Journal time! This is the final installment of my Science of Aging supplement in my Plastic and Reconstructive Surgery Journal.
This article is talking about the microbiome. Do the bacteria on your skin affect your aging? It would seem to make sense to me, as we are finding out correlations from your gut microbiome to all sorts of medical issues, from Crohn’s disease to heart disease.
This article, “Temporal Variation of the Facial Skin Microbiome: A 2 year Longitudinal Study in Healthy Adults” looks into just this issue. The human skin has a microbiome, which is personalized based on your body site, age, gender, and lifestyle. They looked at the microbiome on 115 patients over a 2 year period. They wanted to see the dynamics of the bacteria, and see how it would affect skin conditions.
What is in your microbiome of your skin? There are bacteria, fungi, and viruses. Prior studies have shown
- the biome stability varies with site of skin: the facial skin is more stable than dryer sites like the forearm.
- There is also variability between people: those with wider biome composition tend to have more change.
- Taking antibiotics or being sick can change your biome
- Sebaceous sites are more stable
- The facial skin microbiome is “remarkably robust and resilient to external stress”
- Acute washing with antibacterial soaps do not seem to modulate the microbiome in the hours post-wash
- inflammatory diseases are associated with altered stability of the biome.
Study:
- 16S RNA sequencing to check cheek adn forehead skin microbiome
- They looked at diversity and composition of the biome over a 2 year period
- 115 patients, men and women
- Skin data: wrinkles, hyperpigment, porphyrins, skin color tone, stratum corneum barrier function, pH, hydration, elasticity
Findings:
They found overall the facial skin microbiome composition and diversity were relatively stable for most patients. There was a subset with substantial changes from one year to the next, associated with changes in the skin barrier function and follicular porphyrins.
- More diversity correlates negatively with pore density, porphyrins, and water loss through the skin
- The more pores, the higher the skin surface area, which causes water loss
- C. acnes causes porphyrin synthesis, which lead to skin inflammation and progression of acne, though they did say visible acne did not always correlate with the C. acnes concentration
- Limitation: mostly Caucasian patients were studied. How do different skin types affect things?
Conclusion?
They state we should study this more.
My thoughts?
Bacteria and the biome is super interesting to me. I believe in skin bacteria having effects on the body. I have patients prep with surgical soap for days ahead of surgery (after reading this study I question, does it help? since the body has more easily disrupted biomes than the face? the fact I have people use the antibacterial wash for days ahead of time make more of a difference?) and I recommend probiotics when on antibiotics to help repopulate the gut with “good” bacteria.
One thing they brought up which I think is critical is that not all bacteria are bad, even C. Acnes. They commented on how C. Acnes may keep drug resistant bacterial like MRSA from getting a foothold.
As with all things in life, as you get older you realize “all” or “none” is frequently not the answer. The world is not black and white, but shades of grey. I think we will likely find this with our biome as well. We want a diverse, balanced biome.
But as I alluded before, we know from the many studies done on gut flora that bacteria can have a real health affect. Crohns, MS, heart disease all have documented studies showing the bacteria in symptomatic patients is remarkably different. There are fecal transplants (yes. you take poop from one person and put it in another) which are done to help with disease. And there are some bacteria which are just bad.
All this needs to be studied. But I do think there is *something* there to discover.