The Role of the Skin Microbiome in Pathogenesis of Atopic Dermatitis - Current State of Knowledge
DOI:
https://doi.org/10.12775/JEHS.2025.82.60518Keywords
skin, microbiome, atopic dermatitis, dysbiosis, atopic dermatitis treatment, personalized therapyAbstract
Introduction and purpose
The subject of this article is the role of the skin microbiome in the pathogenesis of atopic dermatitis - the current state of knowledge. As is known, the skin plays a key role in protecting the body and maintaining homeostasis, cooperating with the microbiome, which affects its immune functions. The purpose of this article is to provide a comprehensive review of current research on the microbiome's role in the pathogenesis of atopic dermatitis (AD).
Materials and methods
The presented article was developed based on a broad database of peer-reviewed scientific publications obtained from reputable sources such as PubMed, Google Scholar and literature authored by renowned researchers from both Poland and abroad. In the process of analysis and interpretation of information, only scientific publications with a high impact factor were taken into account. The analyses performed include both clinical and experimental studies, as well as systematic reviews and meta-analyses, which allowed for obtaining a comprehensive view of the current state of knowledge in this field.
Description of the state of knowledge
Atopic dermatitis (AD) is a chronic inflammatory disease, the pathogenesis of which is associated with disorders of the skin microbiome, leading to the dominance of pathogenic microorganisms, such as Staphylococcus aureus. Standard methods of treating atopic dermatitis (AD) often bring only short-term relief. Understanding the role of the microbiome in this disease opens the way to new, more effective therapies, such as probiotics and methods supporting the reconstruction of skin microflora, enabling a more personalized therapeutic approach.
Conclusion
The aim of the article is to draw attention to the role of the microbiome in atopic dermatitis (AD), which is currently one of the most common skin diseases. It affects not only children but also adults, influencing their quality of life.
References
1. Wan P, Chen J. A calm, dispassionate look at skin microbiota in atopic dermatitis: an integrative literature review. Dermatol Ther (Heidelb). 2020;10:53–61. doi: https://doi.org/10.1007/s13555-020-00352-4
2. Belkaid Y, Hand T. Role of microbiota in immunity and inflammation. Cell. 2014;157:121-141. doi: https://doi.org/10.1016/j.cell.2014.03.011
3. Bjerre RD, Bandier J, Skov L, Engstrand L, Johansen JD. The role of the skin microbiome in atopic dermatitis: a systematic review. Br J Dermatol. 2017;177:1272–1278. doi: https://doi.org/10.1111/bjd.15390
4. Grice EA, Segre JA. The skin microbiome. Nat Rev Microbiol. 2011;9:244-253. doi: https://doi.org/10.1038/nrmicro2537
5. Malinowska M, Tokarz-Deptuła B, Deptuła W. The human microbiome. Advancements of Microbiology. 2017;56:33-42. doi: https://doi.org/10.21307/PM-2017.56.1.033. Polish.
6. Adamczyk K, Garncarczyk AA, Antończak PP. The microbiome of the skin. Dermatology Review. 2018;2:286. doi: https://doi.org/10.5114/dr.2018.75584
7. Kong HH. Skin microbiome: genomics-based insights into the diversity and role of skin microbes. Trends Mol Med. 2011;17:320-328. doi: https://doi.org/10.1016/j.molmed.2011.01.013
8. Callewaert C, Ravard Helffer K, Lebaron P. Skin Microbiome and its Interplay with the Environment. Am J Clin Dermatol. 2020;21(Suppl 1):4–11. doi: https://doi.org/10.1007/s40257-020-00551-x
9. Percival SL, Emanuel C, Cutting KF, Williams DW. Microbiology of the skin and the role of biofilms in infections. Int Wound J. 2012;9:14-32. doi: https://doi.org/10.1111/j.1742-481X.2011.00836.x
10. Boxberger M, Cenizo V, Cassir N, Scola La B. Challenges in exploring and manipulating the human skin microbiome. Microbiome. 2021;9:125. doi: https://doi.org/10.1186/s40168-021-01062-5
11. Geloen A, Raillan A. The skin microbiome. A guide to the world of natural and sustainable skincare [translated by Weksej A]. Kraków: Znak Koncept; 2021. ISBN: 9788324073832
12. Trznadel-Grodzka E, Tyc-Zdrojewska E, Kaszuba A. Seborrheic diseases. In: Adamski Z, Kaszuba A, eds. Diagnostic Methods in Dermatology, Venereology and Medical Mycology. Vol 2. Lublin: Czelej; 2015:235-247. ISBN: 9788375632071
13. Sanford JA, Gallo RL. Functions of the skin microbiota in health and disease. Semin Immunol. 2013;25(5):370-377. doi: https://doi.org/10.1016/j.smim.2013.09.005
14. Byrd AL, Belkaid Y, Segre JA. The human skin microbiome. Nat Rev Microbiol. 2018;6(3):143-155. doi: https://doi.org/10.1038/nrmicro.2017.157
15. Reid G, Younes JA, Van der Mei HC, Gloor GB, Knight R, Busscher HJ. Microbiota restoration: natural and supplemented recovery of human microbial communities. Nat Rev Microbiol. 2011;9:27-38. doi: https://doi.org/10.1038/nrmicro2473
16. Kurkowska N, Musiał C. Probiotics in acne skin care. A review of the lastes scientific reports. Aesth Cosmetol Med. 2021;10(2):91-98. doi: https://doi.org/10.52336/acm.2021.10.2.09. Polish.
17. Fournière M, Latire T, Souak D, Feuilloley MGJ, Bedoux G. Staphylococcus epidermidis and Cutibacterium acnes: Two Major Sentinels of Skin Microbiota and the Influence of Cosmetics. Microorganisms. 2020;8(11):2-31. doi: https://doi.org/10.3390/microorganisms8111752
18. Duffy E, Morrin A. Endogenous and microbial volatile organic compounds in cutaneous health and Disease. TrAC Trends in Analytical Chemistry. doi: https://doi.org/10.1016/j.trac.2018.12.012
19. Sybilski AJ, Węgrzynek M. Role of the microbiome and probiotics in the prevention of allergic diseases. Pediatr Med Rodz. 2020;16(1):57–61. doi: https://doi.org/10.15557/PiMR.2020.0010
20. Mańkowska-Wierzbicka D, Karczewski J, Dobrowolska-Zachwieja A, Adamski Z. The microbiome and dermatological diseases. Postepy Hig Med Dosw. 2015;69:978-985. PMID: 26400884
21. Gościńska A, Będzichowska A, Lipińska-Opałka A. Atopic dermatitis and the human skin microbiota. Pediatr Med Rodz. 2023;19(2):78–82. doi: https://doi.org/10.15557/PiMR.2023.0012. Polish.
22. Hrestak D, Matijašić M, Čipčić Paljetak H, Ledić Drvar D, Ljubojević Hadžavdić S, Perić M. Skin microbiota in atopic dermatitis. Int J Mol Sci. 2022;23:3503. doi: https://doi.org/10.3390/ijms23073503
23. Nowicki RJ, Trzeciak M, Kaczmarski M, Wilkowska A, Czarnecka-Operacz M, Kowalewski C, Rudnicka L, Kulus M, Mastalerz-Migas A, Peregud-Pogorzelski J, Sokołowska-Wojdyło M, Śpiewak R, Adamski Z, Czuwara J, Kapińska-Mrowiecka M, Kaszuba A, Krasowska D, Kręcisz B, Narbutt J, Majewski S, Reich A, Samochocki Z, Szepietowski J, Woźniak K. Atopic dermatitis. Interdisciplinary diagnostic and therapeutic recommendations of the Polish Dermatological Society, Polish Society of Allergology, Polish Pediatric Society and Polish Society of Family Medicine. Part I. Prophylaxis, topical treatment and phototherapy. Dermatol Rev. 2019;106:354–371. doi: https://doi.org/10.5114/ada.2020.93423
24. Shi B, Bangayan NJ, Curd E, Taylor PA, Gallo RL, Leung DYM, Li H. The skin microbiome is different in pediatric versus adult atopic dermatitis. J Allergy Clin Immunol. 2016;138:1233–1236. doi: https://doi.org/10.1016/j.jaci.2016.04.053
25. Edslev SM, Agner T, Andersen PS. Skin microbiome in atopic dermatitis. Acta Derm Venereol. 2020;100:adv00152. doi: https://doi.org/10.2340/00015555-3514
26. Cabanillas B, Novak N. Atopic dermatitis and filaggrin. Curr Opin Immunol. 2016;42:1–8. doi: https://doi.org/10.1016/j.coi.2016.05.002
27. Miajlovic H, Fallon PG, Irvine AD, Foster TJ. Effect of filaggrin breakdown products on growth of and protein expression by Staphylococcus aureus. J Allergy Clin Immunol. 2010;126:1184–1190. doi: https://doi.org/10.1016/j.jaci.2010.09.015
28. Nakatsuji T, Chen TH, Two AM, Chun KA, Narala S, Geha RS, Hata TR, Gallo RL. Staphylococcus aureus exploits epidermal barrier defects in atopic dermatitis to trigger cytokine expression. J Invest Dermatol. 2016;136:2192–2200. doi: https://doi.org/10.1016/j.jid.2016.05.127
29. Kong HH, Oh J, Deming C, Conlan S, Grice EA, Beatson MA, Nomicos E, Polley EC, Komarow HD, NISC Comparative Sequence Program, Murray PR, Turner ML, Segre JA. Temporal shifts in the skin microbiome associated with disease flares and treatment in children with atopic dermatitis. Genome Res. 2012;22:850–859. doi: https://doi.org/10.1101/gr.131029.111
30. Totté JEE, van der Feltz WT, Hennekam M, van Belkum A, van Zuuren EJ, Pasmans SGMA. Prevalence and odds of Staphylococcus aureus carriage in atopic dermatitis: a systematic review and meta-analysis. Br J Dermatol. 2016;175:687–695. doi: https://doi.org/10.1111/bjd.14566
31. Han SH, Cheon HI, Hur MS, Kim MJ, Jung WH, Lee YW, Choe YB, Ahn KJ. Analysis of the skin mycobiome in adult patients with atopic dermatitis. Exp Dermatol. 2018; 27:366–373. doi: https://doi.org/10.1111/exd.13500
32. Zhang E, Tanaka T, Tajima M, Tsuboi R, Nishikawa A, Sugita T. Characterization of the skin fungal microbiota in patients with atopic dermatitis and in healthy subjects. Microbiol Immunol. 2011;55:625–632. doi: https://doi.org/10.1111/j.1348-0421.2011.00364.x
33. Glatz M, Jo JH, Kennedy EA, Polley EC, Segre JA, Simpson EL, Kong HH. Emollient use alters skin barrier and microbes in infants at risk for developing atopic dermatitis. PLoS One. 2018;13(2):e0192443. doi: https://doi.org/10.1371/journal.pone.0192443
34. Flores GE, Seité S, Henley JB, Martin R, Zelenkova H, Aguilar L, Fierer N. Microbiome of affected and unaffected skin of patients with atopic dermatitis before and after emollient treatment. J Drugs Dermatol. 2014;13:1365–1372. PMID: 25607704
35. Wongpiyabovorn J, Soonthornchai W, Wilantho A, Palasuk M, Payungporn S, Sodsai P, Poomipak W, Weschawalit S, Ruchusatsawat K, Bailie GS, Hirankarn N, Somboonna N. Effect of tacrolimus on skin microbiome in atopic dermatitis. Allergy. 2019;74:1400–1406 doi: https://doi.org/10.1111/all.13743
36. Anania C, Brindisi G, Martinelli I, Bonucci E, D’Orsi M, Ialongo S, Nyffenegger A, Raso T, Spatuzzo M, De Castro G, Zicari AM, Carraro C, Piccioni MG, Olivero F. Probiotics function in preventing atopic dermatitis in children. Int J Mol Sci. 2022;23:5409. doi: https://doi.org/10.3390/ijms23105409
37. Li L, Han Z, Niu X, Zhang G, Jia Y, Zhang S, He C. Probiotic supplementation for prevention of atopic dermatitis in infants and children: a systematic review and meta-analysis. Am J Clin Dermatol. 2019;20:367–377. doi: https://doi.org/10.1007/s40257-018-0404-3
38. Niccoli AA, Artesi AL, Candio F, Ceccarelli S, Cozzali R, Ferraro L, Fiumana D, Mencacci M, Morlupo M, Pazzelli P, Rossi L, Toscano M, Drago L. Preliminary results on clinical effects of probiotic Lactobacillus salivarius LS01 in children affected by atopic dermatitis. J Clin Gastroenterol. 2014;48 Suppl 1:S34–S36. doi: https://doi.org/10.1097/MCG.0000000000000233
39. Flowers L, Grice EA. The skin microbiota: balancing risk and reward. Cell Host Microbe. 2020;28:190–200. doi: https://doi.org/10.1016/j.chom.2020.06.017
40. Nakatsuji T, Chen TH, Narala S, Chun KA, Two AM, Yun T, Shafiq F, Kotol PF, Bouslimani A, Melnik AV, Latif H, Kim JN, Lockhart A, Artis K, David G, Taylor P, Streib J, Dorrestein PC, Grier A, Gill SR, Zengler K, Hata TR, Leung DYM, Gallo RL. Antimicrobials from human skin commensal bacteria protect against Staphylococcus aureus and are deficient in atopic dermatitis. Sci Transl Med. 2017;9(378):eaah4680. doi: https://doi.org/10.1126/scitranslmed.aah4680
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Natalia Sidz, Monika Brzozowska, Wiktoria Wardal, Natalia Furlepa , Robert Rzenno, Karolina Wojciechowska, Marcelina Matuszewska , Katarzyna Wicha, Magdalena Tomaszewska, Wiktoria Jedlikowska

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 17
Number of citations: 0