Aesthetic Medicine
Aesthetic Medicine


Small But mighty

As evolving science helps us better understand its function and impact as well as how we can support it topically, the human microbiome has become such a hot topic that Netflix has done an episode on it as part of their Explained series (Vox Productions). It’s worth a watch.

Although we’ve all been talking about the components of the microbiome for a long time (every time you talk about bacteria management with an acne patient, you’re discussing it), the term itself has burst onto our radar in the last few years. So, what is the microbiome, why is it important, and how can we both protect and support it in medical aesthetics?


Microbiome is the term given to all the microorganisms that live on and inside the human body 1 , including bacteria, viruses and fungi. Most of these microbes are harmless, and some are even beneficial.

We’ve known that the microbiome is vast and important for a long time. It was originally estimated that the average human body contains 10 times as many microorganisms as human cells. However, more recent estimates have lowered that to approximately the same number. 3,4,5 That means we are as much microbiome as we are human beings and highlights the importance of keeping these micropassengers happy, healthy and balanced.

It is estimated that individuals have a total of 30 to 50 trillion bacteria 6 and up to 100 trillion microbes. And while estimates vary, there may be over 1,000 different species of microorganisms. Bacteria live on the skin’s surface and inside the mouth, nose and urogenital tract; however, most live in the large intestine.


The skin is colonised by a diverse collection of microorganisms — including bacteria, fungi and viruses — as well as mites. These microbes vary between individuals and also between skin areas within the same individual.

For example, suppose a patient has acne. In that case, they will have a higher number of the C.acnes bacteria than those who don’t, a patient with rosacea may have up to 10 times the amount of the Demodex mite of those that don’t. If a patient has acne on their back, the amount of C.acnes bacteria will differ in that area compared to other areas of the body.

The microbiome makes up an important part of our skin’s natural barrier


The microbiome makes up an important part of our skin’s natural barrier. Alongside the stratum corneum and the hydrolipid barrier, it protects the skin against harmful pathogens, bacteria and other microbes.

Its main role is to prevent bad bacteria and fungi from causing infections. This is accomplished via immune system regulation, enhancing epidermal barrier integrity, and simulating the production of antimicrobial peptides.

One of the microbiome’s most important functions in doing this is bacterial competition. You can think of good bacteria and bad bacteria in a tug of war, and we need to make sure that the good bacteria is strong, healthy, and a likely contender to triumph over bad bacteria.

Doing so and keeping the skin’s microbiome balanced also increases hydration by reducing TEWL, restores the skin’s pH and regulates sebum production. It can also influence the production of carbohydrates, vitamins, amino acids and lipids, so a balanced microbiome enhances skin radiance and decreases redness, sensitivity, acne and advanced signs of ageing. 7 In addition, recent studies have shown that probiotics could improve atopic dermatitis and wound healing and help skin rejuvenation.

As part of our outermost bio-defence system, the microbiome has to constantly recover from daily stressors such as sunlight, pollution and chemicals in cosmetic products.

A disruption of the skin’s delicate ecosystem may not only influence diseases such as atopic dermatitis (eczema) and acne but also cause advanced skin ageing and a compromised barrier function.

These undesirable attributes can limit in-clinic results, forcing you to administer lighter treatments rather than opting for intensive procedures that will drive patient outcomes. They can also cause stinging when applying active topicals leading to poor compliance and limited outcomes from a medical-grade skincare routine.


With the previous points in mind, protecting the skin’s microbiome is an essential part of keeping it healthy. This involves avoiding very harsh products with a high alcohol content, using skincare formulated without known irritants such as artificial fragrance, dyes and sulphates and using a broadspectrum, physical sunscreen to protect against both UVB and UVA rays.

We’ve already been recommending these steps for years, but now, we can do something to support the microbiome directly -the use of postbiotics.


Probiotics include various strains of helpful bacteria that occur naturally on the skin, the living cells. Prebiotics are carbohydrates that serve as a food source for probiotic bacteria so they can function optimally. Postbiotics refer to the metabolic byproducts of probiotic bacteria that are responsible for their many beneficial effects.

At the moment, the European Union regulations don’t allow for the intentional addition of bacteria to skin care and personal care products. However, recent research presents evidence that most of the positive effects we attributed to probiotics are actually due to postbiotics anyway.

Furthermore, postbiotics may also provide the basis for the proper processing of prebiotics, promoting a healthy probiotic population in yet another manner.


This super hydrating moisturiser, the latest product launch by AlumierMD, is formulated with ProBioBalance CLR™ NP, a postbiotic blend designed to rebalance tired, stressed skin by helping to regulate its natural flora.


1. Centre for Ecogenics and Environmental Health ceeh/downloads/FF_ Microbiome.pdf

2. Grice EA and Segre JA. The skin microbiome. Nat RevMicrobiol 2011 Apr;9(4):24453.

3. Judah L. Rosner for Microbe Magazine, February 2014.Ten Times More Microbial Cells than Body Cells in Humans? microbe/10.1128/microbe.9.47.2

4. Alison Abbott for Nature News. 8 January 2016 Scientists bust myth that our bodies have more bacteria than human cells news/scientists-bustmyth-that-our-bodies-have-more-bacteria-thanhumancells-1.19136

5. Sender R, Fuchs S, Milo R (January 2016). Are We Really Vastly Outnumbered? Revisiting the Ratio of Bacterial to Host Cells in Humans. Cell 2016 Jan;164(3):337–40.

6. American Microbiome Institute blog/2016/1/20/how-many-bacterial-vs-human-cells-are-in-the-body

7. Information from several ingredient suppliers 8. Shi LH, Balakrishnan K et al. Beneficial properties of probiotics. Trop Life Sci Res 2016 Aug;27(2):73-90.


Start by recommending a gentle cleanser and exfoliator. SensiCalm, an oil-based cleanser formulated for post-peel skin, can be mixed with Lotus Scrub, a light ecofriendly physical exfoliator to gently buff away cellular debris.

Next up, triple up on defence. EverActive C&ETM + Peptide delivers potent, fresh and active 15% L-ascorbic acid to neutralise damaging free radicals while Alumience A.G.E fights against pollution with a bio-memetic shield.

Finally, it goes without saying that HydraRich must be topped by a broad-spectrum physical sunblock like Sheer Hydration, the perfect sunscreen for dry to ultra-skin.

HydraRich reflects our commitment to clean science and our dedication to multifunctioning formulas. Created with a complex ingredient list, it delivers multifactorial patient outcomes.

To further support the effects of ProBioBalance CLR™ NP, this luxurious formula is rich in antioxidants to help defend the microbiome. Dipeptide-4 is a glutathione-biomimetic antioxidant peptide that protects the skin against glycation damage and environmental stressors. Camellia sinensis leaf extract, a plant extract, has antioxidant and anti-irritant properties. Furthermore, MATRIXYL®Synthe’6 derived from a peptide naturally found in collagen and laminins strengthens and firms skin, reducing the appearance of fine lines and wrinkles.

HydraRich is also jam-packed with humectants that draw moisture from the atmosphere towards them, hydrating and plumping the skin to support these long-term result drivers. Innovative Low Molecular Weight Hyaluronic Acid (LMWHA), which, unlike conventional HA, has enhanced absorption to replenish the lost HA deep in the skin that occurs during the ageing process. A mixture of high and low molecular weight Poly Glutamic Acid (PGA) increases natural moisturising factors and draws water into the skin. Last but certainly not least, to support dry to ultra-dry skin and deliver ultimate skin comfort, squalane, Inca inchi oil, jojoba oil and shea butter, all-natural emollients, help restore the skin’s lipid balance and deeply nourish dry, tight skin.

Victoria Hiscock is European Communications Manager for AlumierMD and has been educating skincare professionals for almost two decades. Victoria brings a vast spectrum of knowledge and education in aesthetic skincare based on her handson experience as well as her time as a trainer. She has a passion for Cosmetic Science and empowering fellow practitioners to develop their profitability through education.

This article appears in the March 2022 Issue of Aesthetic Medicine

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This article appears in the March 2022 Issue of Aesthetic Medicine