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SMiHA, Biomes and the BSID

Our invited Blog this month is from Dr. Holly Wilkinson, Assistant Professor (Wound Healing) Wound Group – Biomedical Institute of Multimorbidity, Centre for Biomedicine. Hull York Medical School.

Holly is the SMiHA speaker at the British Society of Investigative Dermatology annual meeting, March 20-21, 2023. Here she summarises her talk and her recent publication.

"Our skin is home to a diverse range of microorganisms collectively known as the microbiota. From the moment we are born, we become colonised by these microorganisms which adapt over time to the changing microenvironment of our developing skin. Resident “commensal” microbes utilise the sebum, salt and water of our skin to generate metabolites that strengthen the skin barrier. Commensal bacteria, such as Staphylococcus epidermis, even produce antimicrobials and vitally educate the skin’s immune system to protect against pathogens.

Traditional skin microbiology studies have focused on identifying the pathogens that cause skin infections and targeting these pathogens with broad-spectrum antimicrobials. However, with the advent of gut microbiome research, we have now begun to appreciate the importance of the microbiota in maintaining health and treating disease. This revelation has led to the rapid expansion of skin microbiome research across academic, clinical and commercial sectors. From community-level profiling, we now know that different regions of the skin are inhabited by distinct microbial ecosystems. These microbial communities are made up of stable residents and more transient microorganisms, including opportunistic pathogens.

Despite the skin normally exhibiting stable communities of bacteria, a microbial imbalance, or microbial dysbiosis, can be caused by a range of external factors including changes in pH, temperature, and hormone levels. It is therefore not surprising to find that disruption of the microflora is observed in the skin of patients with atopic dermatitis, acne and psoriasis. Microbial alterations are also associated with age-related changes to the skin, such as loss of collagen content. Though these findings present a clear opportunity to develop microbiome modulating products, much of our understanding of the role of the microbiome in skin health is based on correlative analysis and laboratory models that do not mimic the native skin microbial environment. By contrast, animal models provide a full living system to explore skin-microflora relationships but offer limited translation to humans. Animal models are also infrequently used in the cosmetics industry due to legislative restrictions and the drive towards cruelty-free, ethical practices.

The growing consumer interest in the skin microbiome has opened many commercial opportunities, from providing microbiome profiling services and personalised skincare routines, to developing products designed to modulate the microbiome and treat skin concerns. Although these are attractive marketing strategies, current evidence linking skincare ingredients to skin health and the microbiome is lacking. With expanding consumer awareness of the microbiome, there is also increasing pressure on the industry to ensure that existing skincare ingredients do not harm the resident microbiota. The key challenge here is for commercial partners to develop models that effectively demonstrate that products are “microbiome friendly”.

We still have a way to go to understand the links between microbial changes and skin health, but the future looks promising. Research advances continue to drive development of new diagnostic tools to characterise the microbiome, while laboratory approaches are constantly being refined to increase translational relevance of skin microbiome models. Harnessing the power of the microbiome could revolutionise the way we approach skin health, ageing and disease in the not-so-distant future."

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