EXPLORING THE POTENTIAL OF MICROBIOME-CONTAINING MOISTURIZERS IN MANAGING ATOPIC DERMATITIS
Main Article Content
Keywords
Atopic Dermatitis, Skin Microbiome, Dysbiosis, Microbiome-Containing Moisturizers, Gut-Skin Axis
Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin disorder driven by barrier dysfunction, immune dysregulation, and microbiome dysbiosis, affecting up to 20% of children worldwide. This review explores the pathophysiology of AD, emphasizing epidermal defects like filaggrin mutations, elevated pH, and reduced antimicrobial peptides that promote Staphylococcus aureus overgrowth and Th2 inflammation. The gut-skin axis also plays a contributory role, with gut dysbiosis reducing short-chain fatty acids and increasing skin flares. The function of the skin microbiome in immune modulation is also discussed, with commensals such as S. epidermidis synthesizing antimicrobials and inducing T-cell responses through Toll-like receptors. However, age-related changes may disrupt this homeostasis. Microbiome-based moisturizers (prebiotics, probiotics, postbiotics, and synbiotics) have become innovative treatments that help in restoring eubiosis, reducing pH, and increasing hydration. Clinical data, including RCTs and meta-analyses from 2024 to 2025, report improved SCORAD scores, decreased transepidermal water loss, and microbiome normalization, as well as prevention in infants. These non-steroidal alternatives supplement conventional treatment, providing better long-term control.
References
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27. Lee YH, Verma NK, Thanabalu T. Prebiotics in atopic dermatitis prevention and management. Journal of Functional Foods. 2021;78:104352.
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29. Nakatsuji T, Gallo RL. The role of the skin microbiome in atopic dermatitis. Annals of Allergy, Asthma & Immunology. 2019;122(3):263-9.
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31. De Almeida CV, Antiga E, Lulli M. Oral and topical probiotics and postbiotics in skincare and dermatological therapy: A concise review. Microorganisms. 2023;11(6):1420.
32. Chu DK, Koplin JJ, Ahmed T, Islam N, Chang C-L, Lowe AJ. How to Prevent Atopic Dermatitis (Eczema) in 2024: Theory and Evidence. The Journal of Allergy and Clinical Immunology: In Practice. 2024;12(7):1695-704.
33. Dumbuya H, Podimatis K, Kerob D, Draelos ZD. INDIVIDUAL ARTICLE: Efficacy of a Prebiotic Skincare Regimen on Improving Mild Atopic Dermatitis and Severe Xerosis in Diverse Ethnically Patients. Journal of Drugs in Dermatology: JDD. 2024;23(3):SF395747s12-SFs22.
34. Wang L, Xu L. The impact of prebiotics, probiotics and synbiotics on the prevention and treatment of atopic dermatitis in children: an umbrella meta-analysis. Frontiers in Pediatrics. 2025;13:1498965.
35. Capone K, Kirchner F, Klein SL, Tierney NK. Effects of Colloidal Oatmeal Topical Atopic Dermatitis Cream on Skin Microbiome and Skin Barrier Properties. Journal of drugs in dermatology: JDD. 2020;19(5):524-31.
36. Seité S, Zelenkova H, Martin R. Clinical efficacy of emollients in atopic dermatitis patients–relationship with the skin microbiota modification. Clinical, Cosmetic and Investigational Dermatology. 2017:25-33.
37. Bradshaw LE, Wyatt LA, Brown SJ, Haines RH, Montgomery AA, Perkin MR, et al. Emollients for prevention of atopic dermatitis: 5-year findings from the BEEP randomized trial. Allergy. 2023;78(4):995-1006.
38. Grześk-Kaczyńska M, Petrus-Halicka J, Kaczyński S, Bartuzi Z, Ukleja-Sokołowska N. Should Emollients Be Recommended for the Prevention of Atopic Dermatitis?—New Evidence and Current State of Knowledge. Journal of Clinical Medicine. 2024;13(3):863.
39. Nakatsuji T, Hata TR, Tong Y, Cheng JY, Shafiq F, Butcher AM, et al. Development of a human skin commensal microbe for bacteriotherapy of atopic dermatitis and use in a phase 1 randomized clinical trial. Nature Medicine. 2021;27(4):700-9.
40. Myles IA, Earland NJ, Anderson ED, Moore IN, Kieh MD, Williams KW, et al. First-in-human topical microbiome transplantation with Roseomonas mucosa for atopic dermatitis. JCI insight. 2018;3(9):e120608.
41. Lisante TA, Kizoulis M, Nuñez C, Hartman CL. A 1% colloidal oatmeal OTC cream is clinically effective for the management of mild to moderate atopic dermatitis in Black or African American children. Journal of Dermatological treatment. 2023;34(1):2241587.
2. Tsakok T, Woolf R, Smith C, Weidinger S, Flohr C. Atopic dermatitis: the skin barrier and beyond. British Journal of Dermatology. 2019;180(3):464-74.
3. Facheris P, Jeffery J, Del Duca E, Guttman-Yassky E. The translational revolution in atopic dermatitis: the paradigm shift from pathogenesis to treatment. Cellular & Molecular Immunology. 2023;20(5):448-74.
4. Yamamura Y, Nakashima C, Otsuka A. Interplay of cytokines in the pathophysiology of atopic dermatitis: insights from Murin models and human. Frontiers in Medicine. 2024;11:1342176.
5. Zhang Z, Wang R, Li M, Lu M. Current insights and trends in atopic dermatitis and microbiota interactions: a systematic review and bibliometric analysis. Frontiers in Microbiology. 2025;16:1613315.
6. Kim HB, Alexander H, Um JY, Chung BY, Park CW, Flohr C, et al. Skin Microbiome Dynamics in Atopic Dermatitis: Understanding Host-Microbiome Interactions. Allergy, asthma & immunology research. 2025;17(2):165.
7. Koh LF, Ong RY, Common JE. Skin microbiome of atopic dermatitis. Allergology International. 2022;71(1):31-9.
8. Huang C, Zhuo F, Guo Y, Wang S, Zhang K, Li X, et al. Skin microbiota: Pathogenic roles and implications in atopic dermatitis. Frontiers in Cellular and Infection Microbiology. 2025;14:1518811.
9. Emokpae I, Tobia DL, Stamm SD, Lundy P, Weimer DS, Beckler MD. Examining the efficacy of five Lactobacillus species in treating and preventing atopic dermatitis: a systemic literature review. Cureus. 2024;16(7).
10. Paller AS, Kong HH, Seed P, Naik S, Scharschmidt TC, Gallo RL, et al. The microbiome in patients with atopic dermatitis. Journal of Allergy and Clinical Immunology. 2019;143(1):26-35.
11. Tang H, Li W, Xu Y, Zhou Y, Hamblin MR, Wen X. Gut microbiota modulation: a key determinant of atopic dermatitis susceptibility in children. Frontiers in Microbiology. 2025;16:1549895.
12. Jimenez-Sanchez M, Celiberto LS, Yang H, Sham HP, Vallance BA. The gut-skin axis: a bi-directional, microbiota-driven relationship with therapeutic potential. Gut Microbes. 2025;17(1):2473524.
13. Rios-Carlos M, Cervantes-García D, Córdova-Dávalos LE, Bermúdez-Humarán LG, Salinas E. Unraveling the gut-skin axis in atopic dermatitis: exploiting insights for therapeutic strategies. Gut microbes. 2024;16(1):2430420.
14. Lee S-Y, Lee E, Park YM, Hong S-J. Microbiome in the gut-skin axis in atopic dermatitis. Allergy, asthma & immunology research. 2018;10(4):354-62.
15. Anggawirya B, Sawitri S. The role of microbiome-containing moisturizers in atopic dermatitis. 2024.
16. Chen YE, Fischbach MA, Belkaid Y. Skin microbiota–host interactions. Nature. 2018;553(7689):427-36.
17. Lunjani N, Ahearn-Ford S, Dube FS, Hlela C, O’Mahony L. Mechanisms of microbe-immune system dialogue within the skin. Genes & Immunity. 2021;22(5):276-88.
18. Zhang X-E, Zheng P, Ye S-Z, Ma X, Liu E, Pang Y-B, et al. Microbiome: role in inflammatory skin diseases. Journal of Inflammation Research. 2024:1057-82.
19. Chinnappan M, Harris-Tryon TA. Novel mechanisms of microbial crosstalk with skin innate immunity. Experimental Dermatology. 2021;30(10):1484-95.
20. Ratanapokasatit Y, Laisuan W, Rattananukrom T, Petchlorlian A, Thaipisuttikul I, Sompornrattanaphan M. How microbiomes affect skin aging: the updated evidence and current perspectives. Life. 2022;12(7):936.
21. Woo YR, Kim HS. Interaction between the microbiota and the skin barrier in aging skin: a comprehensive review. Frontiers in Physiology. 2024;15:1322205.
22. Kim H-J, Kim JJ, Myeong NR, Kim T, Kim D, An S, et al. Segregation of age-related skin microbiome characteristics by functionality. Scientific Reports. 2019;9(1):16748.
23. Jung Y, Kim I, Jung D-R, Ha JH, Lee EK, Kim JM, et al. Aging-Induced Changes in Cutibacterium acnes and Their Effects on Skin Elasticity and Wrinkle Formation. Microorganisms [Internet]. 2024; 12(11).
24. Chandan N, Rajkumar JR, Shi VY, Lio PA. A new era of moisturizers. Journal of Cosmetic Dermatology. 2021;20(8):2425-30.
25. Whiting C, Azim SA, Joly-Tonetti N, Lachmann N, Friedman A. Effects on the Skin Microbiome by a Moisturizer Formulated for Eczema-Prone and Sensitive Skin. Journal of drugs in dermatology: JDD. 2025;24(3):275-80.
26. Prakoeswa CRS, Huda BKN, Indrawati D, Umborowati MA, Anggraeni S, Damayanti, et al. Effectiveness and Tolerability of an Emollient “Plus” Compared to Urea 10% in Patients With Mild‐to‐Moderate Atopic Dermatitis. Journal of Cosmetic Dermatology. 2025;24(2):e70051.
27. Lee YH, Verma NK, Thanabalu T. Prebiotics in atopic dermatitis prevention and management. Journal of Functional Foods. 2021;78:104352.
28. Flint E, Ahmad N, Rowland K, Hildebolt C, Raskin D. Topical Probiotics Decrease the Severity of Atopic Dermatitis. A Systematic Review and Meta-Analysis of Double-Blind, Randomized, Placebo Control Trials. medRxiv. 2024:2024.07.30.24311221.
29. Nakatsuji T, Gallo RL. The role of the skin microbiome in atopic dermatitis. Annals of Allergy, Asthma & Immunology. 2019;122(3):263-9.
30. Prajapati SK, Lekkala L, Yadav D, Jain S, Yadav H. Microbiome and Postbiotics in Skin Health. Biomedicines [Internet]. 2025; 13(4).
31. De Almeida CV, Antiga E, Lulli M. Oral and topical probiotics and postbiotics in skincare and dermatological therapy: A concise review. Microorganisms. 2023;11(6):1420.
32. Chu DK, Koplin JJ, Ahmed T, Islam N, Chang C-L, Lowe AJ. How to Prevent Atopic Dermatitis (Eczema) in 2024: Theory and Evidence. The Journal of Allergy and Clinical Immunology: In Practice. 2024;12(7):1695-704.
33. Dumbuya H, Podimatis K, Kerob D, Draelos ZD. INDIVIDUAL ARTICLE: Efficacy of a Prebiotic Skincare Regimen on Improving Mild Atopic Dermatitis and Severe Xerosis in Diverse Ethnically Patients. Journal of Drugs in Dermatology: JDD. 2024;23(3):SF395747s12-SFs22.
34. Wang L, Xu L. The impact of prebiotics, probiotics and synbiotics on the prevention and treatment of atopic dermatitis in children: an umbrella meta-analysis. Frontiers in Pediatrics. 2025;13:1498965.
35. Capone K, Kirchner F, Klein SL, Tierney NK. Effects of Colloidal Oatmeal Topical Atopic Dermatitis Cream on Skin Microbiome and Skin Barrier Properties. Journal of drugs in dermatology: JDD. 2020;19(5):524-31.
36. Seité S, Zelenkova H, Martin R. Clinical efficacy of emollients in atopic dermatitis patients–relationship with the skin microbiota modification. Clinical, Cosmetic and Investigational Dermatology. 2017:25-33.
37. Bradshaw LE, Wyatt LA, Brown SJ, Haines RH, Montgomery AA, Perkin MR, et al. Emollients for prevention of atopic dermatitis: 5-year findings from the BEEP randomized trial. Allergy. 2023;78(4):995-1006.
38. Grześk-Kaczyńska M, Petrus-Halicka J, Kaczyński S, Bartuzi Z, Ukleja-Sokołowska N. Should Emollients Be Recommended for the Prevention of Atopic Dermatitis?—New Evidence and Current State of Knowledge. Journal of Clinical Medicine. 2024;13(3):863.
39. Nakatsuji T, Hata TR, Tong Y, Cheng JY, Shafiq F, Butcher AM, et al. Development of a human skin commensal microbe for bacteriotherapy of atopic dermatitis and use in a phase 1 randomized clinical trial. Nature Medicine. 2021;27(4):700-9.
40. Myles IA, Earland NJ, Anderson ED, Moore IN, Kieh MD, Williams KW, et al. First-in-human topical microbiome transplantation with Roseomonas mucosa for atopic dermatitis. JCI insight. 2018;3(9):e120608.
41. Lisante TA, Kizoulis M, Nuñez C, Hartman CL. A 1% colloidal oatmeal OTC cream is clinically effective for the management of mild to moderate atopic dermatitis in Black or African American children. Journal of Dermatological treatment. 2023;34(1):2241587.
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Jul 30, 2025
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How to Cite
Feroza Fatima, Urooj Mirza, Jameel Sayed, Maria Farooqi, Omar Imran, & Sufia Sayed. (2025). EXPLORING THE POTENTIAL OF MICROBIOME-CONTAINING MOISTURIZERS IN MANAGING ATOPIC DERMATITIS. Journal of Population Therapeutics and Clinical Pharmacology, 32(6), 1649-1656. https://doi.org/10.53555/dqxfn665
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Author Biographies
Feroza Fatima
Specialist Dermatologist, Primary Health Care Corporation, Qatar.
Urooj Mirza
Urooj Mirza, Specialist Dermatologist, Doha Specialized Dental and Dermatology Center Doha, Qatar.
Jameel Sayed
Jameel Sayed, Specialist Dermatologist, Ultra Cosmetic Medical Center, Doha, Qatar.
Maria Farooqi
Maria Farooqi, Consultant Dermatologist, King Abdullah Medical City Makkah Kingdom of Saudi Arabia.
Omar Imran
Omar Imran, Dow International Medical College Karachi Pakistan.
Sufia Sayed
Sufia Sayed, Royal College of Surgeons in Ireland, Bahrain.
How to Cite
Feroza Fatima, Urooj Mirza, Jameel Sayed, Maria Farooqi, Omar Imran, & Sufia Sayed. (2025). EXPLORING THE POTENTIAL OF MICROBIOME-CONTAINING MOISTURIZERS IN MANAGING ATOPIC DERMATITIS. Journal of Population Therapeutics and Clinical Pharmacology, 32(6), 1649-1656. https://doi.org/10.53555/dqxfn665