The skin microbiome

outline

A SECOND SKIN
The gut is not the only part of the human body that hosts an important microbiome. The surface of the skin is home to a
sprawling and complex microbial ecosystem, which interacts with the immune system and influences dermatological health.
By Michael Eisenstein; infographic by Lucy Reading-Ikkanda

MICROBIAL NICHES HEALTHY COLLABORATIONS

The skin contains a diverse microbial The skin is a largely dry and nutrient-poor environment, but some microbes such as
ecosystem, which is seeded at birth, but Staphylococcus epidermidis and Cutibacterium acnes are able to survive. These skin residents
evolves until a person reaches sexual maturity. communicate with host cells and help to defend against infection and injury2.

Relative abundance of bacteria, eukaryotes

and viruses on the skin of healthy adults1
Bacteria Eukaryotes
OILY SKIN
(for example, ear folds
and forehead)
This area is home to
bacteria that consume
lipids, such as
Staphylococcus
spp. and Cutibacterium
acnes, particularly
during puberty, when
sebum production increases.
Viruses Pathogens
Certain bacteria produce
chemicals that suppress
Peptides inflammation and help to
reinforce tight cell
Bacteria, such as contacts that allow the
S. epidermidis, skin to act as a barrier.
secrete antimicrobial
peptides that prevent
pathogen invasion.

MOIST SKIN
(for example, the Keratinocytes
groin and armpit)
Sweat attracts species
of Corynebacterium
and Staphylococcus,
which contribute EPIDERMAL
to body odour. LAYER
Dendritic
cell

DRY SKIN
(for example, the
forearms and palms) DERMAL
LAYER
Dry skin has the most Sebaceous
diverse microbiome, gland
which is rich in species Some bacteria
of Betaproteobacteria interact with
and Flavobacteriales. immune cells called
dendritic cells to
summon cytotoxic
T cells, accelerating
wound healing.
THE FEET
Feet have their own Cytotoxic
distinctive ecosystem. T cells
The community is made
up mainly of bacteria,
but the fungi present
are much more diverse Context matters
than in other areas of
the body. Away from the skin community,
S. epidermidis can cause
serious opportunistic infections
by producing proteases that
stick the bacteria to the surface
References: 1. Byrd, A., Belkaid, Y. & Segre, J. of medical devices, such as
Nature Rev. Microbiol. 16, 143–155 (2018); 2. Bacteria and cells are not to scale. venous catheters.
Flowers, L. & Grice, E. A. Cell Host Microbe 28,
190–200 (2020); 3. Scharschmidt, T. C. et al.
Immunity 43, 1011–1021 (2015).

S210 | Nature | Vol 588 | 17 December 2020

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 Watch an animation
at go.nature.com/
collections/skin-
microbiome-outline

TURF WARS LEAD TO DISEASE

The bacterium Staphylococcus aureus is associated with atopic dermatitis, a form of eczema common in
children that can give rise to other allergies later in life. Several beneficial species of Staphylococcus
normally protect against S. aureus, but genetics, and possibly environmental and lifestyle factors, can
mean this balance of power is disturbed in some individuals, making them susceptible to the condition.

Protected Vulnerable

Bacteria, such as C. acnes,

digest lipids to create an S. aureus
acidic environment that is
inhospitable to pathogens.

1
Different strains Beneficial Bacteria block
Staphylococcus ‘quorum sensing‘ S. aureus produces
Certain strains of C. acnes enzymes that
produce pro-inflammatory species produce signals produced
antibiotics by S. aureus that allow the bacteria
molecules, creating the to disrupt the
redness and sores associated against S. aureus. would initiate
aggressive epidermal barrier
with acne. This production is and break through.
exacerbated by high levels of infection. Enzymes
vitamin B12.

2
Cytotoxic S. aureus secretes
T cells molecules that
elicit a strong
T-cell immune
response.

Environmental
Mast antigens
cell 3
The signals also attract
Soon after a baby is immune cells called mast
born, S. epidermidis in cells, which help to fuel
hair follicles helps to atopic dermatitis and other
recruit regulatory Regulatory allergic reactions to
T cells that train the T cells environmental antigens,
immune system to which can now cross the
protect skin microbes3. damaged skin.

Nature | Vol 588 | 17 December 2020 | S211

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