicrobials, their microbes carry genes that are resistant to antibiotics. This leads researchers to believe that the ability to resist and heal themselves existed way before drugs were introduced to humans.
Whether it's causation or correlation remains to be determined, but research notes that these more primitive people have virtually no presence of inflammatory skin issues.
So how do we reconnect with our roots and get our skin microbiomes back to where they need to be?
We still have research to do, but we’re learning that our skin isn’t meant to be a sterile surface. For the first time in dermatology and medicine, we’re viewing our skin in a radically different way. We’ve learned that it’s difficult, if not impossible, to have a healthy digestive system without the right balance of microorganisms.
It’s just as likely impossible to have healthy skin without a healthy microbial community as part of it.
Photo Credit: Stocksy