Risk Your Microbiome to Smooth a Wrinkle? Run.

A spider web from Carte Blanche a Tomas Saraceno


"The press briefing for October’s Clinical Cosmetic Reconstructive Expo in London was delayed – there had been another death. A cluster of journalists gathered on the mezzanine while below them visitors filtered past signs for She Lase and Zero Gravity Skin and a stand for a company called Eurosilicone that claims to have been “Empowering women for over 30 years”. At the far end of the conference hall, a woman was having her jawline enhanced with fillers in front of a rapt crowd; the Safety in Beauty stand was empty."  "Rear View: The Big Business of Bottoms", The Guardian 11.18.18

In the last few weeks I have been looking at recent r&d in the field of the human microbiome and skincare. As the subject is dear to the heart of Balbec, I wanted to take a post to share my thoughts. But first...

What we know about the incredibly complex human microbiome at this point is very little. In a short time, we're likely to discard some of this knowledge as incorrect. 

We know: that there is at least a gut-brain-skin axis, wherein our skin is more than third kidney, it is also our third brain; that being human means we are over half bacteria and the relationship with respect to our material being is host and resident bacteria; that the latter functions through signaling systems of the former: the immune and neuroendocrine pathways.  We know that each of us has our own distinct, signature microbiome and that there is no way of reading this thumbprint, or profile--yet.

Our microbiome is as it is due to our genetics, environment, culture, food, and habits. And we are also finding--our age. Both the biodiversity and balance (or lack of-- dysbiosis) of the microbiota directly impacts our health.

Balance is a critical factor of the microbiome, whether in terms of its axis (what happens in the gut can affect the skin and brain by way of complex signaling), or in terms of the representation and distribution of bacteria. Through the cultural overuse of antibiotics and strong sterilization methods such as hand sanitizers guided by a mentality of germophobia, we've gotten into the habit of meddling with the microbiome and damaging its biodiversity. 

The silver lining is: years of harsh treatment have led us to a very exciting field of inquiry. The more we learn about the microbiome, the richer our knowledge of the human body will be. Undoubtedly, we will find solutions unimaginable to us now.

Still, it doesn't require a great leap of thought to realize we will find ourselves with problems unimaginable should we fail to honor and weigh the delicate structure of the microbiome at every stage of our inquiry with our desire for improvement. Yes we have been remiss and overzealous in stripping away our bacteria and we are poorer for it. But we can make a big difference simply by making lifestyle changes that can go a long way in healing and sustaining a microbiome that is ultimately self-balancing under the right conditions. Spending more time outdoors, eating a high fiber, minimally processed diet that includes fermented foods, forgoing strong detergents and cleansers that strip the acid mantle of our skin, avoiding hand sanitizer and sleeping enough (and we know now that the bacteria in our gut have a role in regulating our circadian rhythms) are day to day solutions. If probiotics from food are not enough to heal the gut when necessary, probiotic supplements are helpful. And of course, we can always use extreme caution with last-resort antibiotics. At this stage of our understanding of the microbiome, this is enough...a lot, actually. Clear and beautiful skin will naturally follow as a result. 

However, because research and development on skin and the microbiome is focussed on improving our microbiomes through manipulation of microbiota, it behooves us to  carefully evaluate how far we wish to go into the unknown for the sake of cosmetic enhancement. Because on the one hand, our microbiota function within a paradigm of balance, which is neither news nor a problem for holistic systems such as Chinese medicine or Ayurveda. And on the other hand, developments for skincare solutions as they have recently materialized are undertaken within a paradigm that operates in fragments and trades within discrete systems of health: dermatology, neurology, gastroenterology, and so forth.  

Although this research is in its infancy, the backlash of being in germ destruction mode for so long sometimes takes the form of a restoration project. We now have a host of products presuming and/or  promising to increase the general diversity of our microbiome and restore skin back to its natural environment and/ or to what it might have been at a different time period. Some companies are even looking to antique models, (the way we were) for inspiration to intervene and thus restore our microbiomes. 

Despite the super tempting claims for clearer and healthier skin, do we know what our natural environment or biodiversity really is or how it works in response to the conditions within which we live?  And what about the fact that each one of us has our own world of diversity to contend with? Furthermore, we can't know entirely why we have evolved as we have, and if that evolution is all good or all bad. I'm not sure these treatments are better than the lifestyle changes above. They may well be way worse.

For maturing skins there are now products that intend to mimic the bacterial distribution of younger skin. But do we fully know what else in our brain or in our gut the forced redistribution may trigger through subtle, refined, and complex signaling? Surely despite all the bad press on aging, there are some logical reasons that our bodies do what they do as they grow older. And if we introduce something that potentially creates dysbiosis through targeted redistribution in our older systems, is it at all possible that we are creating real complications for our aging bodies? Is ironing out that pesky wrinkle and stimulating a bit of collagen production really worth the risk? How about giving yourself a lovely, loving nightly face massage instead? It is effective and nil on nasty side effects as long as you keep your nails short. 

While the backlash might sound logical, and improvements aspirational, the premise may be flawed at its heart also because it rehearses the cosmetic/health improvement and marketing trap. It's the old, you're not enough as you are, so let me help you number. We're also back to meddling. The danger is that we know too little about how the whole microbiome works together. And in a balance system, to speak of "side effects" is a gross diminishment. 

I am skeptical of a proposal or product that tells me that it is going to restore my skin's microbiome to its natural environment by bringing back by my skin's biodiversity. Excuse me? I haven't even met you. Moreover, I don't think I really want to given that you've already presumed to dictate which bacteria fall into the realm of acceptable diversity.

I am skeptical of a product that promises to change our microbiome piecemeal by introducing bacteria from other cultures or from humans of a different generation. I am also skeptical of efforts to redesign the distribution of our microbiome.  Especially for the sake of looking a little better.

For starters I'm not sure it really works. Importing bacterium from communities which live on diets of unprocessed foods, sleep according to regulated circadian rhythms, and experience stress differently than most urban/ suburbanites do, and asking this  bacterium to make a targeted difference independently of those other lifestyle choices is shortsighted. Then, to make the consumer feel his or her microbiome needs a  product to complete itself is insidious and incorrect. Incomplete in relation to what? This becomes an existential question and one I would be slow to pose to a pharmaceutical company. To then promise fulfillment only as long as your product is used sounds like business as usual. 

To be fair, such R& D finds economic incentive from a culture that is:

1) Deeply attached to looking youthful and has difficulty in appreciating young beauty as one, but not the only defining characteristic of beauty. Thus the cravings for anti-aging products.

2) Privileges the isolated fix in favor of the slower, less dramatic lifestyle improvements, and broader perspective. This accounts for anything from blemish concealer (and don't get me wrong, I love mine) to cosmetic surgery or a full on addiction to injectables. 

3) in constant need of perceived improvement that stems from a suffering of never being enough.

By themselves each is more or less problematic depending on your point of view. Put the three together with an eye to the microbiome as the medicine chest or makeup bag of the future and we've got a crucible. There is a tone deafness to the holistic beauty that underlines the spirit and workings of the microbiome.

We are in for a volatile ride and will benefit by noticing the messages driving the products we're being fed, by listening for the cognitive dissonance--the sound of having each foot in a different boat. A book published earlier this year by an American dermatologist as a clarion call to all dermatologists to acknowledge as "surprising science" that gut health has an effect on skin health--that inflammation in one will manifest as inflammation on the other is such an example.  Along with her recommendations to exercise and eat a diet that includes fermented food, and probiotic supplements, she also recommends that we add a life-long retinol to our daily skincare regime starting in our 20s. She suggests that by our 40s, we should be increasing the dosage. This doesn't square.

Thus far I have named no names, but Alexandra Soveral, who I feel is one of the more compelling skincare practitioners has this to say about it in her recent book: Perfect Skin, Unlocking the Secrets

As for facials and skincare products offering mild skin resurfacing [this would include retinols], I truly believe they should come with a health warning, just as cigarettes do... The daily use of products with skin resurfacing ingredients will for the first few days, destroy your acid mantle. Then it will start removing the dry skin cells underneath...as soon as your acid mantle is removed, the skin will immediately try to rebuild it; after all, the body makes it for a reason--its your first line of defence.  Once the top layer of skin goes, your skin will again try to replace it. As the skin goes into overdrive trying to protect itself, you go into overdrive trying to stop it. The result is sensitive skin that is exhausted. This also has an impact on the immune system.  All organs, including the skin, directly communicate with the immune system.  Therefore, keeping your immune system on constant high alert means that it is always ready for an inflammatory response. And what is the biggest cause of ageing? Inflammation (207).

All to say: be careful of what you want, because you just might get it, along with something that you didn't.

So what about Balbec and the skin microbiome?  The probiotics we use are in the form of a fermented food. They are the live lactobacillus cells within the yogurt of our clay and yogurt based cleansers.  As such, the yogurt provides probiotics while on the skin and can help support a healthy skin microbiome, just as eating a diet with fermented food can support a healthy gut microbiome.  And as food, it also provides nourishment for the natural resident beneficial bacterial on the skin and provides bioavailable nutrients to the skin. 

As we use live cells, which are neither extracts nor ferments, we do not use preservatives.  Not only would the probiotic strain(s) in question perish, but this would also be damaging to the delicate strains that exist in the microflora of the skin, thus negatively impacting the biodiversity of the microbiota. This is a factor to keep in mind when evaluating skincare that is often mislabeled as probiotic skincare. If it is shelf stable and contains preservative, it is quite likely that the "probiotic" is simply in name and inactive.

The probiotic care of yogurt cannot colonize the skin microbiome or cause dysbiosis, just as it cannot do so in the gut. Furthermore, yogurt has been used on the skin by numerous cultures and for centuries to good effect. While not an option for vegans, we know (and this is worth a great deal) that it does no harm. Furthermore, yogurt cleanses the face gently and effectively without stripping away the acid mantle, thereby allowing the microflora of the skin to live at a good ph and help strengthen the skin barrier.  

Our prebiotic cleansing powder NOMAD is another food (this time not fermented), but minimally processed dried fruit and flower that nourishes the skin's resident bacterial, again, helping to strengthen our natural microflora.  

We are in for a lot of exciting discovery within the field of the human microbiome, if we can just get out of our own way. I'll leave you with a poem that always comes to mind when I think of our bodies--host and bacteria, and all that we go through--in sickness and in health. It gives me much needed perspective. 


The Guest House

This being human is a guest house.
Every morning a new arrival.

A joy, a depression, a meanness,
some momentary awareness comes
as an unexpected visitor.

Welcome and entertain them all!
Even if they are a crowd of sorrows,
who violently sweep your house
empty of its furniture,
still, treat each guest honorably.
He may be clearing you out
for some new delight.

The dark thought, the shame, the malice.
meet them at the door laughing and invite them in.

Be grateful for whatever comes.
because each has been sent
as a guide from beyond.

— Jellaludin Rumi







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