Assoc. Dr. Vesela Raykova has 20 years of practice as a microbiologist and 10 years of clinical practice in dermatology. He teaches at the Medical University in Sofia at the Department of "Medical Microbiology" and leads the Laboratory of Sexually Transmitted Diseases. He is a dermatologist at a metropolitan aesthetic clinic. We talk to Prof. Raykova about the role of the microbiome in skin he alth.
Associate Professor Raykova, what is the microbiome of the human body and especially that of the skin?
- Our body is not sterile. We coexist with many microorganisms. Their totality determines the so-called microbiome of the human body. How we will feel and whether we will be he althy depends to a large extent on the coexistence of microorganisms on and in our body. Our normal flora (the microbiome) has a positive effect on the skin, the digestive tract, the nervous system, the endocrine system.
We acquire our microbiome at the time of birth, when the child passes through the mother's natural birth canal and when breastfed. Over time, it is gradually enriched. A baby's microbiome is different from that of a toddler, an active young person, and an older adult. Normal flora changes because it is affected by physiological processes in the human body, as well as environmental factors.
As an example, I can give the acidity of the body, which changes, causing some microorganisms to disappear or greatly decrease in concentration, while others increase. The change in temperature also affects the flora. However, she has an optimal range in which she thrives best, and when that is disturbed, they change.
The presence or absence of the water-lipid film on our skin, created by the sebaceous and sweat glands, also determines the type and functioning of the microbiome. In reality, the microbiome adapts to us, but so do we. We live in symbiosis. For us to be he althy, this micromyoma must be kept in balance. If antibiotics are taken, for example, which aim to fight disease-causing microorganisms, they also affect the normal flora and thus the balance is disturbed. And this is a prerequisite for the development of disease states.
How to restore the balance of the microbiome if we have taken antibiotics?
- A direct link has been found between the microbiome of the skin and that of the gastrointestinal tract. When taking antibiotics, the normal flora in the body is suppressed. The recommendation is for her to recover. This is done by taking probiotics, which restore the concentration of intestinal microorganisms and restore the balance between microorganisms in our body. In addition to probiotics, there are also prebiotics that support the functioning of the microbes in the probiotics. And the so-called are increasingly used. symbiotics - preparations that are a combination of probiotics and prebiotics. They can be taken orally, but are now available that are applied through cosmetic products to the skin.
Assoc. Dr. Vesela Raykova
Does this mean that it is enough to take symbiotics to normalize the skin microbiome as well?
- Not enough. The way of life, the presence of chronic stress, nutrition, physical activity and sports, as well as the sleep and rest regime are also important. These factors in combination with symbiotics can work together and maximize their effect.
Does the condition of the skin depend on stress and on our emotional state?
- Yes, of course. With chronic stress in the body, the secretion of the hormones adrenaline and cortisol increases. They stimulate the heart and lung function, but damage the quality of the skin. When a person is stressed, the blood flow to the skin is reduced and the nutrient flow is reduced accordingly. Hence, the concentration of antioxidants, as well as the saturation of the area with oxygen, is lowered. Gradually, the skin begins to wither, fine lines and wrinkles form in it, its color changes - it becomes uneven, dryness, redness and the appearance of dermatitis conditions are observed, which are the basis for subsequent skin diseases.
What do you advise your patients whose skin has been badly affected by stress but has not yet progressed to severe skin disease?
- In addition to probiotics, it is appropriate to take the so-called superfoods and adaptogens.
Superfoods are nutritional supplements, unique in their content of nutrients in a natural and unprocessed form - closest and natural to our body. They are a source of proteins, vitamins, minerals, essential polysaccharides, antioxidants, enzymes and essential fatty acids. They are useful for the body and the immune system, but they also affect the detoxification of the body and maintain the body's balance. Examples of superfoods are chia seeds, goji berries, hemp seeds and spirulina, coconut oil, wheat grass and many more.
Adaptogens, in turn, support the body's vital functions during stress and overwork, heavy physical or mental exertion, cold, heat, radiation, high altitude, change of seasons. Adaptogens are herbs containing specific substances. They are considered an alternative to stimulants and nootropics.
An example of an adaptogen is rhodiola (golden root), ginseng, ashwagandha, etc. I am convinced that the combination of the above substances, longer and quality sleep plus regular sports restore not only the microbiome of the skin, but the vitality of the whole body, which also affects the he alth and radiance of the skin.
Does skin specific immunity exist?
- The skin is the organ that separates and protects our body from the environment, which first meets the impact of external factors. And to deal with different aggressors, the skin exhibits different defense mechanisms. For example, the epidermis, which is the outermost part of our skin, is made up of multiple layers of cells whose characteristics change from the bottom to the top layer. Nature has made it so that the cells of the lowest layer within 25 to 28 days are gradually pushed up to the outside world, and the outermost ones become more resistant to environmental factors. And if a disease-causing microorganism gets into the deeper layers of the skin, it will be pushed out purely mechanically.
Another defense mechanism of our skin is its acidity and pH. They are determined by the many glands in it, secreting substances that protect us. This film does not allow external factors to negatively affect its function.
Antibodies of the immunoglobulin A class are also found in our skin, which are the first to specifically fight pathogenic microorganisms and prevent their attachment to sensitive cells. And this is the connection between the non-specific and specific protection of our body, the connection between the innate immunity on the part of the skin and that provided by the immune system. Last but not least, a protective mechanism of our skin is the presence of normal flora in it and on its surface.
What signals does our skin send us and when should we consult a dermatologist?
- When the skin becomes more sensitive, when it starts to change color, when the feeling of dryness, irritation or itching appears, a specialist should be sought and taken care of in time to avoid the development of more severe conditions. My advice is not to self-medicate. Often the manifestations of different skin conditions look very close or identical. And in order to make the most adequate decision about what the skin needs, a correct diagnosis is necessary. And that, after all, is the job of specialist dermatologists.