Part III. Microbiome and Maintaining Skin Health: Prebiotics and Probiotics

By Theophila Lee & Susan Yoomin Im

This is the third in a three-part series on the microbiome. See Part One for a discussion on the microbiome in general and Part Two for a discussion on the microbiome and mental health. 

Skin microbiome diversity 

Your skin, the largest organ in your body, is also characterized by its own diverse microbiome community. It is an epidermal lawyer that primarily functions as barrier to protect your body against impacts and pressure, temperature variations, harmful microorganisms, and damaging radiation and chemicals. Researchers estimate that there for every one square centimeter of skin, there are multiple trillions of bacteria, viruses, parasites, fungi, and yeast present

The skin microbiome is very site-specific. Think about the different textures of various places around your skin: above your cheeks, under your armpit, in the crease of your leg. Each of these sites have different properties: your face and scalp are oilier, your arms and legs are drier, and your feet and armpits are moister. As you might expect, because of these differing compositions, different sites on your skin have different microbiome community compositions.  This has implications on disease, as skin ailments generally occur in site- specific manners: acne on the face, foot fungus on feet, eczema in arm and leg creases, etc. 

Furthermore, your skin’s microbiome is also constantly changing. It can be affected by many factors such as: environmental factors such as UV exposure and pollution; hormonal changes like those that occur during puberty; workplace humidity or dryness levels; and even skin-on-skin contact between mothers and infants or between partners (yes, your significant other can influence your skin health!) 

Skin microbiome and disease 

Already, researchers are learning more about the link between microbiome imbalance and skin health disruption in a variety of conditions including: early skin aging, heightened skin sensitivity, atopic dermatitis, rosacea, eczema, redness, psoriasis, and dryness. For example, a recent Johns Hopkins study showed an increased abundance of a specific facial bacteria strain among rosacea patients as compared to healthy controls. These identified bacteria may prove useful in looking for new therapeutic targets for rosacea.  In another recent study studying mice with eczema, researchers identified an abundance of a specific “bad” bacterial strain known to release toxins and break down skin barriers and a dearth of “good” bacterial strains that fight off these toxins. When researchers applied “good” bacteria to the mice’s skin, it prevented flareups. Thus, more research into microbiome diversity can help us to better overall understand its potential to treat various skin ailments.

Skin microbiome and skincare 

Scientists and dermatologists are investigating whether certain topicals incorporating healthy microorganisms on skin can help create a stronger, healthier, and more diverse skin microbiome.  Too often we see harsh facial cleansers and soaps, full of sulfates, parabens, and antibacterial ingredients, stripping our skin of healthy microbial strains and damaging our natural microbiome ecosystem. Just as eating foods rich in prebiotics and probiotics can enhance the diversity of your gut’s microbiome, so too can prebiotics and probiotics help to enrich your skin’s microbiome. 

Think of prebiotics as the water and fertilizer that help your microbial garden flourish. They allow probiotics to thrive and feed “good” bacteria. In skincare, prebiotics are typically found in fiber-rich, vegetable- derived, or pectin-derived ingredients, including: prebiotic thermal water (La Roche- Posey Double Repair Face Moisturizer), colloidal oatmeal (Aveeno Eczema Therapy), algae (Alive Prebiotic Balancing Mask), and beta-glucan (ATEM Super Age Defense Facial Cream). However, while they are beneficial, prebiotics need to work in concert with probiotics to achieve full benefit to your microbiome (and vice versa) 

Probiotics, on the other hand, are the seeds that help your microbial garden grow. Probiotics are live, helpful bacteria naturally created in the process of making fermented foods. “Probiotics in skincare optimize the healing benefits of our skin’s good bugs,” explains Dr. Whitney Bowe, NYC-based dermatologist and author of The Beauty of Dirty Skin. “This includes acting as a protective shield against bad bacteria, dialing down inflammation, and preventing premature aging in skin, among other things⁴.” Like probiotics in our gut, probiotics in the skin promote growth of good bacteria and eliminate bad bacteria.

When fermentation occurs, yeast produces a plethora of helpful enzymes such as amino acids, vitamins, antioxidants, and anti-inflammatories that are beneficial to skin. This leads to super-charged ingredients that have higher potency in creating gentler, more nourishing ingredients can break down particles in a more calming and non-irritating manner. Probiotic ingredients in skincare include fermented damask rose (SU:M37 Rose Cleansing Stick… fun fact, the 37 refers to the optimal temperature for fermentation), fermented milk (ATEM First Milk Facial Treatment Mask), and galactomyces ferment filtrate (SKII Facial Treatment Essence). Note that the probiotics need to be live in order to help rebalance the microbiome. Probiotic skincare ingredient that say ferments (i.e., lactobillucs ferment) or lysates (i.e. bifidia bacteria lysate) at the end might hydrate the skin but will not re-cultivate the microbiome. 

Try mixing up your skincare routine with some prebiotic and probiotic cleansers. Let us know in the comments below if it lives up to the hype!


  1. “What Is the Skin Microbiome?” YouTube, Jackson Laboratory, 2017,
  2. Rainer, Brian. “Skin Microbiota in Rosacea Differs from Healthy Skin.” Healio Dermatology, 19 Sept. 2019,
  3. Reynertson, Kurt. “Anti-inflammatory activities of colloidal oatmeal (Avena sativa) contribute to the effectiveness of oats in treatment of itch associated with dry, irritated skin.” J Drugs Dermatol, January 2015,
  4. Yirka, Bob. “Study Shows Skin Microbiome Imbalance Likely behind Eczema Flareups.” Medical Xpress – Medical Research Advances and Health News, Medical Xpress, 2 May 2019,
  5. Nazish, Noma. “Why Probiotic Skin Care Is Worth The Hype, According To Experts.” Forbes, Forbes Magazine, 1 Apr. 2019,

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