Skin health: Managing the skin microbiome
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Unit 619
February 2025
The purpose of this activity is to provide an understanding of the human skin microbiome and its interplay with skin physiology to guide a low-risk management strategy for primary, chronic and secondary skin conditions that regularly present in clinic.
Our understanding of the human skin microbiome and its interplay with skin physiology is increasing. This emerging knowledge can be used in general practice to guide a low-risk management strategy for primary, chronic and secondary skin conditions that regularly present in clinic.
The difference in the evidence base and regulatory requirements for therapeutic goods and cosmetics is vast. Yet, as practitioners, we rely on both almost equally for the treatment of many dermatological conditions.
Moisturisers, soaps, shampoos, cleansers and emollients form the backbone of many treatment guidelines. However, as cosmetics are not subject to therapeutic regulations, the labelling claims on these products often have no validity in the medical sphere.
By drawing on recent advances in our knowledge of the skin microbiome and physiology, we can start to apply evidence when selecting these ‘inert’ cosmetic products for moisturising and cleansing the skin. A knowledge of how the skin microbiome functions, and the ideal pH value for this, can be useful if you experience treatment failure, if patients are unwilling to comply with involved treatment regimens and review processes or when traditional treatments risk disease or impair medication uptake (eg oral anti-fungal medications). In such instances, general practitioners may choose to augment treatment with topical options. These techniques can be applied either as standalone treatments or as adjuncts to traditional treatments.
At the end of this activity, participants will be able to:
Ashley, a shy girl of average weight and height, aged 17 years, presents to clinic with her mother. She is concerned about her skin, which is not clearing up despite ‘using everything’.
Ashley is distressed about her acne as nothing she has tried has worked. She views the condition of her skin as an impediment to socialising.
Lee, female and aged 53 years, has been amenorrhoeaic for 12 months. She has an appointment with you to discuss the results of blood tests confirming her menopausal status, but the main reason for her visit today is the dryness of her skin.
Flick, aged 58 years, has been on a disability pension for more than 15 years. She hobbles into the clinic using her walking stick for support. Flick has type 2 diabetes and is also managing hypertension with medications. She is mildly obese. She complains that a mosquito bite she received a few months ago has turned ‘a bit nasty’, and this is the first time she has had it looked at. You notice that she is slightly breathless but speaking in full sentences.
Frank, aged 35 years and a patient at your clinic for over 20 years, presents for a skin check. Frank’s family emigrated from Ireland when he was aged three years. Being of Irish descent, his skin is not genetically suited to the Australian conditions; you rate his skin as Fitzpatrick skin type II. When he was young, shirts, sunscreen and shade came a poor second to enjoying time at the pool with his mates, and he received multiple sunburns.
Each unit of check comprises approximately five clinical cases, and the choice of cases will cover the broad spectrum of the unit’s topic. Each unit will be led by a GP with an interest and capability in the topic, and they will scope the five different cases for that unit in collaboration with the check team.