The Skin Microbiome in Atopic Dermatitis and Its Relationship to Emollients

BACKGROUND: Human-associated bacterial communities on the skin, skin microbiome, likely play a central role in development of immunity and protection from pathogens. In atopic patients, the skin bacterial diversity is smaller than in healthy subjects. OBJECTIVE: To review treatment strategies for atopic dermatitis in Canada, taking the skin microbiome concept into account. METHODS: An expert panel of 8 Canadian dermatologists explored the role of skin microbiome in clinical dermatology, specifically looking at atopic dermatitis. RESULTS: The panel reached consensus on the following: (1) In atopic patients, the skin microbiome of lesional atopic skin is different from nonlesional skin in adjacent areas. (2) Worsening atopic dermatitis and smaller bacterial diversity are strongly associated. (3) Application of emollients containing antioxidant and antibacterial components may increase microbiome diversity in atopic skin. CONCLUSION: The skin microbiome may be the next frontier in preventive health and may impact the approach to atopic dermatitis treatment.