EXPLORING THE POTENTIAL OF MICROBIOME-CONTAINING MOISTURIZERS IN MANAGING ATOPIC DERMATITIS

Atopic dermatitis (AD) is a chronic inflammatory skin disorder driven by barrier dysfunction, immune dysregulation, and microbiome dysbiosis, affecting up to 20% of children worldwide. This review explores the pathophysiology of AD, emphasizing epidermal defects like filaggrin mutations, elevated pH, and reduced antimicrobial peptides that promote Staphylococcus aureus overgrowth and Th2 inflammation. The gut-skin axis also plays a contributory role, with gut dysbiosis reducing short-chain fatty acids and increasing skin flares. The function of the skin microbiome in immune modulation is also discussed, with commensals such as S. epidermidis synthesizing antimicrobials and inducing T-cell responses through Toll-like receptors. However, age-related changes may disrupt this homeostasis. Microbiome-based moisturizers (prebiotics, probiotics, postbiotics, and synbiotics) have become innovative treatments that help in restoring eubiosis, reducing pH, and increasing hydration. Clinical data, including RCTs and meta-analyses from 2024 to 2025, report improved SCORAD scores, decreased transepidermal water loss, and microbiome normalization, as well as prevention in infants. These non-steroidal alternatives supplement conventional treatment, providing better long-term control.