The skin biome was a hot topic at the 23rd World Congress of Dermatology in 2015. Until recently, a key dermatological concept was that the skin is a barrier designed to keep things out rather than interact with the environment.
But recent advances in skin biology reveal that the skin is a dynamic organ, packed with benign organisms that can benefit us—if we let them do their job.
One of the most important ideas that came out of the Human Microbiome Project was that nearly everyone carries 'bad bug' pathogens in the gut. But in healthy individuals, pathogens don't cause disease: they just coexist happily with their host and the rest of the microbiome. It's only when the entire system falls out of balance that those bad bugs begin to act up and cause problems.
This is also true of the skin biome. Wiping out the good bugs that live there—by using 'antibacterial' products, for example—leaves empty spaces for pathogens to proliferate and turn nasty. Antibacterial products disrupt the delicate balance between good and bad bugs, and knock the immune system out of kilter, which increases the risk of allergies, especially in children.1
Both the gut and the skin form part of the immune system. In fact, the immune system is present wherever there's potential for the body to be harmed by coming into contact with the outside world. As the body's largest organ, the skin represents a major site of interaction with microbes in our environment. The skin and gut are two of the primary locations where we need protection, and they are intimately connected.
Your skin biome is partly governed by an evolutionarily ancient branch of the immune system called 'complement'. The clever complement system works like a molecular alarm and first responder, leading the counterattack against 'microbial insult' when bad bugs try to break in.
It also has anti-inflammatory functions, and may be responsible for maintaining a diverse set of microbes on your skin, keeping it healthy.2
It might seem strange to focus on the fact that your skin is teeming with invisible bugs. But do bear in mind that most of these are good bugs—helpful, non-pathogenic commensal bacteria. They perform critical services for us too, but mainly, they block the bad bugs from getting too strong a foothold.
Scientists have found that the bacteria that normally live on our skin actually protect it against infection. Our skin health relies on commensal microbes interacting with our skin's immune cells.3 This means that your immune system, your gut and your skin are inextricably linked, and must all function together to keep your skin in good shape.
When it comes to the condition of your skin, the main idea is to repopulate the bugs inside your gut and those on your skin.
Besides antibiotics, the following can also harm the microbiome.
Sugar feeds bad bugs—like pathogenic Escherichia coli. When your diet is low in fibre and high in sugar, bad bugs go crazy and start stealing iron from your body's own cells. Your body responds by ramping up immune activity, basically starting a microbial war that can result in obesity, diabetes, and inflammation-related disorders like eczema, psoriasis, rosacea and acne.4
A landmark study, published in January 2016, showed that squirrels with lower levels of stress hormones also had more diverse microbiomes. When their stress levels went up, their bug diversity went down as their levels of potentially harmful bacteria increased.
This study was the first of its kind to be conducted in a natural environment, and the first to show that there's a link between stress and microbiome diversity in the wild.
As the researchers concluded, "Bacterial diversity within animals and people is emerging as an essential component of health, and this study provides data that shows the link between low stress and a healthy microbiome."5
According to new research, the antimicrobial and antifungal agent triclosan, which is used in many consumer products, can rapidly disrupt bacterial communities found in the gut.6 Triclosan was first used as a hospital scrub in the 1970s, and is now one of the most common antimicrobial agents in the world. It's an ingredient in shampoos, deodorants, toothpastes, mouthwashes, kitchen utensils, cutting boards, toys, bedding, socks and trash bags. It continues to be used in medical settings, and is easily absorbed through the skin.
Triclosan has been linked to cancer and bone malformations in animals.7 It's in a class of environmental toxicants called 'endocrine-disrupting compounds' (EDCs), which are thought to negatively impact human health by mimicking and affecting hormones. There is also growing concern among the scientific community and consumer groups that EDCs are dangerous to humans at even lower levels than previously thought.8 So, if you have eczema, food allergies, hay fever or asthma, exposure to triclosan may be making it worse.7
A live solution
We usually associate acne with the teenage years, but dermatologists are finding that adult-onset acne is becoming increasingly common, especially in women, in their 20s, 30s, 40s and even 50s, and is on the rise in the UK. A 2015 study of 92 private dermatology clinics found an eyebrow-raising 200 per cent increase in the number of people seeking specialist acne treatment.
Recent research has linked acne to the state of your microbiome. A Polish report from 2015 stated that "An imbalance in the microbial community may cause pathological conditions... of the skin such as . . . acne."9
However, taking probiotics has been found to lower levels of stress-induced hormones in the system, so heading off the conditions that can trigger acne flares. Probiotics may have the additional benefit of helping to reduce anxiety and depression.10
Emerging research also suggests there may be a link between a low-glycaemic diet and an improvement in acne.11
Kefir is a potent drink made by fermenting milk with a living kefir culture, called 'grains', containing multiple strains of beneficial bacteria and yeast. It has long been known that ingesting the live organisms in these probiotics can aid digestion and boost immune-system function. But now, studies are finding that kefir can also improve many skin conditions, such as eczema, acne and a variety of allergic skin conditions by acting on the immune system in the following three ways:
(1) suppressing the production of allergen-specific antibodies to immunoglobulin E (IgE), so blocking the production of histamine, which stimulates allergic responses12
(2) preventing allergy-producing antigens from passing through the intestinal wall,12 and
(3) enhancing the action of protective Treg cells, which prevent the development of autoimmune disorders.13
In recent years, as scientists have learned more about the role of probiotics in the human microbiome, interest in them has soared. But all probiotics are not created equal. Liquid probiotics, which contain bacteria living and thriving in their own medium, thereby increasing in strength and numbers over time, are more powerful than products containing dried or dehydrated probiotics, in which these bacteria die off over time.
So, if you suffer from eczema, psoriasis, rosacea or acne, it's more effective to opt for the exponentially greater strength of a multistrain probiotic like kefir, which contains a vast number of beneficial bacteria and yeasts working together as a symbiotic whole and containing many more strains of good bacteria than a probiotic pill or powder.
And, crucially, the bacteria in kefir are 'non-transient,' which means that many of these strains survive the digestive process to actually reach the large intestine, where they can then achieve long-term benefits. This is different from 'live' yoghurt, which contains 'transient' bacteria that are killed off by stomach acid during digestion.
Kefir can be made from cow's, goat's, oat or almond milk. You can also make water kefir with water kefir grains, but this is much less potent than milk kefir, and you'll need to consume more of it as a daily dose.
If you suffer from a skin condition caused by an autoimmune disorder, such as psoriasis or patchy hair loss, you should choose kefir that's dairy milk-based, as it's been shown that dairy products boost the effectiveness of probiotics.4 What's more, kefir made with goat's rather than cow's milk has been found to be even more beneficial to human health and much less allergenic.14
Live active goat's milk kefir returns all those good bugs to where they need to be inside your body, where they can repair the damage to your microbiome and your health caused over time by antibiotic drugs, sugar, stress and antimicrobial products.15
But goat's milk kefir is—let's say this politely—an acquired taste. It's extremely tart and fizzy. You can sweeten your kefir by blending it with fruit (see recipes, pages 51 and 52), but if you do that, be sure to consume it immediately. Don't let it sit overnight, as the fructose (fruit sugar) will degrade the power of the probiotics.
How can you tell if you or a family member has a damaged microbiome?
• On the skin, microbiome damage can show up as eczema, psoriasis, rosacea or acne1
• In the joints, it can show up as rheumatoid arthritis2
• Within the gut, it can manifest as food allergies3 and irritable bowel syndrome (IBS)4
• In the nervous system, it might show up as chronic fatigue5 or as a nervous system disorder like multiple sclerosis (MS)6
• In the lungs, it can present as asthma7
• In the nose and eyes, it can show up as hay fever or seasonal allergies8
• In the brain's behavioural centre, it can present as anxiety and depression.9
Blueberry Super Smoothie
170 mL (6 fl oz) kefir
Handful of fresh or frozen blueberries
1 Tbsp maca powder
1 Tbsp cold-pressed virgin flaxseed oil
Stevia to taste
Place all ingredients in a blender and blitz until smooth. The malty-tasting maca powder gives this lovely purple superfood drink a real kick.
A recipe for a healthy skin
Drink dairy kefir (preferably goat's milk)
Consider skincare products using natural probiotics
Drink bone broth, which contains copious amounts of collagen, which helps to repair the skin's surface
Cut out refined sugar
Choose low-carb, slow-burning foods
Go for good omega-3 fatty acids
170 mL (6 fl oz) kefir
Half an avocado
1 Tbsp cold-pressed virgin
Stevia to taste
Place all ingredients in a blender and blitz until smooth.
Note: Depending on the type of stevia, start with a pinch and work up gradually, as stevia is considerably sweeter than ordinary sugar.
Excerpted from The Good Skin Solution: Natural Healing for Eczema, Psoriasis, Rosacea and Acne by Shann Nix Jones (Hay House, 2017)