Premier Specialty Network Dermatology Articles

Skin Bacteria Do Not Change Much, Despite Regular Washing

New research now shows that despite regular cleaning and contact with microbe-contaminated objects, our personal skin microbiome remains surprisingly stable over time.

Our skin is home to huge numbers of bacteria, fungi, and viruses, and each of us has a unique fingerprint of our particular mix of microbial communities that is defined by its genetic makeup or microbiome.

Writing in the journal Cell, researchers from the National Human Genome Research Institute (NHGRI) and the National Cancer Institute (NCI) – both in Bethesda, MD – suggest their findings should help us better understand how skin diseases develop.

While most of the microbes that live on our skin are friendly and cause no harm, some have been linked to skin disorders, such as acneeczema, and psoriasis.

Studies of the more harmful skin microbes have helped us understand, for example, why eczema tends to affect moist areas such as skin in the bends of the arms and legs, while psoriasis tends to appear on the outside, more exposed parts of elbows and knees.

In previous work, the researchers had already established that microbial communities not only have a strong preference for particular sites, but that each person has a unique genetic fingerprint of the range of microbes on their skin.

Within-person stability greater than between persons

For the new study, the researchers wanted to explore a less well-studied area, and that is how the microbial communities on our skin change over time and whether these fluctuations have a role in health and disease.

They found to their surprise that skin microbial communities remain remarkably stable over time, despite coming into regular and frequent contact with other sources of bacteria, fungi, and viruses, including other people, clothing, surfaces, and bacteria-laden objects.

The researchers analyzed the genetic makeup of microbes in skin samples taken from 12 healthy volunteers at three successive intervals, ranging from 1 month to 2 years apart. The samples came from 17 sites on the body. For the analysis, they used an approach called “metagenomic shotgun sequencing.”

In their paper, senior study authors Dr. Julie Segre, of the NHGRI, and Dr. Heidi Kong, of the NCI, and colleagues note how they found “an individual’s short- and long-term community similarity significantly exceeded similarity between individuals,” and that these findings are similar to “observations in gut and other communities.”

However, they also found that the stability of the microbial communities varied from person to person, and to different extents with different strains.

For example, oily sites – such as on the back and in the tube that runs from the outer ear to the middle ear – showed the least variation over time, as did highly exposed and dry sites, such as the palms.

But on skin areas with a much larger range of different microbes, such as the feet and moist sites, the researchers found the microbial fingerprint was much less stable over time. They suggest this could be because of the influence of personal hygiene or because the sites are exposed to more variable environments.

Because they only studied a small number of healthy adults, the researchers now plan to widen their investigations to include patients with eczema and skin disorders that arise because part of the body’s immune system is missing.

Future studies can use the knowledge of the relative stability of the skin microbial communities in healthy adults to understand how various exposures or disease state may alter these skin microbes.”
Dr. Julie Segre

For example, researchers could study acne patients to find out if specific strains of skin microbes flourish during flare-ups or change when patients take antibiotics.

Tips to Put a Stop to Early Aging

Dermatologists can’t stress it enough: How you treat your skin now will affect its future appearance. While it may seem silly to worry about wrinkles long before you have any, it’s true that preparation pays off.

According to dermatologists, more women in their twenties are asking for anti-aging tips. So, what can you do keep your skin looking young and healthy? Kiehl’s Since 1851, a company that specializes in skin and hair care formulas derived from natural ingredients, offers the following tips:

  • Rest up. There’s a reason “you look tired” and “you look great” aren’t synonymous. But did you know that the position in which you sleep can also affect your looks? If you sleep face-down, fluid can collect beneath your eyes. Try sleeping face-up with your head slightly elevated with pillows. If you do wake up with facial swelling, try tapping the skin beneath your eyes or applying a cold compress.
  • Apply vitamin C. Your skin contains more vitamin C than any other antioxidant, including the much-touted vitamin E. To keep vitamin C at an optimal level, make sure you are applying a skincare formula that contains plenty of vitamin C.
  • Reduce your sodium intake. You can make your doctor and your skin happy at the same time! When you eat too much sodium, you can cause your body to shift fluid into extracellular spaces, especially beneath your eyes. Avoid excess sodium intake to benefit both your health and your skin.

“Vitamin C helps keep skin even and bright, and it offers potent antioxidant protection from environmental stressors, such as pollution and sunlight,” said Dr. Adam Geyer, fellow of the American Academy of Dermatology, Instructor in Clinical Dermatology at Columbia University and Kiehl’s Brand Ambassador.

Two of Kiehl’s products, “Powerful-Strength Line-Reducing Concentrate” to improve tone and texture all over the face and “Line-Reducing Eye-Brightening Concentrate” formulated specifically for the eye area to boost radiance and minimize wrinkles, contain 10.5 percent vitamin C.

Unlike many retinol products, they won’t cause photosensitivity and irritation and are gentle enough for twice-daily use. Apply them after cleansing, both day and night to obtain the greatest results.

SOURCE: Kiehl’s

Arthritis Drug Helps Bald Man Grow Full Head Of Hair

There is no cure or treatment for alopecia universalis, an uncommon autoimmune disease that causes loss of hair over the entire scalp and body.

Now doctors at Yale University in New Haven, CT, report how they successfully restored hair on the head and other parts of the body in a 25-year- old man with the disease that had left him nearly completely hairless all over.

The treatment and the results, written about in the Journal of Investigative Dermatology, say it is the first reported case of a successfully targeted treatment for this rare form of alopecia areata, which occurs when the immune system mistakenly attacks the hair follicles.

After the treatment, which uses an FDA-approved drug for rheumatoid arthritis called tofacitinib citrate, the patient regained a full head of hair, eyebrows and eyelashes, plus facial, armpit, groin and other hair, none of which he had when he first sought medical help.

Senior author Brett A. King, assistant professor of dermatology at Yale University School of Medicine, says the results were exactly what they hoped for, and represent a “huge step forward” in treating patients with the condition. He adds:

While it’s one case, we anticipated the successful treatment of this man based on our current understanding of the disease and the drug. We believe the same results will be duplicated in other patients, and we plan to try.”

As well as alopecia universalis, the patient had also been diagnosed with another condition called plaque psoriasis, which causes scaly red areas to develop on the skin. The only hair he had on his body was in the psoriasis plaques on his head.

His doctor referred him to Yale’s dermatology unit for treatment of the psoriasis – he had never received treatment for alopecia universalis.

Tofacitinib had already been used successfully in humans to treat psoriasis – and in lab mice, it has been shown to reverse a less extreme form of alopecia called alopecia areata. So it made sense, the researchers thought, to see if the drug could tackle the alopecia universalis as well as the psoriasis.

“There are no good options for long-term treatment of alopecia universalis,” Prof. King explains, “The best available science suggested this might work, and it has.”

Hair growth visible after 2 months of treatment

To begin with, the team put the patient on a 5 mg twice daily dose of tofacitinib. After 2 months, his psoriasis began to improve, and he had hair on his scalp and face – for the first time in 7 years.

From then on, the researchers increased the dose to 15 mg a day. After another 3 months, the patient had a full head of hair, and had also grown eyebrows and eyelashes, and hair on his face, in his armpits, and other areas.

After 8 months of treatment, all his hair had regrown, say the researchers, adding that they saw no lab abnormalities and the patient reported feeling no side effects.

Prof. King suggests the drug – which is designed to treat the autoimmune disease rheumatoid arthritis – stops the immune system attacking the hair follicles.

He has already proposed a trial using a cream form of the medicine as a treatment for alopecia areata.

According to the National Organization for Rare Disorders, there are about 2.5 million Americans with alopecia areata, which affects both males and females equally and can surface at any age, but most typically during childhood.

A study found molecular signals that trigger hair growth in mice. Writing in the journal Cell, the researchers described how they found molecular signals from stem cells under the fatty layer of the skin were important for bringing about hair growth.

Another study, reported by Medical News Today in August 2014, revealed how a bone marrow disease drug helped restore hair growth in alopecia areata patients.