Understanding Your Skin Microbiome

The surface of your skin is an ecosystem where about 1,000 species of bacteria thrive. Some microorganisms interact with your immune system in the hypodermis or innermost layer of the skin so that your body can produce antibodies, called antimicrobial peptides, against "bad bugs" and infections. Meanwhile, other microorganisms work to keep out the bad microbes directly. Hence, there should be a balance of microorganisms residing in this "community" for your skin to stay healthy.

Microbiome Imbalance Causes Acne 

This balance is influenced by various factors. In the case of acne, your skin produces more sebum as part of the changes your body experiences during adolescence. The skin becomes inflamed in response to this sebum overproduction, causing your skin microbiome to be more prone to acne-causing bacteria. Andrea Szegedi of Hungary's University of Debrecen asserted in her study that acne should, therefore, be seen more as a natural, physiological occurrence rather than an "accidentally occurring disease." 

Szegedi's conclusion that the imbalance in skin bacteria leads to acne agrees with the earlier findings of a team from UCLA's David Geffen School of Medicine. The group led by Dr. Huiying Li discovered that the bacterium Propionibacterium acnes (P. acnes) is found in people with and without acne, but they found out that adults with acne had high levels of genes linked to the toxin-producing bacteria that promoted inflammation. Meanwhile, the skin of acne-free adults contained more genes that helped protect the skin from being colonized by harmful bacteria. Li suggests that treatments focusing on "modulating" skin microbiota are better than using antibiotics that can kill bacteria beneficial to the skin.

Facial Mapping Can Point to Areas of Imbalance

Traditional face mapping is rooted in Eastern medicine that says the condition of your skin can tell how healthy or unhealthy your body's internal organs are. Although it's not a fool-proof method, you can use the principle of examining parts of your face where acne abounds to help you determine what stimulates its appearance. Some products and bad habits contribute to the imbalance of your skin microbiome in those zones.

Forehead

• The condition of the skin on your forehead and between your brows reveals the health of your digestive system, particularly your intestines and bladder, according to traditional facial mapping. However, dermatologists say that this could be more of a reflection of your hair type and the kind of hair care products you use. 

• If you notice plenty of pimples around the rim of your head, go for non-comedogenic shampoo and conditioner that won’t clog your pores instead of oil-based products. Acne growth can also be aggravated by pores that are clogged by sweat and dirt from unwashed hair or greasy chemicals from greasy oils, gels, and other hair styling products. Shampoo that's left unrinsed and residue from makeup are also other culprits. The wearing of hats and caps can also trap bacteria on your forehead.

Cheeks

• Ancient facial mapping says your cheeks give away the condition of your respiratory system. However, dermatologists say that the health of your cheeks can be due to the daily things they come in contact with: smartphones, pillowcases, and bedsheets. Keeping these items clean can help reduce the chances of dirt clogging your pores in this area. You may also have to check if there are irritants in your shaving cream, makeup foundation, or sunscreen. 

Nose 

• The skin on your nose is linked to your heart according to the old face mapping approach. Scientifically, however, the nose has more oil glands than any other part of your face so pimples are more likely to emerge in this area. Regular and proper cleansing will help keep pores on the nose clear. However, skin specialists advise consulting a doctor regarding high blood pressure or liver dysfunction if acne persists on your nose.

Chin and jawline

• More women experience acne in these areas as a result of hormonal changes during their menstrual periods and menopause. Androgens stimulate higher oil production and cause pores to get clogged.

How to Look After Your Skin Microbiome

As the largest organ of your body, your skin serves as the primary line of defense between your body and the outside world. How can you maintain a healthy balance of microbes on your skin? 

Create the right pH environment.

• You can hold the growth of pathogens or disease-producing organisms at bay by ensuring that your skin stays slightly acidic, particularly within the 4.5 to 5.5 pH level. This state also limits the damage made by ultraviolet rays from the sun. Too much soaping, using harsh cleansers, and overusing hand sanitizers and antibiotics can make your skin too alkaline, reduce your microbiome diversity, and increase risks of allergy, bacterial resistance, and further skin issues. Scrubbing and aggressive drying of the skin can create micro-tears that can become breeding ground of pathogens. Gently pat your skin dry instead of rubbing vigorously with a towel. 

Apply nitric oxide-releasing products.

• There’s growing support in the scientific community for the use of creams and gels containing nitric oxide. Studies show that nitric oxide can reverse antimicrobial resistance and prevent P. acnes-induced inflammation. This will be a powerful part of your anti-acne arsenal against acne biofilms or acne bacteria communities that form in "sebum-rich microniches," which include the hollows of your skin glands and hair follicles.

Eat healthy.

• Incorporate or increase the amount of high-fiber food such as green vegetables, fruits, beans, and whole wheat in your diet. Foods rich in fibrous carbohydrates contain prebiotics, which are food for good bacteria. Also, take a lot of probiotics, which contain good live bacteria, such as yogurt, kefir, and fermented food like apple cider vinegar, cultured vegetables, pickles, miso, kimchi, and kombucha. 

Exercise.

• A protein called dermcidin is secreted when you sweat. It's an antimicrobial peptide that works against pathogens and fungus on the skin. At the same time, exercising can open your pores for a time and let the gunk out of your skin. This is why it's advisable for women to work out without make-up. Sweating can also help dead skin come off faster.

Stay hydrated.

• Water consumption replenishes cells, which are also mostly made of water, flushes out toxins, and helps plump up the skin, making your pores shrink. This reduces the clogging of pores with dirt, which is how pimples and acne start.

Wear sunscreen and protect your skin from pollution.

• Apply sunscreen and wear a hat and clothing that will protect your skin from UV exposure if you need to go outdoors. Research shows that UV rays can induce the release of antimicrobial peptides and negatively affect cellular immune response that can lead to skin diseases. A separate study says that pollution particles can settle on the skin and block your pores.

Practice good stress management.

• Neuropeptides, or chemicals released by the skin to protect you from trauma or infection, can cause skin itching and inflammation when you’re stressed. Acne lesions can worsen and other skin conditions can appear when the outer layer of your skin weakens and becomes more sensitive due to stress. That's why it's important to practice breathing exercises, muscle relaxation, and other activities to reduce or manage stress. Find healthier alternatives to the high-sugar, fatty/oily foods you may indulge in during stressful situations. 

General Tips for Controlling Teen Acne

Although acne isn't triggered by dirty skin, cleanliness plays a big part in properly managing teen acne as well as these other steps:

• Don't scratch, pick, or squeeze your pimples. 
• Cleanse—don't scrub—your face twice a day with a gentle cleaning agent and warm water. Don't over-wash and over-dry your skin as dry skin can worsen acne.
• Avoid falling for the latest trendy product promoted online. Allow your acne breakout to calm down—this may take five days to a week—and stick with your basic routine.
• Regularly clean your hair, and keep it away from your face. 
• When shaving your face, alternate between a clean, sharp razor and electric shaver. Then use warm water to soften your beard. Shave as lightly as possible to avoid irritating pimples.
• Clean your eyeglasses regularly.
• Wear only clean headbands and caps. Minimize contact or pressure on your skin from items such as your phones, tight collars or straps, and helmets.
• Look for "non-acnegenic" and "non-comedogenic" (whiteheads and blackheads) makeup and greasy hair products. Never sleep with your makeup on.
• Avoid overexposure to the sun as it may aggravate skin inflammation. 

Keeping a balanced skin microbiome takes a commitment to a healthy lifestyle. Knowing what factors can trigger skin microflora imbalance and the steps you can take to keep your skin microbiome in check will help you manage acne better.