Microbiome and Postbiotics in Skin Health

Abstract

The skin microbiome, a diverse and dynamic ecosystem of microorganisms, plays a pivotal role in maintaining skin health by interacting with skin cells, immune components, and structural barriers. It is essential for skin homeostasis, immune defense, and protection against pathogenic colonization. Dysbiosis in the microbiome has been implicated in numerous dermatological conditions, including acne, eczema, psoriasis, and rosacea. Acne, the most prevalent skin condition, affects up to 85% of individuals at some point in their lives, while eczema and psoriasis impose significant public health and economic burdens. The composition of the skin microbiome varies across skin types and anatomical sites, with sebaceous, moist, and dry areas fostering distinct microbial communities. Emerging therapeutic strategies such as microbiome-targeted treatments offer novel avenues for addressing skin diseases. Among these approaches, postbiotics have gained significant attention for their safety and efficacy. Unlike probiotics, postbiotics are non-viable microbial cells or their metabolites, which reduce safety concerns while providing functional benefits such as UV protection and wound healing. This review consolidates current insights into the role of the skin microbiome in health and disease, emphasizing postbiotics as a promising therapeutic strategy by exploring the clinical and commercial potential of microbiome-based treatments, particularly postbiotics, and their ability to redefine dermatological care and improve patient outcomes.

Keywords: acne; dermatology; eczema; postbiotics; psoriasis; skin barrier function; skin diseases; skin health; skin microbiome.

Figure 1

Illustration of skin microbiome balance and immune response regulation. The commensal microbiome, including Staphylococcus epidermidis, supports skin homeostasis and immune balance. An imbalance can lead to a shift towards a pathogenic microbiome, triggering immune responses. LC and CD103+ dendritic cells detect microbial changes and interact with CD8+ T cells, leading to IL-17A secretion. Keratinocytes respond by producing antimicrobial peptides, contributing to pathogen defense. The sebaceous gland and hair follicle microenvironment play key roles in this process. Arrow (→) indicates direction of flow of signals, while block arrow () indicates inhibitory pathway.

Figure 2

Skin microbiome dysbiosis in different dermatological abnormalities. This illustration highlights the association between skin microbiome dysbiosis and various dermatological conditions. Acne occurs due to an increase in the abundance of Cutibacterium acne. Rosacea causes increased levels of Staphylococcus epidermidis, Demodex folliculorum, and Cutibacterium acne. Further, during psoriasis, there is an enrichment of Firmicutes and Streptococcus and a reduction in actinobacteria, Burkholderia, Corynebacterium and Lactobacillus. Vitiligo/hyperpigmentation causes a reduction in the diversity of Cyanobacteriaceae and Flavobacteria. Atopic dermatitis is due to the dysregulation of the microbiome with increased Staphylococcus aureus and decreased Staphylococcus epidermidis. Moreover, the alopecia areata expresses high levels of Corynebacterium and Cutibacterium with a reduction in Staphylococcus caprae. This figure underscores the significance of microbial balance in maintaining skin health and that of its perturbation as a contributing factor to disease pathogenesis.

Figure 3

Production and bioactive properties of postbiotics. This diagram illustrates the process of obtaining bioactive properties from microorganisms through various treatments such as thermal treatment, UV irradiation, EMR radiation, sonication, cell wall lysis, and fermentation. Fermentation leads to the secretion of intracellular metabolites that contribute to postbiotic activity. Bioactive properties include diverse therapeutic effects against acne, rosacea, psoriasis, atopic dermatitis, and vitiligo/hyperpigmentation. It also shows immunomodulatory, UV-protective, and wound healing properties. This highlights the promising therapeutic potential of postbiotics in maintaining health and addressing skin-related issues.