How do you know if your microbiome is off?

What is the microbiome?

The human microbiome is defined as the full array of microorganisms, and their genomes, that live in and on humans. These microorganisms inhabit a particular site of the human body and form distinct microbial communities (microbiota) such as those found on the skin or the scalp microbiome. The composition of an individual's microbiome can be influenced by several factors such as age, environment and method of birth.

Without testing, there are a few signs that can indicate whether your microbiome is potentially off-balance. An imbalance in the microbiome, also known as dysbiosis, can manifest as a condition in different body areas such as acne vulgaris or dandruff. In this post, we explore potential signs of imbalance in the skin, scalp, oral and vaginal microbiomes. 


Signs of a skin microbiome imbalance

Skin-resident microbes inherently help to maintain a healthy skin barrier, however, if disrupted, changes in the skin microbiome can lead to inflammation, dryness, irritation and itchy skin (Skowron et al., 2021). Several studies have also shown that dysbiosis is implicated in the manifestation of inflammatory skin conditions such as acne and atopic dermatitis. 


Acne

One of the major factors involved in acne pathogenesis is thought to be an imbalance of the bacteria Cutibacterium acnes. Although C.acnes is also present on healthy skin, studies show that a loss of microbial diversity and loss of balance between C. acnes phylotypes appears to play a role in the triggering of acne (Dréno et al., 2020).

 
Atopic Dermatitis (Eczema) 

Studies have shown that individuals with atopic dermatitis have a disturbed skin microbiome and are more often colonised with Staphylococcus aureus compared to healthy individuals. The presence of S. aureus contributes to the inflamed, dry and itchy skin commonly experienced by individuals with atopic dermatitis.


Signs of a scalp microbiome imbalance

Studies have revealed that the scalp microbiome is characterized by a relatively low bacterial diversity, as compared to the other body sites and is dominated by Cutibacterium acnes, Staphylococcus epidermidis and Malassezia spp (Saxena et al.,2021). Dysbiosis of the scalp microbiome has been linked to conditions such as seborrheic dermatitis and dandruff.

 
Seborrheic Dermatitis

Seborrheic dermatitis is a common chronic, inflammatory skin disease that can affect the scalp and other sebum-gland-rich areas of the body. Scalp seborrheic dermatitis (SD) is a chronic type of inflammatory dermatosis associated with the proliferation of Malassezia species (Wang et al., 2021). The common signs of seborrheic dermatitis are flaking, scaling and inflammation.


Dandruff

Dandruff is a light disease state of seborrheic dermatitis, also associated with the proliferation of Malassezia species. Thus, scalp microbiome dysbiosis may present itself as dandruff, characterised by mild inflammatory reactions that present as abnormal flaking of the scalp and sometimes with mild erythema (redness).

 
Signs of an oral microbiome imbalance

The oral microbiome comprises a complex and diverse community of microorganisms living within the oral cavity and is the third most diverse after the gut and skin microbiome. Changes in the oral cavity can lead to dysbiosis which has been associated with the development of diseases such as periodontitis and gingivitis.


Periodontitis (Gum Disease)

Periodontitis, otherwise known as gum disease, is an irreversible inflammatory condition that affects over half of the world’s population and is a major cause of tooth loss. Although the cause of periodontitis is multifactorial, the presence of plaque is thought to be the primary factor. Plaque is formed when salivary glycoproteins adhere to the tooth surface, creating an environment for both Gram-positive and Gram-negative bacteria to colonise. It is the uncontrolled growth of the Gram-negative component of subgingival biofilm that leads to periodontitis (Aruni et al., 2015). Common signs of periodontitis include persistent bad breath, swollen gums and loose teeth.

 
Gingivitis

Gingivitis and periodontitis are a continuum of the same inflammatory disease, whereby gingivitis may lead to periodontitis if left untreated. Dysbiosis in the oral microbiome may manifest as gingivitis which is characterised by red, swollen and bleeding gums.

 
Signs of a vaginal microbiome imbalance 

Vaginal microbiota constitutes about 9% of the total human microbiota. These microbes live in a mutualistic relationship with the host vagina protecting it from potentially pathogenic microbes like those causing bacterial vaginosis (Saraf et al., 2021).


Bacterial Vaginosis

Changes in the vaginal microbiota including a loss of Lactobacillus species and an increase in facultative and anaerobic organism populations result in bacterial vaginosis (Saraf et al., 2021). This imbalance in the vaginal microbiome often leads to unusual discharge.

 
In summary

Whilst these signs can indicate a potential imbalance in your microbiome, they can also be caused by other factors. Microbiome testing would be ideal to provide certainty of an imbalance, however not many personal care brands offer this method of diagnosis to consumers. One example of a skincare brand that does offer this service is Gallinée, enabling personalised skin routine recommendations via an in-depth skin health report.


Advice for brands

We recommend differentiating your brand by harnessing the power of microbiome testing. The results of our market research on over 3,500 participants found that 80% demand a customised microbiome-based skincare product that factors ethnicity, age, location and skin concerns. By conducting in vivo testing on your products you can ensure they maintain the microbiome. Additionally, we can partner with your brand to offer our at-home skin microbiome testing kit, allowing you to provide skin health reports and personalised product recommendations to your customers based on their individual microbiome profiles.