The second annual microbiome conference was held in San Francisco recently. The talks ranged from scientists investigating individual microbial species that call the skin microbiome their home, such as Staphylococcus aureus and Proprionibacterium acnes, to entrepreneurs with biome-based products designed to improve skin health.
All of the talks confirmed what we on the cutting edge of the skin care industry have suspected for quite some time: skin microbiome research will soon provide the game changing knowledge we’ve been searching for when it comes to treating skin. It was only a few years ago that our understanding of the relationship between the health of the gut microbiome to overall health began to increase the number and improve the efficacy of treatment modalities across a wide range of diseases; yet the change in medical practices has already been profound, and not just on the technical side. Philosophically, we have progressed from the “germ theory of disease to the germ theory of health.” 
This was medicine’s leap into the 21st century, and now skin care is not far behind. Advances in our understanding of the skin microbiome will soon allow us to leave behind the world of “skin care” predicated on products whose ingredient selection is based on a combination of guesswork, wishful thinking and a follow-the-leader mentality. Taking its place will be the concept of “skin health,” with one of its primary tenets being that healthy skin is not “germ-free.” It is, in fact, quite the opposite.
Of course, we have a long way to go. But the enthusiasm, persistence, dedication and hard work with occasional flashes of brilliance that characterized the conference speakers inspired a thought that I hope captures the essence of the change coming soon to your local skin care establishment: the beauty of science is about to transform the science of beauty.
Here are some highlights from the conference.
It’s complicated. The more we look, the more we come up against the wonder of seemingly endless complexity and the more we realize how little we know. What we think we know today may end up in the trashbin of yesterday’s established beliefs. That’s the real beauty of science—its only god is skepticism. As for the skin microbiome, what our observations presently tell us is that it is made up of about a trillion different microorganisms of about a thousand different species. But it gets considerably more complicated these days because we now know that identification doesn’t stop at the species level; for treatment methods designed to address acne or atopic dermatitis to achieve success, differentiation must be at the strain level.
Novel acne solution. Some scientists are attempting to resolve skin issues like acne by focusing on specific microbes at the strain level. Proprionibacterium acnes has long identified as the principle culprit in causing acne. Now, scientists have identified over 100 different strains of the little bug and not all of them are troublemakers. In fact, the toxic, acne-causing strains may be few in number and a future treatment modality may consist of repopulating acneic skin with less toxic strains of P. acnes.
Atopic dermatitis treatment approach. It is known that AD sufferers experience an AD bloom or flare when the presence of Staphylococcus aureus is pronounced. A fascinating piece of research targeted a single strain of Staphylococcus hominis, which has the capacity to reduce overcolonization of S. aureus through three modes of action—releasing AMPs (antimicrobial peptides), attenuating production of inflammatory lipoteichoic acid and blocking toxins produced by S. aureus. Microbiome research is telling us over and over that the way to achieve skin health is by following our own microbiome’s example. In a balanced microbiome, the helper microbes have the tools to keep pathogens in check. Skin care’s emphasis in the future will be on balancing the microbiome rather than engaging in wholesale slaughter of innocent lives. 
Aging. Yet another study suggested that microbiome characteristics were predictive of the age of the individual. Which, of course, led me to think that if that’s the case, why don’t we simply repopulate older skins with the microbes found in younger skin? Instead of facelifts we would have microbial transplants, with once a month “facials” consisting of supplying us oldsters with youthful, bouncy microbes. Hmm… Again, it’s complicated, because the ecosystem of the skin is, of course, responsible for the change in the microbial populations. So you don’t want to populate a desert with a whole host of critters who will die in a day for lack of sustenance, poor things. Before introducing helper bugs, we should prepare the skin ecosystem to support them in the style to which they are accustomed. Which brings up the question, which comes first, the ecosystem or the bugs? 
Gut-skin-brain axis. Yes, it’s true what they say: you don’t have healthy skin if your gut is unhealthy or out of balance. In fact, SIBO and leaky gut syndrome create inflammation that may show up as acne in the skin. I suspect the obverse is also true: if you have healthy skin, your gut is probably fine. It did make me think about Korean women and their reputation for beautiful skin. What if it isn’t about all those beauty products they’re using but actually about eating kimchee every day? 
Education. There are so many questions we have yet to answer, with each “answer” generating a thousand more questions. For example, one might infer from the studies that show that psoriasis sufferers exhibit less biodiversity than normal skin that biodiversity plays a role in maintaining healthy skin—except that other studies show that normal skin can be healthy without exhibiting much biodiversity. We don’t really know what microfloral biodiversity means anyway, because while our DNA is 99.9% similar, our microbiomes are only 10% similar, one from another. In short, microbiomes are a vast territory we have just begun to explore.
While we know we have a long way to go before we can make pronouncements about the microbiome, lack of hard and fast rules can get in the way of delivering the message about what we know. We do know that respecting one’s microbiome and maintaining its balance is vastly important to maintaining healthy skin. Education is important to the continuance of microbiome research, for obvious reasons, and also a matter that touches on public health. How we deliver the microbiome message is a crucial piece of the puzzle. 
Education and research
Contrary to conventional wisdom, people really do want to hear about the latest scientific research—at least our customers do. Indeed, they prefer it to claims coming out of nowhere based on very little in the way of real science. We try as much as we can to communicate the current state of cutting-edge research, as well as our own research, especially now that we finally have the tools we need to investigate at ever-deeper levels. It’s very exciting and we know you share our excitement.
The challenge for a manufacturer is to actually make products that fit the new requisites of biome-safety: products that encourage the right kinds of bacteria to thrive on the skin, while discouraging the growth of pathogens. To incorporate the best and brightest of microbiome research into ingredients, and then use them to create products that significantly improve the health of the skin is the greatest challenge. It’s a challenge that we, as a company, are eager to embrace.
We’ve talked a lot about the exciting future of skin health, but for many of our loyal customers it might rather beg the question: where do your existing products fit in to all this futuristic happy talk? The answer is that we intend to continue as we have begun, by developing topical products that use an R&D model based on core principles:
Ingredients must have good and long-standing scientific studies behind them with respect to efficacy and safety.
Functionality of ingredients depends on stability and deliverability.
Ingredients need to work with each other non-competitively; synergy is even better.
It’s not about single ingredients, it’s not even about single products—it’s about integrating all the elements, ingredients and products, into a working whole whose ultimate goal is to improve skin function.
Good skin care, like good research, is a process of learning and discovery. Our customers expect and achieve good results now, but they also understand that they are an integral part of our journey towards the even-better. We don’t do it without you, but then, you can’t do it without us. Thank you for listening, thank you for caring, thank you for being there.
For a more detailed discussion of the microbiome, you may want to read these articles or listen to the Publisher’s Weekly Podcast: A Conversation with Marie Veronique Nadeau. If you’d like to learn more about the microbiota that determine the health and beauty of your skin, or you have an issue with teenage acne, adult acne or rosacea, Marie's book The Acne Answer can be purchased on our website or on Amazon, where Kindle or paperback versions may be purchased.