SKIN MICROBIOME A B C
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Figure 2: Communication network amongst the protective skin microbiome. 2A: Acne microbiome; 2B: After treatment placebo; 2C: After treatment with 2% EPI
members of the protective microbiome community (Figure 1). All the protective microbes are connected with each other in a food web. Foreign or pathogenic microbes cannot benefit from this food web. For them, the skin and skin microbiota are hostile environments. Furthermore, the members of a skin
microbiome in balance are keeping each other under control. When one of the species starts to grow to a dangerously high level for the community, the other members produce antimicrobial peptides to limit the growth of that species. Finally, the species of a skin microbiome
in balance are not only working together, but they also work together with the skin cells. They provide the skin with necessary vitamins, antioxidants and proteins that warn and support our immune system. This way of working results in beautiful, smooth, and healthy-looking skin.
The skin microbiome out of balance When the members of the protective community stop communicating and stop working together, the skin microbiota goes out of balance. This leads to some alarming consequences: food is not shared anymore, there is certainly no cooperation anymore with the skin cells, and certain species are growing beyond control. Above all, the skin becomes stressed as
it is losing its main alley and protector. Skin disorder is lurking. So a microbiome out of balance is more than just a dangerous increase of a certain species. The increase is
14000 12000 10000 8000 6000 4000 2000 0
Initial Placebo 2% EPI
www.personalcaremagazine.com Figure 3: Amount of communication/cooperation between the micro-organisms
merely the result of a loss of cooperation and communication. The skin has become a dangerous place
for protective skin microbiome members, as pathogens are now setting the rules. Pathogens do not care about the skin or the protective skin microbiome.
The acne classics All publications present C. acnes as the main villain, as the pathogen that infects the skin, and the master brain behind all the suffering of the acne patient. Indeed the C. acnes abundance in healthy skin is around 60%,1 while in acne-prone skin the abundance is around 80%. Together with C. acnes, some accomplices are put on trial. Usually, S. epidermidis, Malassezia and
Streptococcus pyogenes are identified as these usual accomplices. Therefore the classic acne treatment is focused on killing the villain. There are numerous ingredients in the cosmetic and pharmaceutical industry that kill or inhibit C. acnes. Famous examples are salicylic acid, benzoyl peroxide, antibiotics, retinol, plant extracts, and even probiotics. In all honesty, no one is 100% happy with
these treatments as there can be side effects in the long term. Classic treatments dry out the skin or irritate the skin even more. There is also the risk of relapse as the resourceful C. acnes fight back and often find a way to overcome the treatment. Long-term antibiotic treatments even welcome the entrance of an extra pathogen: K. pneumoniae. The masterpieces created by this pathogen are extremely large pustules.
100 80 60 40 20 0
Initial Placebo Figure 4: Skin microbiome composition September 2023 PERSONAL CARE 2% EPI
The hidden truth of acne The classic description is of course correct, but it is only part of the cryptic puzzle. An interesting question would be: why C. acnes becomes suddenly a criminal? All criminals are born innocent and somewhere along the way they get lost. How does it happen that the good C. acnes disconnects from his friends and even starts to destroy his own precious home: the skin?
C. acnes lost his way because of a
catastrophic event that happened quite abruptly on the skin. The peaceful and harmonious skin gets floated with a tsunami of sebum. This sudden excess of sebum is terribly destructive for the microbial balance for two reasons. Firstly, one type of food is suddenly
available in an excess abundance to the skin microbiome. The micro-organisms that directly metabolize sebum are profiting from this new food situation. The sebum lovers such as C. acnes, S. epidermidis and Malassezia are exploding in number. Their need to cooperate with the other members declines. S. epidermidis even prefers to feed mainly on the newly available fast food and ignores the dead skin cells, which they should eat. Consequently, the whole food web collapses and all the former friends of
C.acnes, such as Corynebacteria, Brevibacteria, and Micrococci are starving. There is no longer any form of cooperation or communication. The protective skin microbiome disappears, and the skin is left unprotected. Secondly, the sudden appearance of a
massive blanket of sebum on the skin suffocates
Number connections
Species diversity
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