As mbg’s associate health editor, Gretchen has become the go-to person for any (and every) health question in our office. Her strategy is simple: approach modern health conundrums using a combination of ancient wisdom and current research. In Modern Medicine, Gretchen will deconstruct the latest wellness trends by evaluating research and consulting leading integrative health experts to tell you what’s brilliant—and what’s bogus.
You may have noticed a new type of product on the shelves: face washes, toners, and masks infused with probiotics, the beneficial bacteria many of us have been taking in oral capsules for years to protect our gut health. And while it might seem counterproductive—since historically skin care has been about cleaning the face by removing dirt, bacteria, and germs—the more we learn about the bacteria on our skin the more we realize that it might be there to protect us. This has led to a new movement exploring probiotics as a possible solution to all of our most frustrating skin woes.
And it makes sense that scientists, researchers, and product developers are looking for a new avenue: At least 50 million Americans are struggling with acne, and inflammatory skin conditions like eczema and psoriasis are on the rise in adults (and sadly, children as well). So does the skin really have its own special bacteria? And what does that mean for our skin health? Is the microbiome the key to that even-toned, radiant glow? Could the skin microbiome possibly be as important as the gut microbiome for our overall good health? To answer these questions, we'll dive deep into the skin microbiome and what it means for your health, consulting leaders in integrative dermatology, probiotic research, and holistic skin care along the way.
Wait, there are bacteria on my skin?
Yep, and fungi, too. But unlike the rhetoric of nineties-era skin care, these microbes are not your enemies. Many of us know that our guts are home to trillions of bacteria—which help keep our immune system, metabolism, and moods in good shape—but sometimes we forget that we actually have bacteria all over us. And since the skin is the body's largest organ, providing a barrier between our internal environment and the outside world, it seems reasonable to assume that the skin microbiome plays a pretty big role in our health, too.
So what do we really know about this mysterious second microbiome? According to Dr. Douglas Toal, a clinical microbiologist and probiotic expert, "A wide range of microorganisms inhabit the skin, including bacteria, fungi, and viruses." We know that the bacteria on the skin are highly diverse, variable, and dependent on the individual's personal history and environment. We also know that different areas of the skin have different types of bacteria on them, and that the bacteria on one person's feet, for example, tend to be similar to the bacteria on everyone else's feet. How does our skin bacteria compare to the bacteria in our gut? "Regarding composition, there are significant differences between the microbes in the gut and those on the skin," explains Dr. Toal.
Are bacteria the real secret to flawless skin?
If washing your skin with bacteria is a step outside your comfort zone, we get it. And there's no doubting the fact that some bacteria are harmful, but we can't discriminate against the entire domain because of the activities of a few select species. So to better understand the theory behind all these new probiotic-based products, we asked some of our experts and found that bacteria work to:
1. Protect against inflammatory skin diseases like psoriasis and eczema.
2. Occupy a wide range of areas on the skin to create a barrier against harmful pathogens and microorganisms.
3. Interact with our cutaneous immune system to promote a healthy immune response.
4. Prevent and treat acne.
5. Decrease skin inflammation and redness.
6. Act as antioxidants to prevent sun damage and aging.
7. Support healing of burns and scars.
And this is just a preliminary list; according to Jasmina Aganovic—the president of Mother Dirt, a company developing biome-friendly cosmetics—scientists and researchers are still working to uncover all the ways in which bacteria affect our skin—but it's an exciting area of research. And while she is an obvious proponent of skin probiotics—having founded a product line and working to advance skin microbiome research with her company's parter AOBiome—this is a pretty exciting area of study, since uncovering the precise benefits of our skin bacteria will help us understand what might be happening when these same bacteria become unbalanced (think skin disease).
So could a disruption in the microbiome really be to blame for our skin woes? As an integrative dermatologist and mbg skin health expert, Dr. Cybele Fishman considers the skin bacteria in many of her patients—but especially those suffering from acne, rosacea, seborrheic dermatitis, perioral dermatitis, and eczema. "I think the key word there is BALANCE. There are bacteria, fungi, and mites on the skin. Having the right amount of each is what helps prevent disease. When they are not in balance with one another it can manifest as skin disorders," she explains. Theoretically, topical probiotics would restore this much-needed balance to the skin, and the science seems to be supporting the idea that bacteria-infused lotions and creams could help heal various skin diseases.
How do I know if I need skin probiotics?
The wellness community has been concerned with the bacterial balance in our digestive tract for years. And with good reason. Our modern lives take a real toll on our microbiome, and dysbiosis, leaky gut, and candida can be detrimental to almost every aspect of our health. So now that research is pointing to the great importance of our skin microbiome, how do we maintain its natural balance? Or even more: What are we doing to upset the balance? Well, much like for our gut microbiome, our modern lives are hard on our poor skin bacteria.
According to Dr. Fishman, a lot of different factors can affect our skin's microbial balance including age, sex, hormones, climate (especially humidity), skin conditions like atopic dermatitis, the overuse of antibiotics, and underlying issues with our immune system or blood sugar. "But my favorite factor is lifestyle, which is the easiest to control. Things like hygiene—sometimes too much or too little—and sometimes the wrong kind of hygiene can hurt the skin bacteria," she explains.
Are my cosmetics killing the beneficial bacteria on my skin?
Dr. Toal is also of the opinion that our personal skin microbiome is influenced by several genetic and environmental factors, explaining that oil secretion, pH levels, moisturization, and the products we use on our skin help or hurt these bacteria. So what skin products, exactly, are causing a problem? According to Aganovic, we're still learning. What we do know is that products with preservatives (since they are meant to be antimicrobial) will have an impact on the body's bacterial balance, so it makes sense that they would also disrupt the skin ecosystem.
Dr. Eva Zasloff, an integrative medicine doctor and mbg health expert recommends using only paraben- and sulfate-free products on babies, which protects their newly forming skin microbiome, and says this concept applies to adults as well. "When we use harsh soaps and shampoos, we often not only remove the dirt but also the natural oils and peptides that our bodies make to help maintain a balanced microbiome for our skin and scalp." And so it seems the gentler the better when it comes to our skin microbiome—in case we needed another reason to switch to chemical-free, nontoxic cosmetics.
And so it seems that the aisles and aisles of skin care products—many promising to transform our skin health—could actually be part of the problem. Enter new product lines infused with these beneficial microbes—also promising to transform our skin. Not surprisingly, the next question we have is: "Do they really work?" Because the sheer thought of ditching all those expensive potions for our natural bacteria has us on the edge of our seats.
So, should I be putting probiotics on my face?
Dr. Fishman thinks developing topical probiotics makes a lot of sense: "I have been using kefir masks for years to treat skin conditions in my patients; it really helps." In her integrative approach to dermatology—balancing the skin bacteria and pH are everything. Dr. Toal is also optimistic about topical probiotics. "This is an area of ongoing research, but the evidence is strong that probiotic application may be effective in supplementing the treatment of skin conditions such as acne," he said.
Where do you find these products? They seem to be everywhere, so to narrow it down we consulted mbg's beauty editor—who is well-versed in all things skin care and probiotics. According to Kayla, some great options to consider are Tula Discovery Kit ($52), Mother Dirt AO+ Probiotic Mist ($49), and Marie Veronique Probiotic + Exfoliation Mask ($50).
Will my skin look better if I use one of these products?
If you've gotten this far, you may be considering trying out one of these products. But will you really notice a difference? Dr. Fishman tells us that her patients enjoy the kefir mask because it's safe and feels soothing—explaining that it can be a real game changer for many of her patients. Jasmina says users of her line of probiotic products confirm that their skin looks and feels better, and it allows them to use far less product. "Users are able to cut down on products like moisturizers and deodorant and find that their skin is more balanced, less oily or less dry, and even less sensitive," she explains. The reviews seem to be good for many of these bacteria-friendly products.
Are probiotics the future of dermatology and skin care?
Gut health is undeniably becoming a central factor in the future of medicine. So is the microbiome the future of skin disease treatment as well? Dr. Fishman believes that as the gut microbiome continues to become more prominent in medical and layperson dialogue, more attention will be paid to the skin microbiome. One of Dr. Fishman's favorite things about the kefir mask she prescribes her patients is that it is quick and cheap in a medical system in which prices are out of control. (We like that about it, too.) And it seems this is part of a general trend to go back to basics when it comes to skin care. And it you think about it, it makes sense. Right now we have a system in which we strip our faces of beneficial bacteria and then use products (filled with sunscreen, antioxidants, vitamins, etc.) to try to replace the protective and healing functions of the bacteria. Maybe we should just back up a few steps and support our natural bacteria in the first place?
Should I try topical probiotics?
We understand that even with all this information, it can be hard to grasp exactly how the skin microbiome works and what it really means for our skin care. It can be even harder to decide if you should go out and invest in one of these products. And we can't exactly answer that question, but we do think it's worth exploring—especially if you have one of the stubborn conditions mentioned by our health experts.
So what's the take-away? It's definitely time to zoom out and start seeing the microbiome as more than just gut bacteria. And that doesn't just mean considering the skin, too. We have bacteria all over our bodies. Some new research is even showing that our individual microbiome actually forms a cloud around us, following us everywhere we go and interacting with the people we spend the most time with. Many scientists think we've only scratched the surface when it comes to the enormous role bacteria play in our health and how we've evolved with them in, on, and around us. The future of dermatology—and even medicine as a whole—may very well focus on how we can live in harmony with our microbial friends.
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