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The effect of antibacterials on the skin

The effect of antibacterials on the skin
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Your skin has its own little ecosystem, with over a thousand species of bacteria taking up prime skin real estate. Each square centimeter of your skin contains about a million microbes. When you apply antibacterials, like soap or sanitiser, you kill many of them. Some come back quickly, while others disappear forever.

What common microbe families live on my skin?

  • Actinobacteria
  • Firmicutes (like staph)
  • Proteobacteria
  • Bacteriodetes
  • Fungi (Malassezia species)
  • Mites (Demodex species)

Residents versus transients

Some of these bacteria live on your skin all the time, while others are just passing through: residents and transients, just like regular neighbourhoods. Residents come back quickly after cleansing, while transients, because they have no roots in the ‘hood, can be washed away, never to return.

Skin bacteria are natural, normal and healthy, and in fact you need them to be well. We would die if we were completely sterile, which is all but impossible anyway. The healthy microbes that normally live on skin and conversely the bad microbes that cause infections are called commensal and pathogenic.

We want to keep the goodies and manage the baddies. Some pathogens isn’t necessarily a bad thing – it’s when the good microbes are run out of town that we’re in trouble, since the pathogens can take over and rule the roost. This is when you can get an infection. Transient microbes may have more pathogenic potential than commensal bacteria, but balance is critical. You need your good bacteria to keep the bad bacteria in check.

Many skin conditions come with an imbalance in your microbes (chicken or egg, we’re not sure), with eczema being a classic example, thought to be linked with staph aureus. Staph is found in over 90 per cent of eczema patients, though it is naturally found in our nose, where it likes to live – harmlessly. The minute the skin gets broken, however, staph can wreak havoc, causing infections.

Should I use antibacterials or not? 

Generally it is advised to avoid antibacterials, because they are designed to alter your microbial balance – you wouldn’t take antibiotics ‘just because’, so don’t do the same to your skin. If you have a healthy skin microbiome, you only damage it by using antimicrobials, but it is true that on the other hand, if you have staph on your skin, it will help by killing a pathogen.

It’s better to use ordinary cleansing methods where possible to keep your microbiome intact, but your skin clean and undamaged. Normal hand-washing and showering techniques are perfectly acceptable. We advise that unless you are specifically told to, avoid using antibacterials – that is antibacterial soap, sanitisers, deodorants, and creams on the skin.

Not sure what to do with your skin?
We are expert dermatologists.

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