The Effect of the Microbiome

In dermatology, we're understanding more recently the effect of the microbiome. It's interesting to realize that in every square inch of your body, there are millions and millions of microbes. Dysbiosis is actually what we treat in dermatology. Many diseases, seborrheic dermatitis, for example, dysbiosis, atopic dermatitis, dysbiosis.

In atopic dermatitis though, we have a direct relationship between the presence of Staph aureus on the skin and the flares of atopic dermatitis. The problem is it's very difficult to eliminate Staph aureus from the skin because it is the immune system that controls the organisms that are present on the skin's surface. So for some reason, people with atopic dermatitis have more Staph aureus. So in order to normalize the microbiome and wipe out the Staph aureus, but also some other agents as well, people are turning to ways such as hypochlorous acid sprays to try and get rid of the Staph aureus.

The problem is you have to continue treatment. So we used to advise decreased bathing in atopic dermatitis, but we now know that removing Staph aureus is critically important. This has led to increased insights in prebiotics, probiotics, postbiotics. And so, the treatment of atopic dermatitis may want to expand beyond traditional therapies, just to control the itch-scratch cycle, into ways of normalizing the skin microbiome and dealing with Staph aureus colonization.