Christine Esposito, Managing Editor11.05.20
R&D teams and dermatologists alike continue to explore what’s happening on the surface of the skin, including the ingredients and formulations that impact the microbiome. And while the literature builds on the microbiome, we’ve only scratched the surface; there’s much work to be done in the pursuit of healthy skin, say stakeholders in skin care formulation and treatment, especially when it comes to skin maladies that plague consumers.
“We are learning about the skin microbiome at an incredible rate, and increasingly we understand that it plays a critical role in both the development of atopic dermatitis/eczema and even in triggering day to day flare ups. Importantly, it has been shown that an abnormal microbiome is present in almost all patients with eczema, and in particular, the bacteria Staphylococcus aureus (staph) tends to be much more common,” said Dermatologist Dr. Peter Lio, who serves on the board of directors of the National Eczema Association.
Lio pointed to a paper by Heidi Kong and colleagues that demonstrated that at the start of an eczema flare, the bacterial diversity on the skin goes down while staph increasingly dominates.
“In fact, these changes precede the flare up, and importantly, they reverse before the flare begins to calm. In that groundbreaking paper and one she published just a few years later, they were able to state that staph actually drives the disease, at least in some cases,” he said.
According to Lio, although there is often widespread inflammation and skin barrier damage in eczema, topical products remain extremely important in treating eczema.
“Moisturizers in particular have the ability to strengthen the skin barrier and improve its health. For some, this is enough to help restore the microbiome to a better state. Even topical corticosteroids, when used carefully and strategically, can actually help restore the microbiome, paradoxically reducing staph bacteria loads,” he told Happi in an interview during Eczema Awareness Month (October).
Lio said there are a number of new antibacterial and antiseptic treatments that may also play a role. For instance, stabilized hypochlorous acid gels may have an effect on the microbiome, and even show some effect on the biofilms produced by some bacteria that make them very stubborn, he said.
“Topical probiotics and post-biotics (referring to live bacteria and killed bacteria or bacteria parts, respectively) also may play a role, though I’d say we’re still in the experimental phase with most of these products. Finally, a topical endolysin enzyme that selectively breaks down staph but leaves other bacteria intact has potential to play a role in this condition as well,” Lio noted.
Brand Level Development
According to dermatologists, today’s lifestyles can lead to issues with the skin barrier, and naturally, the microbiome.
“We know that the microbiome is part of our skin barrier, and it has been shown that many lifestyle choices can damage the barrier: not sleeping enough, using harsh products, scratching and rubbing at the skin: all of these can damage the microbiome. Some things are harder to avoid than others, including pollution in the environment, modern bathing practices, and many products that contain preservatives which may damage the healthy bacteria in the body. If this sounds a little overwhelming, it is! We’re trying to figure out where best to focus our resources in helping keep the microbiome robust and healthy, and how to optimize healing when things go awry,” Lio told Happi.
Keeping the microbiome healthy is critical to healthy skin.
“Having a healthy skin flora/microbiome is so important because it’s our first defense against injury or unwanted pathogens. Skin can be left vulnerable if the microbiome is damaged, which can happen in many ways, including the use of harsh soaps, cleansers, exfoliants and other skin care products with ingredients that strip the skin of its protective acidic state, incorrect use of antibiotics, environmental stressors, poor diet and stress, to name a few,” said Julie Clark, founder and CEO of Province Apothecary, Toronto.
Clark told Happi that Province Apothecary’s approach has always been to work with the natural functions of the skin and body, not against them.
“This means supporting what the skin (and body) know how to do naturally in order to find health and balance, by using gentle but effective techniques with the use of nourishing, organic, clean and green ingredients in all of our products. We are always looking to bring in new, healthy ingredient technology that supports a healthy microbiome and doesn’t try to manipulate it.”
For eczema, Clark said Province Apothecary’s first line of defense is its hero product, Healing Eczema Balm, the brand’s first launch eight years ago. She pointed to the formulation’s soothing, repairing and anti-inflammatory properties that topically treat all types of skin conditions, including eczema, rosacea and inflamed acne.
Gladskin, a European eczema care brand and newcomer to the US marketplace, has been well-received since its debut in Q1 this year, according to Skyler Stein, president of GladSkin USA.
“We’re happy to be a DTC brand, especially in light of the challenges to brick and mortar retail this year,” said Stein. “Our customers are re-ordering at a great rate, really the best ‘review’ you can get.”
The endolysin in Gladskin, named Micreobalance, is a smart protein which was developed more than 10 years ago in collaboration with ETH Zurich. Over five years of research went into developing Gladskin Eczema Cream which ensures the stability of the smart protein, while providing needed moisturization, in a formula much more pleasant to use than most eczema remedies, according to Stein.
“In addition, most newer products with microbiome claims are prebiotic or probiotic. There is a great deal of noise around the skin microbiome these days, but only Gladskin works to directly balance the good and the bad bacteria that make up a normal skin microbiome,” said Stein.
“There is a real need to educate consumers about the skin microbiome, especially making consumers aware of dangerous ingredients, like antibiotics and steroids. Similarly, there is a great need for products to compensate for the increase in handwashing during the pandemic. This is critical for those who are eczema prone or who suffer from chronic skin conditions,” he said.
Other industry stakeholders pointed to the need to educate consumers.
“It can certainly be easy to forget about the skin microbiome, since the microorganisms that live within its ecosystem are way too small to see with the naked eye. However, consumers should definitely care about these tiny microbes because they are so important for the overall health of your skin,” said Laura Marinelli, PhD, microbiologist and scientific advisor at Ellis Day Skin Science. “The skin microbiome does everything from helping to maintain the barrier function of your skin to promoting immune function and protecting you from infection caused by pathogenic bacteria and viruses. What’s more, when your skin microbiome becomes imbalanced, it can lead to an array of different skin problems, such as breakouts, sensitivity and inflammation, as well as more serious conditions like psoriasis and eczema.”
Ellis Day Skin Science’s Wild Resilience Active Phage Serum is said to reset the skin microbiome, support the reduction of blemishes, hormonal breakouts, redness and inflammation that lead to aging, and make skin healthier and more resilient. It features an active ingredient called Cutiphage, described as a proprietary blend of active bacteriophages (phages) that kill the blemish-causing strains of Cutibacterium acnes (C. acnes) bacteria on skin.
“Unlike other skin care actives, phages are biological in nature; they are ubiquitous and even live on your skin already. In fact, some studies have shown that people with healthy skin have an increased abundance of phages, which keep C. acnes bacteria in check,” said Marinelli.
Phages, she said, infect and kill only their target bacteria, which sets them apart from other ingredients.
“This means that unlike antibiotics or OTC ingredients like benzoyl peroxide that kill a wide array of bacteria, the Cutiphage in Wild Resilience only kills a specific type of bacteria, so it won’t disrupt the health of your overall skin microbiome. And unlike products labeled as ‘probiotics,’ which often contain either bacterial byproducts or types of bacteria not native to skin, C. acnes phages are naturally found on healthy skin as mentioned above, so they are able to stay on the skin and work their magic,” Marinelli said.
According to Marinelli, industry has already learned much about the richness and diversity of the skin microbiome during the past decade. And as techniques for analyzing the skin microbiome become more robust and advanced, Marinelli predicts more studies that assess how the skin microbiome in a particular individual varies with time and under different conditions, such as seasonal and hormonal changes and stress.
Banking On It
Last month, a new player entered the skin care space—Symbiome, which founders say is the first science-based skin care brand to create a collection of “BioIntact” products that nourish the skin microbiome. The company recently closed a $15 million financing round led by True Ventures that included Bold Capital Partners, Mission Bay Capital and Gisev Family Office.
“Currently the clean skin care marketplace is filled with brands that are defined by what is not included—the infamous ‘dirty list,’” said Symbiome CEO Vicki Levine. “In comparison, Symbiome uses rigorous scientific research to understand what our skin has lost in the modern world in order to be intentional about our formulations. Our deep understanding of the skin microbiome—and what it has lost in the modern world—has allowed us to formulate a collection that only puts back the essential nutrients our skin needs to thrive.”
Symbiome is big on using a short ingredient list that it insists packs a punch.
“Our proprietary cold-emulsion process allows us to create supercharged BioIntact creams with as few as three ingredients, preserves the potency and rich biological integrity of these natural ingredients, while optimizing the benefits to the skin. Completely eliminating heat, this process has a lower carbon footprint and is more sustainable than traditional processes,” noted Founder and Chief Scientific Officer Larry Weiss, who formulated botanical disinfectants at CleanWell as well as probiotic skin care products for Mother Dirt.
Symbiome’s Postbiomic Fermentation of natural ingredients from the Amazon rainforest utilizes a proprietary blend of ancestral, native microbes to unlock and optimize the bioavailability of valuable nutrients and enzymes, noted Weiss.
“Not only does this process break down these components so that they are more readily absorbed by the skin, it requires lower temperatures, therefore preventing degradation and reducing energy costs. The result: optimal bioavailability and shelf stability, with minimal impact on the planet,” he said.
Symbiome’s range features four facial oils, including Rebalance 001, which contains fermented coffea arabica (green coffee) seed oil and fermented mauritia flexuosa (buriti) fruit oil. Symbiome’s The One restorative cream also contains just three ingredients, including lactobacillus ferment, which is rich in terpenes that help regulate the skin microbiome and soothe sensitive skin. The lengthiest ingredient list can be found the daily cleanser, which contains oenocarpus bataua (seje) fruit oil, isoamyl laurate, glycerin, water, croton cajucara (sanoma) leaf oil, turnera ulmifolia (xanana) flower and leaf oil and sucrose laurate.
“Our scientific research allows us to only put back the nutrients our skin microbiome needs to be healthy. We avoid unnecessary ingredients that may increase the chemical burden to the skin, disrupt the skin microbiome and cause irritation or sensitivity. By creating BioIntact products that support healthy, resilient skin, there is simply no reason to add anything else,” concluded Weiss.
Proof of Purchase
The beauty industry is rife with labels, certifications and standards—and there’s one that addresses the microbiome, too.
Codex Beauty’s Bia range recently achieved microbiome-friendly certification according to MyMicrobiome Standard 18.10. The certification is described as the first seal of quality that awards microbiome-friendly cosmetics and personal care products.
MyMicrobiome Standard 18.10 is one of six standards developed in 2018 by MyMicrobiome AG, Liechtenstein, under the scientific guidance of microbiologist Kristin Neumann PhD.
MyMicrobiome standards grew from Neumann’s personal interest in the microbiome and her realization that many brands had their own claims regarding how their products might be beneficial for the skin microbiome.
“I was actually surprised that this kind of standard [did not exist],” Neumann told Happi.
“Buyers want microbiome-friendly products and not pure marketing products,” she insisted.
Digging Deeper
Scientists are digging deeper and conducting more research on the microbiome.
In June, Johnson & Johnson Consumer Health presented findings from the longest longitudinal study of infant and mother skin microbiome research at the American Academy of Dermatology Virtual Meeting Experience (VMX) 2020. The study, along with new research shared on the first longer-term clinical assessment of cleanser types on skin microbiome, offers important insights for the care of newborn skin through childhood, as well as for the selection and development of skin cleansers and moisturizers.
In September, new developments related to the skin microbiome came out of National Institutes of Health (NIH).
An experimental treatment for eczema that aims to modify the skin microbiome reduced disease severity and increased quality of life for children as young as three years of age, according to a NIH study. The improvements persisted for up to eight months after treatment stopped, according to the September 9 edition of Science Translational Medicine. The experimental therapy contains strains of live Roseomonas mucosa—a bacterium naturally present on the skin—originally isolated from healthy volunteers and grown under carefully controlled laboratory conditions. For four months, clinical trial participants or their caregivers periodically applied this probiotic therapy to areas of skin affected by eczema.
“These early-stage findings suggest that R. mucosa therapy may help relieve some children of both the burden of eczema symptoms and the need for daily treatment,” noted Anthony S. Fauci, MD, director of NIH’s National Institute of Allergy and Infectious Diseases, which led the study—yes, that Dr. Fauci!
NIH has exclusively licensed the R. mucosa therapy to Forte Biosciences to advance the potential treatment through further clinical development.
Also in September, Dutch biotech company Micreos Human Health, parent to Gladskin, started to enroll patients in a Phase I/IIa study to assess the safety and efficacy of XZ.700 in those with mild to moderate atopic dermatitis, marking the world’s first evaluation of a pharmaceutical endolysin for topical use in humans. Endolysins are highly specific enzymes that cut the bacterial cell wall, rapidly killing only the target bacteria, regardless of antibiotic resistance, while preserving the skin microbiome. XZ.700 specifically targets Staphylococcus aureus.
More research will help the beauty business move beyond marketing hype when addressing the health of the microbiome.
“We are learning about the skin microbiome at an incredible rate, and increasingly we understand that it plays a critical role in both the development of atopic dermatitis/eczema and even in triggering day to day flare ups. Importantly, it has been shown that an abnormal microbiome is present in almost all patients with eczema, and in particular, the bacteria Staphylococcus aureus (staph) tends to be much more common,” said Dermatologist Dr. Peter Lio, who serves on the board of directors of the National Eczema Association.
Lio pointed to a paper by Heidi Kong and colleagues that demonstrated that at the start of an eczema flare, the bacterial diversity on the skin goes down while staph increasingly dominates.
“In fact, these changes precede the flare up, and importantly, they reverse before the flare begins to calm. In that groundbreaking paper and one she published just a few years later, they were able to state that staph actually drives the disease, at least in some cases,” he said.
According to Lio, although there is often widespread inflammation and skin barrier damage in eczema, topical products remain extremely important in treating eczema.
“Moisturizers in particular have the ability to strengthen the skin barrier and improve its health. For some, this is enough to help restore the microbiome to a better state. Even topical corticosteroids, when used carefully and strategically, can actually help restore the microbiome, paradoxically reducing staph bacteria loads,” he told Happi in an interview during Eczema Awareness Month (October).
Lio said there are a number of new antibacterial and antiseptic treatments that may also play a role. For instance, stabilized hypochlorous acid gels may have an effect on the microbiome, and even show some effect on the biofilms produced by some bacteria that make them very stubborn, he said.
“Topical probiotics and post-biotics (referring to live bacteria and killed bacteria or bacteria parts, respectively) also may play a role, though I’d say we’re still in the experimental phase with most of these products. Finally, a topical endolysin enzyme that selectively breaks down staph but leaves other bacteria intact has potential to play a role in this condition as well,” Lio noted.
Brand Level Development
According to dermatologists, today’s lifestyles can lead to issues with the skin barrier, and naturally, the microbiome.
“We know that the microbiome is part of our skin barrier, and it has been shown that many lifestyle choices can damage the barrier: not sleeping enough, using harsh products, scratching and rubbing at the skin: all of these can damage the microbiome. Some things are harder to avoid than others, including pollution in the environment, modern bathing practices, and many products that contain preservatives which may damage the healthy bacteria in the body. If this sounds a little overwhelming, it is! We’re trying to figure out where best to focus our resources in helping keep the microbiome robust and healthy, and how to optimize healing when things go awry,” Lio told Happi.
Keeping the microbiome healthy is critical to healthy skin.
“Having a healthy skin flora/microbiome is so important because it’s our first defense against injury or unwanted pathogens. Skin can be left vulnerable if the microbiome is damaged, which can happen in many ways, including the use of harsh soaps, cleansers, exfoliants and other skin care products with ingredients that strip the skin of its protective acidic state, incorrect use of antibiotics, environmental stressors, poor diet and stress, to name a few,” said Julie Clark, founder and CEO of Province Apothecary, Toronto.
Clark told Happi that Province Apothecary’s approach has always been to work with the natural functions of the skin and body, not against them.
“This means supporting what the skin (and body) know how to do naturally in order to find health and balance, by using gentle but effective techniques with the use of nourishing, organic, clean and green ingredients in all of our products. We are always looking to bring in new, healthy ingredient technology that supports a healthy microbiome and doesn’t try to manipulate it.”
For eczema, Clark said Province Apothecary’s first line of defense is its hero product, Healing Eczema Balm, the brand’s first launch eight years ago. She pointed to the formulation’s soothing, repairing and anti-inflammatory properties that topically treat all types of skin conditions, including eczema, rosacea and inflamed acne.
Gladskin, a European eczema care brand and newcomer to the US marketplace, has been well-received since its debut in Q1 this year, according to Skyler Stein, president of GladSkin USA.
“We’re happy to be a DTC brand, especially in light of the challenges to brick and mortar retail this year,” said Stein. “Our customers are re-ordering at a great rate, really the best ‘review’ you can get.”
The endolysin in Gladskin, named Micreobalance, is a smart protein which was developed more than 10 years ago in collaboration with ETH Zurich. Over five years of research went into developing Gladskin Eczema Cream which ensures the stability of the smart protein, while providing needed moisturization, in a formula much more pleasant to use than most eczema remedies, according to Stein.
“In addition, most newer products with microbiome claims are prebiotic or probiotic. There is a great deal of noise around the skin microbiome these days, but only Gladskin works to directly balance the good and the bad bacteria that make up a normal skin microbiome,” said Stein.
“There is a real need to educate consumers about the skin microbiome, especially making consumers aware of dangerous ingredients, like antibiotics and steroids. Similarly, there is a great need for products to compensate for the increase in handwashing during the pandemic. This is critical for those who are eczema prone or who suffer from chronic skin conditions,” he said.
Other industry stakeholders pointed to the need to educate consumers.
“It can certainly be easy to forget about the skin microbiome, since the microorganisms that live within its ecosystem are way too small to see with the naked eye. However, consumers should definitely care about these tiny microbes because they are so important for the overall health of your skin,” said Laura Marinelli, PhD, microbiologist and scientific advisor at Ellis Day Skin Science. “The skin microbiome does everything from helping to maintain the barrier function of your skin to promoting immune function and protecting you from infection caused by pathogenic bacteria and viruses. What’s more, when your skin microbiome becomes imbalanced, it can lead to an array of different skin problems, such as breakouts, sensitivity and inflammation, as well as more serious conditions like psoriasis and eczema.”
Ellis Day Skin Science’s Wild Resilience Active Phage Serum is said to reset the skin microbiome, support the reduction of blemishes, hormonal breakouts, redness and inflammation that lead to aging, and make skin healthier and more resilient. It features an active ingredient called Cutiphage, described as a proprietary blend of active bacteriophages (phages) that kill the blemish-causing strains of Cutibacterium acnes (C. acnes) bacteria on skin.
“Unlike other skin care actives, phages are biological in nature; they are ubiquitous and even live on your skin already. In fact, some studies have shown that people with healthy skin have an increased abundance of phages, which keep C. acnes bacteria in check,” said Marinelli.
Phages, she said, infect and kill only their target bacteria, which sets them apart from other ingredients.
“This means that unlike antibiotics or OTC ingredients like benzoyl peroxide that kill a wide array of bacteria, the Cutiphage in Wild Resilience only kills a specific type of bacteria, so it won’t disrupt the health of your overall skin microbiome. And unlike products labeled as ‘probiotics,’ which often contain either bacterial byproducts or types of bacteria not native to skin, C. acnes phages are naturally found on healthy skin as mentioned above, so they are able to stay on the skin and work their magic,” Marinelli said.
According to Marinelli, industry has already learned much about the richness and diversity of the skin microbiome during the past decade. And as techniques for analyzing the skin microbiome become more robust and advanced, Marinelli predicts more studies that assess how the skin microbiome in a particular individual varies with time and under different conditions, such as seasonal and hormonal changes and stress.
Banking On It
Last month, a new player entered the skin care space—Symbiome, which founders say is the first science-based skin care brand to create a collection of “BioIntact” products that nourish the skin microbiome. The company recently closed a $15 million financing round led by True Ventures that included Bold Capital Partners, Mission Bay Capital and Gisev Family Office.
“Currently the clean skin care marketplace is filled with brands that are defined by what is not included—the infamous ‘dirty list,’” said Symbiome CEO Vicki Levine. “In comparison, Symbiome uses rigorous scientific research to understand what our skin has lost in the modern world in order to be intentional about our formulations. Our deep understanding of the skin microbiome—and what it has lost in the modern world—has allowed us to formulate a collection that only puts back the essential nutrients our skin needs to thrive.”
Symbiome is big on using a short ingredient list that it insists packs a punch.
“Our proprietary cold-emulsion process allows us to create supercharged BioIntact creams with as few as three ingredients, preserves the potency and rich biological integrity of these natural ingredients, while optimizing the benefits to the skin. Completely eliminating heat, this process has a lower carbon footprint and is more sustainable than traditional processes,” noted Founder and Chief Scientific Officer Larry Weiss, who formulated botanical disinfectants at CleanWell as well as probiotic skin care products for Mother Dirt.
Symbiome’s Postbiomic Fermentation of natural ingredients from the Amazon rainforest utilizes a proprietary blend of ancestral, native microbes to unlock and optimize the bioavailability of valuable nutrients and enzymes, noted Weiss.
“Not only does this process break down these components so that they are more readily absorbed by the skin, it requires lower temperatures, therefore preventing degradation and reducing energy costs. The result: optimal bioavailability and shelf stability, with minimal impact on the planet,” he said.
Symbiome’s range features four facial oils, including Rebalance 001, which contains fermented coffea arabica (green coffee) seed oil and fermented mauritia flexuosa (buriti) fruit oil. Symbiome’s The One restorative cream also contains just three ingredients, including lactobacillus ferment, which is rich in terpenes that help regulate the skin microbiome and soothe sensitive skin. The lengthiest ingredient list can be found the daily cleanser, which contains oenocarpus bataua (seje) fruit oil, isoamyl laurate, glycerin, water, croton cajucara (sanoma) leaf oil, turnera ulmifolia (xanana) flower and leaf oil and sucrose laurate.
“Our scientific research allows us to only put back the nutrients our skin microbiome needs to be healthy. We avoid unnecessary ingredients that may increase the chemical burden to the skin, disrupt the skin microbiome and cause irritation or sensitivity. By creating BioIntact products that support healthy, resilient skin, there is simply no reason to add anything else,” concluded Weiss.
Proof of Purchase
The beauty industry is rife with labels, certifications and standards—and there’s one that addresses the microbiome, too.
Codex Beauty’s Bia range recently achieved microbiome-friendly certification according to MyMicrobiome Standard 18.10. The certification is described as the first seal of quality that awards microbiome-friendly cosmetics and personal care products.
MyMicrobiome Standard 18.10 is one of six standards developed in 2018 by MyMicrobiome AG, Liechtenstein, under the scientific guidance of microbiologist Kristin Neumann PhD.
MyMicrobiome standards grew from Neumann’s personal interest in the microbiome and her realization that many brands had their own claims regarding how their products might be beneficial for the skin microbiome.
“I was actually surprised that this kind of standard [did not exist],” Neumann told Happi.
“Buyers want microbiome-friendly products and not pure marketing products,” she insisted.
Digging Deeper
Scientists are digging deeper and conducting more research on the microbiome.
In June, Johnson & Johnson Consumer Health presented findings from the longest longitudinal study of infant and mother skin microbiome research at the American Academy of Dermatology Virtual Meeting Experience (VMX) 2020. The study, along with new research shared on the first longer-term clinical assessment of cleanser types on skin microbiome, offers important insights for the care of newborn skin through childhood, as well as for the selection and development of skin cleansers and moisturizers.
In September, new developments related to the skin microbiome came out of National Institutes of Health (NIH).
An experimental treatment for eczema that aims to modify the skin microbiome reduced disease severity and increased quality of life for children as young as three years of age, according to a NIH study. The improvements persisted for up to eight months after treatment stopped, according to the September 9 edition of Science Translational Medicine. The experimental therapy contains strains of live Roseomonas mucosa—a bacterium naturally present on the skin—originally isolated from healthy volunteers and grown under carefully controlled laboratory conditions. For four months, clinical trial participants or their caregivers periodically applied this probiotic therapy to areas of skin affected by eczema.
“These early-stage findings suggest that R. mucosa therapy may help relieve some children of both the burden of eczema symptoms and the need for daily treatment,” noted Anthony S. Fauci, MD, director of NIH’s National Institute of Allergy and Infectious Diseases, which led the study—yes, that Dr. Fauci!
NIH has exclusively licensed the R. mucosa therapy to Forte Biosciences to advance the potential treatment through further clinical development.
Also in September, Dutch biotech company Micreos Human Health, parent to Gladskin, started to enroll patients in a Phase I/IIa study to assess the safety and efficacy of XZ.700 in those with mild to moderate atopic dermatitis, marking the world’s first evaluation of a pharmaceutical endolysin for topical use in humans. Endolysins are highly specific enzymes that cut the bacterial cell wall, rapidly killing only the target bacteria, regardless of antibiotic resistance, while preserving the skin microbiome. XZ.700 specifically targets Staphylococcus aureus.
More research will help the beauty business move beyond marketing hype when addressing the health of the microbiome.