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Yang Yu, MD, a chief resident in the Department of Dermatology, is the lead author of a literature review now posted in the online version of the British Journal of Dermatology.
The review, “Changing our Microbiome: Probiotics in Dermatology,” summarizes that oral and topical probiotics appear to be effective for the treatment of certain inflammatory skin diseases and demonstrate a promising role in wound healing and skin cancer. Yu’s work demonstrates academic excellence and innovation, both part of President Neville Pinto’s platforms for the Next Lives Here initiative.
Below, Yu describes her research pursuits:
Our review presents the basic science and clinical trial data that support the role of the gut and skin microbiome in dermatology. We reviewed the current clinical data on the use of both oral and topical probiotics in the prevention and treatment of several skin diseases, including atopic dermatitis, acne, psoriasis, seborrheic dermatitis, chronic wounds, and skin carcinogenesis.
In general, we found that the available clinical trials yielded positive results with improvement of skin conditions after probiotic intervention. Oral and topical probiotics appear to be effective, especially for the treatment of certain inflammatory skin diseases including atopic dermatitis and acne vulgaris. They also demonstrate a promising role in wound healing and possibly skin cancer.
My fascination with the skin microbiome arises from past research findings on Cutibacterium acnes, the bacteria implicated in acne. We found that not all strains of this bacteria are created equally. More inflammatory phylotypes of Cutibacterium acnes were found in the majority of patients with acne, while other phylotypes that possessed anti-inflammatory capabilities were more highly associated with individuals unaffected by acne.Therefore, these differences in immune system activation caused by different strains may contribute to acne pathogenesis. Thus, the subject of probiotics seemed like a natural extension of my research. By adding “healthy” bacteria in the form of a topical probiotic, one can theoretically replace an acne or disease-inducing microbiome in restoration of a normal, healthy one. These same principles have already been demonstrated in the gut! Why not apply the idea to the skin? Probiotics represent an innovative approach to manipulate the skin microbiome and expand the spectrum of treatment options for dermatologists.
Research on the human microbiome has greatly increased over the past decade with applications extending into many medical specialties. However, its relevance to skin diseases is less well-known in the medical community. Similarly, the use of probiotics to manipulate the microbiome has been recently explored, but despite popularity in the media, little is known about the data supporting their utility and applicability in dermatology. Through this review, we have provided a concise summary of the available evidence, intended to aid in understanding both the basic science and the clinical applicability.
Yes, I will be continuing my research on the microbiome and acne pathogenesis. Next year I hope to begin clinical research on different formulations of a topical probiotic for the treatment of acne vulgaris.
* Spencer Dunaway, MD, (a 2019 College of Medicine graduate) is the second author.