Skin Microbiome and Aging: Connected for the Long Haul?
Key Takeaways
A growing body of research suggests that frailty, and not chronological aging, cam predict microbiome disruption.
Microbiomes of frail older adults contain more pathogens and antibiotic resistance genes on their skin.
Microbiome-targeted treatment strategies may offer future options for managing cutaneous aging and infection risk.
The skin microbiome is not just a passive reflection of age, but in fact may be a key player in how skin ages and its ability to resist decline.
During her presentation on the intersection of microbiomes and skin aging at the 2025 Science of Skin Summit in Austin, TX, Julia Oh, PhD, a professor of dermatology, integrative immunobiology, and molecular genetics and microbiology at Duke University, highlighted a number of studies by her research group and collaborating researchers showing different ways that the skin microbiome is associated with skin aging.
“Aging skin doesn’t just look different—it’s colonized differently,” Dr. Oh said. “We see not only a loss of beneficial commensals but a rise in pathogenic and inflammatory strains that have the potential to accelerate skin dysfunction.”
Dr. Oh talked about a study conducted in collaboration with researchers from the University of Connecticut evaluating shifts in the skin, oral, and gut microbiota between younger adults, community-dwelling older adults, and frail older adults in nursing facilities. Using skin, oral, and stool samples subjected to high-depth DNA sequencing, they found that frail skin showed increased heterogeneity, reduced microbial resilience, and the highest burden of antibiotic resistance genes.
“We were surprised to see such a stark contrast, especially on the skin, compared to gut or oral sites,” she added.
These analyses suggested that frailty, not chronological age, drives destabilization of the skin microbiome. “Microbial instability, hyperdiversity, and colonization by pathogens like Staphylococcus aureus were most pronounced in frail individuals,” she noted. “Chronological age had far less predictive value than clinical frailty scores.”
Another study Dr. Oh highlighted examined skin from younger and older French women and found a direct association between declining collagen quality and microbial disruption.
“As collagen degraded in aging, we saw expansion of acne-associated C. acnes subtypes—the same strains we see in inflammatory skin disease,” she said.
The cumulative evidence from these studies, Dr. Oh maintained, suggests a different way of looking at the skin microbiome and its relationship to the aging of skin.
“The microbiome is not just a biomarker of aging—it’ll be found to be part of the mechanism,” she said. “We're beginning to see that skin aging and immune aging are deeply intertwined with microbial composition.”
Dr. Oh concluded by noting her lab is now exploring microbial engineering approaches with the goal of targeting facets of skin aging, such as restoring commensal dominance, skin barrier, immune function, and colonization resistance to pathogens. “If we can reinforce the skin microbiome, we may be able to slow or even reverse some of the physiologic decline associated with frailty,” she noted.
Source: Oh J. Microbiome and aging. Presented at: Science of Skin Summit. September 5-7, 2025. Austin, TX