Winter often elicits skincare frets in patients, but by providing the appropriate advice and products, you can help them understand that their skin can not only successfully withstand the worsening weather but be boosted both in health and appearance. NIHR takes a look at the factors to consider and the importance of restoring balance to the skin’s microbiome.

In winter, cooler temperatures, harsh winds and artificial heating can strip the skin of precious moisture, causing dryness, irritation and discomfort. Extra care is therefore essential to rehydrate, rebuild the skin’s barrier, and ease irritation.

Understanding the Skin Microbiome

Referring to the complex ecosystem of micro-organisms that live on its surface, the skin’s microbiome is crucial to the way the skin looks, feels and functions. With approximately one million bacteria per square centimetre of skin, 500 types of bacteria have been identified. These bacteria play a vital role in keeping the skin happy, healthy, and free from sensitivity and even disease.

Populated by both ‘good’ and ‘bad’ bacteria, these microbial communities communicate with each other and the cells to boost immunity and strengthen the skin’s barrier. For a healthy, youthful-looking skin, a balanced microbiome with sufficient bacterial diversity is essential. When the microbiome is depleted, skin conditions such as sensitivity, acne and atopy arise.

As mentioned, a balanced and diversified microbiome is the foundation of good skin health as in an unbalanced microbiome the skin’s barrier is weakened, resulting in both moisture loss and increased penetration of environmental aggressors and allergens. This can in turn result in increased sensitivity, irritation and dryness, as well as being a precursor to inflammatory skin diseases including psoriasis, eczema and acne.

Many factors can impact the skin microbiome, from skincare and household products and washing habits, to pollution, UV radiation, medications and lifestyle factors, such as diet and stress. Dryness, itching, sensitivity, tightness, redness and breakouts are all signs of a possible unbalanced skin microbiome.

The Microbiome and Acne

Acne can be a concern for teenagers and adults alike, and this common skin condition can affect girls, boys, women and men from puberty and beyond. In acne-prone skin, the skin’s microbiome is unbalanced which can cause ongoing inflammation, which can result in acne recurring, even after seemingly effective treatments. Regardless of age, an effective anti-acne product regimen that incorporates gentle, yet effective ingredients to minimise breakouts can help keep the skin clear and under control.

The key to successfully minimising all types of acne is committing to a skincare regimen that includes proven, dermatologist-recommended ingredients. An effective anti-acne regimen might begin with an acne blemish-fighting cleanser that contains benzoyl peroxide clear acne, and also includes moisturisers for day and night that offer non-comedogenic hydration with moisturising ingredients like hyaluronic acid and skin-soothing ingredients like niacinamide. Ceramides can be another beneficial ingredient to look for when assembling an anti-acne skincare regimen, as research has found that skin with acne has reduced levels of these essential skin-barrier lipids.

The Skin Barrier in Eczema and Dermatitis

There are a variety of eczema triggers, including changes in weather, contact with chemicals and the fabrics we wear. While no skin type is immune, those with an impaired skin barrier and dry, sensitive and atopic skin are particularly vulnerable.

Atopic dermatitis (AD) or atopic eczema is the common inflammatory skin disorder. AD characteristically alternates between periods of exacerbation or flares and periods of remission, which may be therapeutically induced or spontaneous. Current knowledge about AD includes abnormalities of the skin barrier (physical and chemical), the immune barrier, and more recently, the microbial barrier or microbiota. There is growing evidence for a tight relationship between them. To obtain satisfactory control of this condition, the clinical strategy to manage AD involves prescribing both anti-inflammatory medications and dermocosmetic products.

AD and the Experts

An array of studies have been homing in on the factors relating to AD in recent years and the importance of a balanced skin microbiome.    

Notably, published in Cell Host & Microbe, researchers at Johns Hopkins reported the discovery of a key underlying immune mechanism that explains why our patients’ skin becomes inflamed. Toxin-producing bacteria on the surface of our skin induces a protein that causes our own cells to react and cause inflammation.

Offering an insight, Lloyd Miller, MD, PhD, Associate Professor of Dermatology at the Johns Hopkins University School of Medicine, explained, ‘Our skin is covered with bacteria as part of our normal skin microbiome and typically serves as a barrier that protects us from infection and inflammation. However, when that barrier is broken, the increased exposure to certain bacteria really causes problems.’

Illustrating the necessity of action, untreated eczema can lead to other allergic conditions, including asthma, food allergies, seasonal allergies and conjunctivitis – but blocking the skin inflammation has the potential to prevent these unwanted conditions.