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Our skin is home to a rich ecosystem of bacteria and fungi that plays a vital role in keeping us healthy. These tiny organisms help protect the skin from harmful invaders, repair damage, and even reduce the effects of harmful UV rays. As research into the skin microbiome grows, experts are exploring how to better support these microscopic guardians for long-term skin health.

The Importance of Skin Microbes

Just beneath the surface of our skin lies a complex world of microbes, including bacteria that help maintain skin health and youthfulness. These bacteria work to keep our skin smooth, supple, and free from infections. Without them, our skin would be more vulnerable to harmful pathogens, irritation, and damage.

Research has shown that these bacteria play a key role in protecting against harmful microbes. They stop dangerous bacteria from taking hold and repair damage to the skin. Some even help shield the skin from harmful UV rays, reducing the risk of sunburn and skin cancer. Supporting this delicate ecosystem is crucial for keeping our skin healthy in the long run.

The Rise of Skin Probiotics

One increasingly popular method for supporting these beneficial bacteria is the use of probiotics in skincare products. Probiotics are live microorganisms that are thought to benefit the body, particularly the skin, by restoring microbial balance. Over a century ago, researchers began using bacteria to treat acne and skin inflammation, such as seborrheic dermatitis.

Today, many skincare companies offer products labeled as “probiotic.” These products include creams, serums, and cleansers that claim to restore the balance of microbes on the skin. While these products often promise smoother, healthier skin, there is a growing concern about whether they live up to their claims.

Probiotic Products: What’s Inside?

Despite claims of probiotic benefits, many of these products do not contain living bacteria. Instead, they often contain ingredients that nourish good bacteria or mimic their biological activity. These ingredients can include prebiotics (which feed beneficial bacteria) or postbiotics (which are byproducts of beneficial bacteria).

The issue lies in the fact that cosmetic regulations are not as strict as those for medical products. Companies can market their products as probiotics with minimal scientific evidence to support their claims. As dermatologist Richard Gallo, a leading expert in skin microbiomes, points out, skin product testing is often less rigorous than in medical settings.

Some skincare products labeled as probiotics contain ingredients that promote the growth of healthy bacteria, but they don’t actually contain live microorganisms. Researchers, however, are exploring new ways to influence the skin’s microbiome using bacterial transplants to restore balance, though this approach is still in its early stages.

The Challenge of Preserving Live Bacteria

One major hurdle in creating probiotic skincare products is preserving live bacteria. Even if the bacteria can survive the storage process, they must compete with the billions of microbes already living on the skin. Bernhard Paetzold, co-founder of a microbiome-focused company, highlights the difficulty of ensuring that the bacteria can thrive on the skin once applied.

For the most part, probiotics in skincare are still in the research phase, and many products on the market today do not contain live, active bacteria. Instead, they may contain ingredients that encourage the growth of beneficial microbes or mimic the effects of probiotics.

How Skin Microbes Relate to Skin Diseases

Researchers believe that disruptions in the skin microbiome may play a role in various skin conditions, such as eczema, rosacea, acne, and psoriasis. In particular, people with eczema often have higher levels of Staphylococcus aureus, a harmful bacterium. This imbalance of microbes can lead to inflammation and other skin problems.

Paetzold notes that while these patterns are often observed, they only show correlation and not direct causation. Scientists still don’t know whether the changes in the skin microbiome cause disease, or if the diseases themselves alter the skin’s microbial environment.

To determine whether bacteria can directly cure skin diseases or prevent them from occurring, researchers must conduct studies where healthy microbes are introduced to sick skin or harmful bacteria are used to trigger disease. However, this research raises ethical concerns, and most studies focus on restoring health through beneficial bacteria.

Early Successes in Microbial Skin Treatments

Encouraging results from small clinical trials have already shown that introducing healthy bacteria can help treat conditions like atopic dermatitis, a chronic form of eczema. For example, Richard Gallo’s team at a leading research institution identified Staphylococcus hominis, a bacterium that is found in healthy skin but rare in eczema patients. This bacterium produces proteins that kill Staphylococcus aureus, the bacterium responsible for much of the inflammation in eczema.

In a 2021 trial, Gallo’s team applied live S. hominis cream to 54 patients with atopic dermatitis. The results were promising: patients showed less redness, itching, and inflammation compared to those who used a placebo.

Other researchers have also tested probiotic treatments for eczema. In 2003, one study used Streptococcus thermophilus cream on 11 eczema patients, which improved the skin barrier and moisture retention. In 2018, another study transferred Roseomonas mucosa bacteria from healthy donors to eczema patients. After 16 weeks, the patients saw improvements in their symptoms.

Probiotics for Acne, Aging, and Sun Damage

Probiotic treatments are not just being used for eczema. Researchers are also exploring the use of probiotics for treating acne, sun damage, and even signs of aging. Acne is often linked to the overgrowth of Cutibacterium acnes, a bacterium that thrives in clogged pores. By introducing bacteria that inhibit C. acnes, researchers hope to reduce acne symptoms without relying on antibiotics.

In one trial, a lotion containing Enterococcus faecalis helped acne patients by significantly reducing pustules. In another study, a cream containing specific strains of C. acnes was shown to reduce acne in participants.

Gallo’s team is also exploring the potential of Staphylococcus capitis, a microbe that has been shown to reduce the growth of C. acnes in animal studies. Unlike antibiotics, which kill a broad range of bacteria, this treatment targets C. acnes specifically, leaving other helpful bacteria on the skin intact.

Moreover, Gallo’s research team discovered that Staphylococcus epidermidis, another skin bacterium, may help prevent UV-related skin cancer. This microbe produces molecules that block DNA replication in damaged cells, reducing tumor formation in lab animals.

More Research Needed

Although the results of these studies are promising, more testing is needed to confirm their effectiveness and safety in humans. In the meantime, researchers continue to investigate the role of prebiotics and postbiotics in improving skin health. Inulin, a type of fiber found in some skincare products, may support beneficial bacteria on the skin, while sphingomyelinase, an enzyme from fermented milk bacteria, may help increase ceramide levels, improving skin structure and moisture retention.

As research advances, we may soon see more probiotic-based therapies available to the public. However, Gallo advises caution when using probiotic creams for general skin care. “I wouldn’t recommend most current probiotic creams,” he says, “They often lack convincing evidence.”

Nurturing the Skin’s Microbial Ecosystem

For now, skincare habits such as moisturizing and protecting the skin from the sun are still the best ways to support the skin’s natural microbial ecosystem. By caring for our skin, we help nurture the invisible bacteria that keep it healthy.

While probiotic skincare is an exciting field, much more research is needed before it becomes a mainstream treatment option. As scientists work to build better bacteria-based therapies, we can expect to see new advancements that offer even more ways to protect and maintain healthy skin.