SKIN MICROBIOME IN SEBORRHEIC DERMATITIS: PATHOGENESIS, THERAPEUTIC IMPLICATIONS, AND ENVIRONMENTAL MODULATION OF DYSBIOSIS

Seborrheic dermatitis (SD) is one of the most commonly diagnosed inflammatory dermatoses. In recent years, the approach to the pathogenesis of SD has been expanded beyond the model describing the proliferation of fungi of the genus Malassezia as the main initiating factor. More recent studies have indicated that one of the key mechanisms is the loss of diversity of the skin microbiota, which enables the dominance of microorganisms promoting the exacerbation of disease lesions. Current reports emphasize the impact of disturbances in the composition of the skin microbiota, impairment of the epidermal barrier, and the host immune response as a complex pathomechanism. In parallel, the literature provides numerous lines of evidence indicating that environmental factors, such as pollution and lifestyle, may actively affect the skin microbiome, promoting its dysbiosis. Consequently, the environment may be considered as one of the factors actively modulating the disease and an important element in the context of personalized therapy aimed at maintaining microbiological balance. The aim of this study is to present current research describing the impact of environmental factors on the development of skin dysbiosis and to discuss a perspective focused on restoring the balance of the skin microbiota and its protective mechanisms as a potential element positively influencing the clinical presentation in patients with seborrheic dermatitis. Disruption of the skin microbiome balance constitutes a key element in the pathogenesis of seborrheic dermatitis, which justifies a therapeutic approach aimed at restoring microbiological homeostasis in order to achieve and maintain disease remission.