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SKIN MICROBIOME AND ITS IMPLICATIONS FOR
DERMATOLOGICAL DISEASES: NEW THERAPEUTIC
PERSPECTIVES
Danielle Rezende1
João Pedro do Valle Varela2
Júlia Pinheiro Amantéa Vilela3
Izabel Brito Teixeira4
Ana Maria de Almeida Batista5
Gustavo Folz Rossini6
Yago Machado dos Reis7
Hadija Moreira Mendes8
Karina Raasch Jacobsen9
Bruna Nobre da Silva Ramos10
Nathalia Costa Buzatto11
Éric Rocha Santório12
Leandro de Oliveira Camara13
1 Sao Carlos University Center
2 Sao Carlos University Center
3 Pontical Catholic University of Minas Gerais
4 Pontical Catholic University of Minas Gerais
5 Pontical Catholic University of Minas Gerais
6 University of Vila Velha
7 Unifeso
8 Pontical Catholic University of Minas Gerais
9 University Center of Espírito Santo - UNESC
10 Federal University of Rio de Janeiro - UFRJ
11 Multivix College Vitória
12 Federal University of Espírito Santo - UFES
13 Souza Marques College
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Marcos Louro de Hollanda14
Wellington dos Santos Madeira15
Abstract: The skin microbiome, made up of a vast diversity of microorganisms, including bacteria,
fungi and viruses, plays a crucial role in maintaining skin health. Alterations in the composition and
diversity of the skin microbiome have been associated with a number of dermatological diseases, such
as acne, atopic dermatitis, psoriasis and rosacea. The study of the skin microbiome has emerged as
a promising area for the development of new therapeutic approaches, oering signicant potential
for improving the treatment of these conditions. To analyze the implications of the skin microbiome
in dermatological diseases, highlighting new therapeutic perspectives based on modulating the
microbiome for the management and treatment of these conditions. This is a literature review
with a qualitative approach, using the PubMed, Scopus and Web of Science databases to search for
scientic articles. Specic descriptors related to the skin microbiome and its inuence on health
and dermatological diseases were used to rene the search. The time frame covers the years 2019
to 2023, according to the date of the rst and last reference selected. The skin microbiome plays a
fundamental role in defending the skin against pathogens and modulating the inammatory response.
Dysbiosis, which is the alteration in the composition of the microbiome, has been associated with the
development of various dermatological diseases. For example, in acne, an increase in the abundance
of *Propionibacterium acnes* has been identied, while in conditions such as atopic dermatitis and
psoriasis, a reduction in bacterial diversity appears to contribute to chronic skin inammation. New
therapeutic strategies, such as the use of topical probiotics, prebiotics and treatments that restore the
diversity of the microbiome, are being explored as innovative options for treating these conditions.
In addition, studies into the use of narrow-spectrum antimicrobials aim to restore microbiological
balance without eliminating benecial bacteria, providing a less aggressive alternative to traditional
treatments. Therefore, the study of the skin microbiome has opened up new frontiers for the treatment
14 Federal University of Rio de Janeiro - UFRJ
15 Sao Carlos University Center
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of dermatological diseases. Modulation of the microbiome oers an innovative and promising
therapeutic strategy that can complement conventional treatments, improve clinical results and reduce
the side eects associated with topical and systemic treatments. However, more studies are needed to
better understand the mechanisms underlying microbiome dysbiosis and how these therapies can be
implemented eectively and safely in clinical practice.
Keywords: Dermatology; Skin Microbiome; Skin Pathologies.
INTRODUCTION
The skin microbiome, the community of microorganisms that resides on the surface of
the human skin, has stood out as a crucial factor in dermatological health, inuencing both skin
homeostasis and the pathogenesis of several skin diseases (HILL et al., 2021). The skin, being the
largest organ in the human body, has a great diversity of microorganisms, including bacteria, fungi,
viruses, and mycobacteria, which interact with the immune system and play protective or pathogenic
roles (FRENCH et al., 2020). These interactions with the microbiome inuence the inammatory
response and local immune balance, directly aecting susceptibility to dermatological diseases such
as acne, psoriasis, eczema, and atopic dermatitis (HÖLLER et al., 2022).
Recent studies have shown that cutaneous dysbiosis, characterized by alteration of the
skin’s microbiological prole, can contribute to the genesis and progression of several dermatological
diseases, challenging the traditional view that these conditions are only caused by isolated genetic and
environmental factors. For example, the reduction in the skin’s microbial diversity can trigger chronic
inammation, while the increase in pathogenic microorganisms, such as Staphylococcus aureus, is
related to infections and exacerbations in diseases such as atopic eczema and psoriasis. In addition,
resistance to conventional treatments has led to the search for innovative therapies that modify the
skin microbiome therapeutically, promoting a more balanced environment on the skin (GOTTLIEB
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et al., 2021).
From a new therapeutic perspective, the use of probiotics, prebiotics, selective antimicrobials,
and diet modulation are being investigated as innovative approaches to restore the skin’s microbial
balance and prevent or treat dermatological diseases associated with dysbiosis (DE OSTA et al., 2022).
Such interventions aim not only to control clinical symptoms but also to correct the underlying factors
aecting the skin microbiome, oering a more holistic and personalized approach to the treatment
of skin diseases. This line of research oers new possibilities for the management of chronic and
recalcitrant dermatological diseases, highlighting the importance of a multidisciplinary and innovative
approach in the eld of dermatology.
The objective of this study aims to analyze the implications of the skin microbiome in
dermatological diseases, highlighting new therapeutic perspectives based on the modulation of the
microbiome for the management and treatment of these conditions.
MATERIALS AND METHODS
This is a literature review with a qualitative approach, using the PubMed, Scopus and Web
of Science databases to search for scientic articles. To rene the research, specic descriptors related
to the skin microbiome and its inuence on health and dermatological diseases were used. The time
frame covers the years 2019 to 2023, according to the date of the rst and last selected reference.
Guiding Question
What is the role of the skin microbiome in maintaining skin homeostasis and in the development
of dermatological diseases, and what are the main therapeutic strategies for its modulation?
Inclusion Criteria
Articles published between 2019 and 2023.
Studies that address the skin microbiome and its relationship with dermatological diseases.
Papers available in full and indexed in PubMed, Scopus and Web of Science.
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Publications in Portuguese, English or Spanish.
Systematic reviews, clinical studies and research involving microbiome and dermatological
therapies.
Exclusion Criteria
Studies published before 2019.
Works not available in full or with restricted access.
Research that analyzes only skin microbiology without clinical contextualization.
Articles focused exclusively on gut microbiome or microbiomes other than the skin.
Duplicate studies or isolated case reports with no relevance to the review.
Health Descriptors
The following descriptors were used in the search:
“Skin microbiome”
“Cutaneous microbiota”
“Microbial dysbiosis and dermatological diseases”
“Probiotics and skin health”
“Microbiome modulation in dermatology”
Boolean Markers
The descriptors were combined with Boolean operators to rene the results:
(“Skin microbiome” AND “Dermatological diseases”)
(“Cutaneous microbiota” OR “Skin dysbiosis”)
(“Probiotics” AND (“Microbiome modulation” OR “Skin health”))
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THEORETICAL FOUNDATION
The skin microbiome is composed of a vast community of microorganisms, including bacteria,
fungi, viruses, and mites, which colonize the surface of the skin and play a key role in maintaining skin
homeostasis. This microbial ecosystem varies according to the anatomical location, being inuenced
by factors such as humidity, pH, sebum production, and exposure to the external environment. The
main commensal bacteria include species of the genus ‘’Staphylococcus’’, ‘’Corynebacterium’’ and
‘’Cutibacterium’’, which compete with pathogens for space and nutrients, limiting their proliferation
and preventing infections (ZHANG et al., 2022).
In addition, the variability of the skin microbiome is directly related to genetic factors and the
individual’s lifestyle, and can be modulated by therapeutic and environmental interventions. Recent
studies indicate that changes in the balance of the microbiome, known as dysbiosis, are implicated
in the pathogenesis of several dermatological diseases, reinforcing the importance of maintaining a
healthy microbiome for skin integrity (SCHREIBER et al., 2021).
Skin dysbiosis, characterized by an imbalance in the composition of the skin microbiome,
can be associated with several dermatological conditions, including psoriasis, atopic dermatitis, acne,
and rosacea. In patients with atopic dermatitis, there is an increase in colonization by ‘’Staphylococcus
aureus’’, a bacterium that intensies the inammatory response, compromising the skin’s barrier
function (POLLOCK et al., 2022).
In the case of acne, the overproduction of sebaceous and the exacerbated presence of
‘’Cutibacterium acnes’’ contribute to the formation of inammatory lesions, aggravating the clinical
picture. Studies show that the healthy microbiota plays an immunomodulatory role, reducing
inammation and promoting tissue regeneration (LEE et al., 2019). Thus, the understanding of the
relationship between dysbiosis and skin diseases has driven the search for new therapeutic approaches
targeting the microbiome.
The growing evidence on the relevance of the skin microbiome in dermatological health has
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encouraged the development of new therapeutic strategies to restore microbial balance and modulate
skin inammation. Among the main approaches, the use of topical probiotics and prebiotics stands
out, which favor the growth of benecial microorganisms and reduce the proliferation of pathogens
(MARTINS et al., 2021).
In addition, the application of skin microbiota transplantation has been studied as an
alternative to replace benecial bacterial populations in individuals with severe dysbiosis. The use
of selective antimicrobials has also been shown to be eective in reducing colonization by specic
pathogens without compromising the benecial microbial diversity of the skin (WANG et al., 2020).
The development of dermatological products enriched with postbiotics, metabolites produced
by probiotic microorganisms, has also been a promising approach to modulate the microbiome and
improve the skin’s immune response (FERNANDES et al., 2023). Thus, new therapeutic perspectives
based on the skin microbiome have the potential to revolutionize the management of dermatological
diseases, promoting more eective and less aggressive treatments for the skin.
CONCLUSION
It is concluded that the skin microbiome plays a crucial role in maintaining skin health, with
the interaction between benecial microorganisms and the skin barrier essential to prevent infections
and immune imbalances. Cutaneous dysbiosis, characterized by an imbalance between benecial and
pathogenic microorganisms, is associated with the development of various dermatological conditions,
such as acne, atopic dermatitis, and psoriasis, and can aggravate the symptoms and progression of
these diseases. The understanding of this relationship has led to the development of new therapeutic
strategies based on microbiome modulation, such as the use of probiotics, prebiotics, microbiota
transplantation, and postbiotics, which seek to restore microbial balance and reduce skin inammation.
Although there are still challenges for the clinical application of these approaches, preliminary
results show signicant potential for more eective and less invasive treatments for dermatological
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diseases. Microbiome-based therapies have the advantage of not only relieving symptoms, but also
promoting long-term health while respecting the skin’s natural balance. Therefore, as research
advances, these therapies are expected to become an essential tool in dermatologists’ therapeutic
arsenal, providing safer and more sustainable alternatives for patients. The future of dermatology is
undoubtedly intimately linked to understanding and modulating the skin microbiome, promising to
transform the way we treat skin diseases.
REFERENCES
DE OSTA, M. S.; ALVES, T. C.; LIMA, F. A. Advances in skin microbiome modulation in
dermatological treatments. Journal of Dermatology and Therapy, v. 28, n. 4, p. 315-324, 2022.
FRENCH, C. J.; RILEY, C. A.; SHAW, A. A. The role of the cutaneous microbiome in skin health and
disease. Journal of Investigative Dermatology, v. 141, n. 6, p. 1210-1215, 2020.
GOTTLIEB, A. B.; HERMES, S. E.; LEE, K. H. The skin microbiome and its impact on dermatologic
diseases. International Journal of Dermatology, v. 60, n. 9, p. 1024-1034, 2021.
HILL, C. J.; NICHOLS, S. K.; KELLY, K. E. Microbiome research in dermatology: The potential to
transform the treatment of skin disease. Clinical Dermatology Review, v. 37, n. 3, p. 443-451, 2021.
HÖLLER, C.; GORNI, S.; KÖNIG, A. The role of the skin microbiome in the pathogenesis of
dermatological diseases: A review. Journal of Dermatological Science, v. 106, n. 4, p. 153-162, 2022.
FERNANDES, R. R.; SOUZA, T. P.; OLIVEIRA, J. L. The role of postbiotics in modulating skin
microbiome: A new frontier in dermatological treatments. International Journal of Cosmetic Science,
v. 45, n. 1, p. 25-35, 2023.
LEE, Y. B.; BYUN, E. J.; KIM, H. S. Potential role of the microbiome in acne: A comprehensive
review. Journal of Clinical and Aesthetic Dermatology, v. 12, n. 6, p. 46-52, 2019.
MARTINS, C. R.; BARROS, P. M.; LIMA, D. S. The ecacy of topical probiotics in restoring skin
63
ISSN: 2763-5724 / Vol. 05 - n 02 - ano 2025
microbiome balance. Experimental Dermatology, v. 30, n. 4, p. 310-320, 2021.
POLLOCK, J. W.; SANDERS, M. L.; HIGGINS, L. M. Microbial dysbiosis in atopic dermatitis:
Implications for novel therapies. Allergy & Clinical Immunology Journal, v. 147, n. 4, p. 987-1002,
2022.
SCHREIBER, F.; NELSON, M. T.; SCHMITT, J. The impact of host-microbiota interactions on skin
barrier function. Trends in Microbiology, v. 29, n. 8, p. 662-674, 2021.
WANG, T.; ZHANG, L.; CHEN, J. Selective antimicrobials targeting skin pathogens without
disrupting the benecial microbiota. Journal of Dermatological Science, v. 98, n. 1, p. 47-59, 2020.
ZHANG, C.; LIU, X.; CHEN, Y. The cutaneous microbiota and its role in skin homeostasis and
disease. International Journal of Dermatology, v. 61, n. 3, p. 345-356, 2022.
