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Innovation

7 Questions for a Researcher Who's Spent a Decade Studying the Skin Microbiome of Kids and Their Moms

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30 mothers. Their 31 children. Ten years ago, Kimberly Capone, Ph.D., set out to study the ways the microorganisms living on their skin evolved over time—and what that could mean for our understanding of skin health. She shares the groundbreaking results.
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ention the word “microbiome” and you likely think about what’s going on in your gut. But your microbiome—the ever-changing mix of good and bad bacteria that live in your body—plays a role in more than just your digestive tract. Your skin actually has its own network of microbes, consisting of bacteria, fungus, mites and viruses.

Your immediate reaction may be to recoil in horror. But rest assured, this is a good thing: These bacteria that take residence on your skin are not there to attack you, but to fend off potential invaders—and help manage such skin conditions as eczema, atopic dermatitis and acne.

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Kimberly Capone, Ph.D., Head of the Microbiome Platform, Johnson & Johnson Consumer Health

“Part of the job of the microbiome is to protect us," says Kimberly Capone, Ph.D. Kimberly Capone, Ph.D., Head of the Microbiome Platform, Johnson & Johnson Consumer Health, Head of the Microbiome Platform, Johnson & Johnson Consumer Health. "These microbiota are our partners, so to speak, to help us interact with the world safely.”

It's a relationship that has fascinated Dr. Capone for the past ten years, when she first set out to learn more about the ways the skin microbiome behaves and potentially changes—and what the implications of this are—by launching a study with 30 mothers and their 31 children over time. This longitudinal study, which is the longest of its kind, was recently presented at the 2020 American Academy of Dermatology annual meeting.

We spoke to Dr. Capone about the study, as well as how her scientific discoveries provide strong evidence of the evolving nature of our skin microbiome, how that relates to skin barrier development—and how she hopes that what she has uncovered can help inform products that could support the microbiome from infancy through adulthood.

Q:

What is the human microbiome, and what role does it play in our skin?

A:

The microbiome refers to the colonies of bacteria that exist in and all over our bodies. There’s been a lot of focus lately on the microbiome in the gut, and how important that is to overall health. But we’re now learning that the bacteria on your skin may be just as important because they serve to protect us from picking up germs in the environment. Everything we touch—whether it’s a bottle of water, a pet or someone's arm—introduces new microbes to our skin.

In short, the microbiome acts as a barrier between your skin and the outside world. And the bacteria that inhabit this barrier can influence the way your skin looks, feels and behaves: The right mix of microbes helps to keep inflammation at bay, which can help combat dozens of skin conditions, including rosacea, acne, eczema and psoriasis.

For example, when you have a skin condition like eczema, your outer layer of skin is weaker, which makes it easier for outside microbes to get in. As a result, unhealthy bacteria can overtake the healthy ones.

Q:

How is our microbiome established?

A:

Believe it or not, it begins at birth. Babies are exposed to vaginal bacteria as they make their way through the birth canal. Infants who are born via C-section don’t get that same exposure, and as a result, have a delay in the development of their gut microbiome.

Research actually shows that these babies are at higher risk of developing allergies and asthma, and we think it’s because these organisms in the microbiome help to build our immune system and kick-start our understanding of the environment. Each person’s microbiome is unique to only them, sort of like our own flora-filled fingerprint.

We discovered that the makeup of the skin microbiome is significantly different in children compared to adults—their skin is colonized by completely different types of bacteria.

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Q:

Ten years is a long time for a study. How did you do it?

A:

At Johnson & Johnson we strive to understand what’s going on both on, and inside, the skin. This research helped shed light on how the microbiome changes over time. How does it evolve? How does it relate to health and disease? What can we do to help maintain, and not disrupt, the healthy changes that occur? How do we give our skin the chance at having the best, most healthy ecosystem it can have?

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A study participant at the beginning and end of the study

When it came to our actual research, we enrolled 30 moms and 31 of their children, aged three months to one year. We periodically examined their forearms and foreheads, rubbing a small area of their skin with a sterile swab and then analyzing it to figure out exactly what organisms were on it.

We saw that the microbiome was more diverse in older infants (between seven to 12 months) than younger ones (between one and three months), so we knew their microbiome was still evolving. So we decided to continue following them to see how their microbiome kept changing. And this lasted for a decade!

Q:

What was the most surprising finding?

A:

There were a few. First of all, we discovered that the makeup of the skin microbiome is significantly different in children compared to adults—their skin is colonized by completely different types of bacteria. This is most likely because, as adults, we have more lipids (an organic compound) in our skin, which a certain type of bacteria loves to feed on.

Another interesting finding is the study confirmed that the skin of older children is still evolving, even at age ten.

Finally, contrary to what we previously believed, our research showed that the skin microbiome does change in adulthood. We found that while the mothers’ microbial diversity remained stable over time, the bacteria itself increased in richness. This means we saw a rise in the number of different kinds of bacteria present on their skin.

Q:

What do you think accounts for the change in the moms’ microbiomes?

A:

What's interesting is that previous studies on women have not shown these same findings. But those studies were not specifically of mothers. While we don’t know for sure, my hunch is this is related to these moms' interactions with their children, and their children’s changing behaviors, diet and microbiome.

We know that when we give birth, we’re providing microbes to our children, so it’s interesting to see some evidence that this sharing continues over time, and goes back and forth. Exactly what effect it could have on mom’s skin and her microbiome remains to be seen, but it’s something we can look into further.

We’re a human and microbial partnership that is constantly influenced by what’s going on around us. And, in turn, we influence our surroundings.

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Q:

Are there cleansers that are better (or worse) for your microbiome?

A:

Potentially. We did a second study that looked at 89 healthy women over four weeks using six different cleansers, ranging in pH (how acidic the solution is). We wanted to understand how use of a daily cleanser could change the microbiome, which is something there's never been a longitudinal study on before.

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Products from the Johnson's® CottonTouch™ line

We found that the skin microbiome of all our participants was maintained with all six cleansers. However, we also found that the cleanser with the highest pH had a drying effect. We think that eventually, as the skin barrier continues to be irritated, it could start to break down and then you’d see changes in the microbiome as a result.

We also have some interesting research on the Johnson's® CottonTouch™ wash and lotion that found the use of these products helped to maintain diversity in the infant skin microbiome after just four weeks. Since the skin microbiome is evolving in children, the use of a lotion may set the groundwork for a better microbiome—one associated with healthy, moisturized skin.

Q:

So, what can we learn from this?

A:

I think the most exciting thing we confirmed is that we don’t simply come into this world, get colonized by microbes, and live with those forever on our skin. We’re a human and microbial partnership that is constantly influenced by what’s going on around us. And, in turn, we influence our surroundings.

The organisms evolve with us over time and provide various functions for our skin. The hope is that we can use what we’ve learned and harness that information to keep the skin healthy—or bring it back to health if things go awry.

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