APR 2018

MedEsthetics—business education for medical practitioners—provides the latest noninvasive cosmetic procedures, treatment trends, product and equipment reviews, legal issues and medical aesthetics industry news.

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Page 33 of 68

"There is very solid evidence emerging showing that the microbiome on our skin is very infl uential when it comes to the overall health of our skin as well as our risk for skin dis- eases, specifi cally chronic, recurring skin diseases that have infl ammation at their root, such as acne, rosacea, eczema, psoriasis and premature aging," says Whitney Bowe, MD, medical director of Integrative Dermatology, Aesthetics & Wellness at Advanced Dermatology in New York City, clini- cal assistant professor of dermatology at the Icahn School of Medicine and author of The Beauty of Dirty Skin. BENEFICIAL BACTERIA Healthy skin has a diverse array of bacteria. "The microbi- ome on the skin is like a rainforest, and the more brightly colored plants that grow in our rainforest, the healthier our skin," says Dr. Bowe. In patients with chronic skin condi- tions, this diversity is decreased and there is an overgrowth of pathogenic or harmful bacteria. Historically, treatment has been geared toward destroying bad bacteria, but our growing knowledge of the skin microbiome is piquing new interest in probiotic-based care. In recent years, researchers have identifi ed several ben- efi cial strains of bacteria that can help reduce fl are-ups of chronic skin concerns and protect against premature skin aging. For example, Lactobacillus paracasei, which inhibits skin infl ammation, and Streptococcus salivarius, which inhib- its the overgrowth of P. acnes, can help to reduce fl are-ups in patients with acne and rosacea, says Dr. Bowe. In addition, certain bacteria provide relief for skin con- cerns that involve poor skin barrier function. " Probiotics, such as Streptococcus thermophilus, can modify the barrier function by increasing ceramide production," says Mary- Margaret Kober, MD, of Riverchase Dermatology in Na- ples, Florida, and co-author, with Dr. Bowe, of "The effect of probiotics on immune regulation, acne, and photoaging" (International Journal of Women's Dermatology, June 2015). Bacterial strains Streptococcus thermophilus, Staph hominis and Staph epidermidis "all seem to be very benefi cial for patients who struggle with eczema and sensitive skin," says Dr. Bowe. How the microbiome affects skin aging is less studied than how the skin's fl ora impacts disease, but we are learn- ing more. "The photoaging component is growing," says Dr. Kober. "The key characteristic of aging skin is that the skin's pH increases, and this can allow the enzymes that break down collagen to become more reactive. Probiotics can help maintain that optimum skin pH of 5, which suppresses some of those enzymes that break down collagen and elastin and lead to the visible signs of aging." | APRIL 2018 31

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