The dual role of skin microbiome modulation in precision care for atopic dermatitis: A review

Atopic dermatitis (AD), a complex dermatological disorder characterized by chronic inflammation and skin barrier dysfunction, serves as a prototypical chronic inflammatory skin disease whose pathogenesis is intricately linked to dysbiosis of the skin microbiota. Modulating the skin microbiota to restore microbial homeostasis has emerged as a crucial dimension in AD management and a focal point of contemporary research. This comprehensive review examines the pivotal role of cutaneous microbiota in both the initiation and progression of AD, with particular emphasis on the profound implications of microbial dysbiosis for skin barrier integrity and inflammatory cascades. Building upon recent scientific evidence, we systematically elaborate innovative applications of microbiota modulation in AD care, elucidating the mechanistic foundations of emerging intervention strategies and their demonstrated clinical efficacy, thereby offering novel perspectives for precision medicine in AD management. Furthermore, we critically evaluate current limitations in AD-related skin microbiome research and propose future research trajectories, establishing both theoretical frameworks and practical guidelines for advancing clinical translation of cutaneous microbiome investigations.