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Skin Microbiome

The skin is the body’s largest organ and it is teeming with trillions of microorganisms, such as bacteria, viruses and fungi, all invisible to the naked eye.

Tagged: Dermatology

Date: 21st April 2022

Medically Reviewed by:  Dr. Susan Mayou (GMC: 2405092)

Last reviewed: 10th January 2024

Skin Microbiome

The skin is the body’s largest organ and it is teeming with trillions of microorganisms, such as bacteria, viruses and fungi, all invisible to the naked eye.

Although this may sound rather unappealing, this ‘skin flora’ is in fact vital to keeping our skin and bodies healthy. 

There are 1,000 different bacterial species and up to 80 different fungi species living within the various layers of skin and all play their part in keeping us in good overall health.

The skin microbiome fights infection, heals wounds and helps our natural immune system to function. Some microbes ward off infection by acting as a natural antibiotic while others alert the immune system to the presence of harmful viruses or bacteria. The skin microbiome can even send signals to activate or de-activate your immune system, enabling your body to heal and control harmful inflammation. It protects against harmful pathogens and keeps the skin acidic, which also keeps germs at bay.

The makeup of the skin microbiome on your body varies according to location, for example, some of these microorganisms may favour dry or oily parts of the body. Other body parts may have a more diverse collection of microorganisms. For example there are multiple different types of fungi that can be found between the toes compared to the palms of the hands. However the palms harbour a higher number of different types of bacteria. Studies show that the most diverse range of microorganisms is found on the forearms, with the fewest located behind the ears.

Although the body’s core microbiota stablises from around the age of three-years-old, there are certain things that can change or disrupt the balance of your skin microbiome. For example, the arrival of puberty triggers the production of sebum, a natural oil found on the skin. Certain bacteria found in the skin microbiome are drawn to this oil, which results in the appearance of teenage acne. The skin microbiome is strong, yet delicate, so it is easy to upset the balance.

Environmental and lifestyle factors can also have an impact on the balance of the skin microbiome. These may include diet, smoking, a sedentary lifestyle, sun exposure and air pollution.

An imbalance of the skin microbiome may also occur for no obvious reason, and this is known as dysbiosis. Extensive research has linked dysbiosis to atopic dermatitis, also known as eczema, and there is also evidence to suggest dysbiosis may be linked to psoriasis, acne and vitiligo. Research is also being carried out on a number of other conditions, including albinism, dandruff, toenail infections, warts and verrucas, to find out how they are affected by skin microbiome imbalance. 

Although we have good knowledge about the role and function of the skin microbiome, there is still more to learn. Research into skin microbiomes is still being carried out, so it’s still unclear how much you can do to actually change your skin microbiome. However, there are a few simple things that you can do to help support your natural skin microbiome as well as support skin health generally.

Using a moisturiser free of harsh ingredients can help give your skin barrier a natural boost and is particularly good for people with skin conditions such as eczema. However you should avoid using too many skincare products as these may affect the delicate balance of your skin microbiome.

Frequent use of antibacterial soaps and hand sanitiser can strip the skin of good bacteria, upsetting the balance of your microbiome. It is important to moisturise after using sanitiser. Other alkaline products, such as household cleaning products, can also have a negative impact on the skin microflora and lead to skin issues.

As if there were not enough good reasons to break the habit, smoking also causes inflammation which causes an imbalance in the skin microbiome.

There is evidence that links gut microbes to the microorganisms which live on the skin. Plant-based foods contain prebiotics which help to give a natural boost to the good bacteria inside and out. Taking high-quality probiotic supplements, which contain live good bacteria, can also help. It’s also important to identify and remove any food which may trigger a reaction, such as dairy or gluten.

If you are eating a healthy, balanced diet, then the sweat you produce during a workout is likely a fortifying prebiotic for the skin microbiome. 

Working out several times a week is great for overall skin health as it increases blood flow to the skin, providing oxygen and vital nutrients.

It may be worth taking your work out outdoors as research has indicated that exposing yourself to green landscapes improves the diversity of microflora. The good microbes found in nature transfer to the skin and nasal biomes through touch and breathing. However, just like other areas of the skin microbiome, further research is needed into the benefits of this.

Certain health conditions, if left untreated or not managed correctly, can cause skin problems to emerge. This includes inflammatory bowel diseases and diabetes, so it is important that you manage medical conditions appropriately to keep your skin microbiome balanced and healthy.


The good news is that if your skin microbiome is not as it should be, even after making key lifestyle changes, there are treatments available that can help to readdress the balance. These might include topical creams or gels or oral medications to address skin problems. For example, an oral and topical antibiotic may be prescribed in cases of severe acne. The treatment will vary from person to person and depends on how the skin microbiome imbalance presents. One of our expert dermatologists will be able to diagnose any skin conditions resulting from an imbalance skin microbiome and treat them accordingly. 

Book an appointment with the dermatologist here at the Cadogan Clinic to see how we can help you achieve good skin health.



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