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  • Writer's pictureDr. Nicola Finley (Internist)

The Truth About Acne: Understanding the Skin Microbiome

Acne can be distressing, as it can impact our physical, social and emotional well-being. It is an inflammatory skin condition, with many factors contributing to it. Some of those factors include foods with high sugar content, dairy foods, stress and hormones. Another important factor is the influence of the skin microbiome. The microbiome refers to the environment created by bacteria, viruses and fungi, and these microorganisms live in healthy tissues like the skin.

Here are 3 key points to know about acne and the skin microbiome:
  1. Acne is not only caused by an overgrowth of certain bacteria on the skin, but also by an imbalance of the skin microbiome. The composition of healthy skin microbiome has a rich diversity of microorganisms with a delicate balance of each.

  2. The gut microbiome impacts acne and the skin microbiome. Studies show that people with acne have distinct differences in their gut microbiome when compared to people without acne. A diet of high amounts of saturated fat, sugar and diary causes inflammation and unfavorable change in the gut microbiome. This in turn impacts the skin microbiome. In contrast, a high fiber diet leads to a healthy diverse gut microbiome. Also, the addition of oral probiotics may be beneficial in restoring the gut microbiome.

  3. Long-term use of antibiotics to treat acne affects the skin microbiome. First-line treatment of moderate to severe acne often involves a regimen of oral or topical antibiotics, which can be effective in reducing the active inflammation of the acne by reducing certain bacteria on the skin. However, the downside is that antibiotics can lead to dysbiosis, which is an imbalance in the skin microbiome (as well as the gut microbiome). This skin microbiome imbalance can increase levels of other harmful bacteria and decrease levels of beneficial bacteria on the skin. Also, antibiotics can reduce the healthy diversity of the skin microbiome.

This discussion of the connection of the gut and skin microbiome to acne highlights why the management of acne is more than just addressing what’s occurring on the surface of the skin. A holistic view of acne addresses all potential factors that can contribute to the development of acne.

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