What lives on your skin?

On every surface, including human skin, lives a community of microorganisms (1). This can include bacteria, yeast, fungi, protists, and viruses. It’s why we wash our hands after coughing, smell after sweating, and are prescribed antibiotics when sick. ‘Bad’ bacteria are talked about all the time, but what about the good stuff?

Microorganisms have been around for almost 4 billion years, while humans have only existed for 8 to 9 million years. We have evolved with microbes in and around us, with our health dependent on having a balance of more ‘good’ bacteria than bad (2). Bacteria are essential for making essential vitamins, fatty acids, amino acids, and other things that are needed to make our bodies function. They protect and support us as little building blocks of life.

As our world transforms with technology, pharmacology, and climate change – our microbiome is impacted. Even lifestyle plays a role as location, hygiene, and cosmetics affect our skin health (3). In general, the more diverse the microbiome, the healthier it is. Having a variety of good bacteria improves the functioning and resilience of our microbiome (4). Researchers from NYU Langone Medical Center discovered the most diverse microbiome belongs to an isolated tribe of Yanomami Indians in the remote Amazonian jungles (5). Despite having no known exposure to antibiotics, the Yanomami have bacteria which have antibiotic properties. These findings suggest that westernization significantly impacts microbiome diversity and that antibiotic strains of bacteria may be a part of the human microbiome without pharmaceutical intervention. 

Juliana Durack, PhD VP of Research and Product Development at Symbiome, a human microbiome discovery company, describes, “The Yanomami people are a rare community of humans who lack most of the inflammatory skin conditions that are commonly seen in the industrialized parts of the world. Studying their microbiome provides an extraordinary opportunity to discover how problems like acne and eczema have emerged and how we may find more natural and safer ways to prevent or treat these problems.” 

Additional evidence suggests that being outdoors and making contact with plants and soil can positively
impact skin microbiome (6). Further research would allow us to better understand how we evolved with our environment and explore our microbial roots.

References:

  1. Grice EA, Segre JA. The skin microbiome [published correction appears in Nat Rev Microbiol. 2011 Aug;9(8):626]. Nat Rev Microbiol. 2011;9(4):244-253. doi:10.1038/nrmicro2537
  2. Zhang YJ, Li S, Gan RY, Zhou T, Xu DP, Li HB. Impacts of gut bacteria on human health and diseases. Int J Mol Sci. 2015;16(4):7493-7519. Published 2015 Apr 2. doi:10.3390/ijms16047493
  3. Boxberger M, Cenizo V, Cassir N, La Scola B. Challenges in exploring and manipulating the human skin microbiome. Microbiome. 2021;9(1):125. Published 2021 May 30. doi:10.1186/s40168-021-01062-5
  4. Skowron K, Bauza-Kaszewska J, et al. Human Skin Microbiome: Impact of Intrinsic and Extrinsic Factors on Skin Microbiota. Microorganisms. 2021; 9(3):543. https://doi.org/10.3390/microorganisms9030543
  5. Lozupone CA, Stombaugh JI, Gordon JI, Jansson JK, Knight R. Diversity, stability and resilience of the human gut microbiota. Nature. 2012;489(7415):220-230. doi:10.1038/nature11550
  6. Clemente JC, Pehrsson EC, Blaser MJ, et al. The microbiome of uncontacted Amerindians. Sci Adv. 2015;1(3):e1500183. doi:10.1126/sciadv.1500183
  7. Grönroos M, Parajuli A, Laitinen OH, et al. Short-term direct contact with soil and plant materials leads to an immediate increase in diversity of skin microbiota. Microbiologyopen. 2019;8(3):e00645. doi:10.1002/mbo3.645
  8. Moitinho-Silva L, Boraczynski N, Emmert H, et al. Host traits, lifestyle and environment are associated with human skin bacteria. Br J Dermatol. 2021;185(3):573-584. doi:10.1111/bjd.20072

Research showing treatment for opioid withdrawal

Opioids are a class of drugs commonly prescribed to treat pain and include drugs like oxycontin, vicodin, dilaudid, and morphine. With over 10 million people reporting misusing prescription opioids in 2020, America is facing an epidemic (1).  The Biden administration is providing $1.5 billion to states and territories, including tribal lands, to fund responses to opioid overdoses and support recovery (2). Opioid withdrawal symptoms are painful and can feel like having the flu. People can experience gastro-intestinal complaints, heart pounding, trouble sleeping, sweating, restlessness, tremor, and more. The intensity and duration of these symptoms is often severe, posing a significant challenge to those wanting to stop using their opioid pain medication. In addition to physical problems, there is a significant psychological challenge from the stigma associated with opioid addiction. Dr. Paul Williams is a family physician affiliated with the University of Pittsburgh Medical Center in Harrisburg who cares for many patients suffering from Opioid Use Disorder (OUD). He shares, “Patients desperately want to quit, but the fear of having to experience the severe withdrawal symptoms is preventing them from trying to quit. We need a way to decrease withdrawal symptoms so that patients can taper off and stay off opiates.”

In response to the epidemic, state and federal governments have increased funding for opioid withdrawal therapy. Current medication-assisted treatments (MAT) for opioid dependency include methadone, buprenorphine, and naltrexone. These are controlled substances that are prescribed just like opioids and while they can help reduce OUD cravings they are not holistic solutions. The aim of these treatments is to replace current opioid use and/or abuse with these prescription medicines while gradually tapering down on dose. While these treatments are effective, once an individual is stabilized on the new replacement medications, they often experience craving and withdrawal symptoms each time their dosage is reduced. These experiences add to the psychological burden of stigma because patients using MAT therapies may be perceived as replacing one opioid for another. Despite the growing availability of MAT, the American Medical Association recently released a report (3) that found barriers to care have worsened the epidemic. Thus, there is an urgent need for more treatment solutions where the added value of non-opioid treatments could impact psychological wellbeing as well.

There is promising early research (4) showing that a combination of specific over-the-counter antihistamines and non-steroidal pain medications like ibuprofen can reduce the intensity and duration of withdrawal symptoms. By targeting inflammation, scientists believe that these medicines can be repurposed in a combination that can both treat pain and decrease withdrawal symptoms through an anti-inflammatory process. These findings are also very important because these commonly used non-opioid medicines are proven to be safe when used appropriately. As a result, this will make it easier and faster to test these new treatments. More research will be coming as physicians and scientists collaborate to take care of patients suffering from OUD.

References:

  1. U.S. Department of Health & Human Services “What is the U.S. Opioid Epidemic”, https://www.hhs.gov/opioids/about-the-epidemic/index.html
  2. https://thehill.com/homenews/administration/3658025-biden-announces-1-5b-in-funding-to-battle-opioid-overdoses-support-recovery/
  3. American Medical Association 2022 Overdose Epidemic Report, https://end-overdose-epidemic.org/wp-content/uploads/2022/09/AMA-Advocacy-2022-Overdose-Epidemic-Report_090622.pdf
  4. Verster JC, Scholey A, Dahl TA, Iversen JM. Functional observation after morphine withdrawal: effects of SJP-005. Psychopharmacology (Berl). 2021;238(6):1449-1460. doi:10.1007/s00213-021-05771-5