Recent advances in understanding the role of the skin microbiome in the treatment of atopic dermatitis
Open accessAbstract
The skin is the largest organ in the human body, and histologically consists of the epidermis, dermis and subcutaneous tissue. Humans maintain a cooperative symbiotic relationship with their skin microbiota, a complex community of bacteria, fungi and viruses that live on the surface of the skin, and which act as a barrier to protect the body from the inside and outside. The skin is a ‘habitat’ and vast ‘ecosystem’ inhabited by countless microbes; as such, relationships have been forged through millions of years of coevolution. It is not surprising then that microbes are key participants in shaping and maintaining essential physiological processes. In addition to maintaining barrier function, the unique symbiotic microbiota that colonizes the skin increases the immune response and provides protection against pathogenic microbes. This review examines our current understanding of skin microbes in shaping and enhancing the skin barrier, as well as skin microbiome–host interactions and their roles in skin diseases, such as atopic dermatitis (AD). We also report on the current status of AD therapeutic drugs that target the skin microbiome, related research on current therapeutic strategies, and the limitations and future considerations of skin microbiome research. In particular, as a future strategy, we discuss the need for a skin‐on‐a‐chip‐based microphysiological system research model amenable to biomimetic in vitro studies and human skin equivalent models, including skin appendages.
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Recent therapies, such as dupilumab and tralokinumab, favor skin microbiota rebalancing in patients with AD.
“Recent therapies, such as dupilumab and tralokinumab, favor skin microbiota rebalancing in patients with AD.94, 105”
From Update on the pathogenesis of atopic dermatitis. (2024) · cites this paper as [94]
Section 8 discusses therapies intended to restore a healthy skin microbiome in patients with atopic dermatitis, but does not identify dupilumab or tralokinumab as doing so. Searches for each drug name found no passage addressing its effect on skin microbiota; the general discussion does not establish the claim about these therapies. (LLM, conf=0.72)
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Tryptophan Metabolism in Allergic Disorders
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Manipulating Microbiota to Treat Atopic Dermatitis: Functions and Therapies
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Skin Microbiome—The Next Frontier for Probiotic Intervention
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Self-citationPotential role of the skin microbiota in Inflammatory skin diseases
Chen, P., He, G., Qian, J., Zhan, Y., & Xiao, R. (2020) · Journal of Cosmetic Dermatology · doi:10.1111/jocd.13538 · Cited by 66 · see citing works
Microbiome therapeutics go small molecule
Cully, M. (2019) · Nature Reviews Drug Discovery · doi:10.1038/d41573-019-00122-8 · Cited by 63 · see citing works
Martins, A. M., Ascenso, A., Ribeiro, H. M., & Marto, J. M. (2020) · Cells · doi:10.3390/cells9040796 · Cited by 60 · see citing works
Fabrication of a pumpless, microfluidic skin chip from different collagen sources
Song, H. J., Lim, H. Y., Chun, W., Choi, K. C., Sung, J. H., & Sung, G. Y. (2017) · Journal of Industrial and Engineering Chemistry · doi:10.1016/j.jiec.2017.07.034 · Cited by 58 · see citing works
Self-citationPaulino, L. C. (2017) · European Journal of Dermatology · doi:10.1684/ejd.2017.3038 · Cited by 57 · see citing works
van de Guchte, M., Burz, S. D., Cadiou, J., Wu, J., Mondot, S., Blottière, H. M., & Dore, J. M. (2020) · Microbiome · doi:10.1186/s40168-020-00933-7 · Cited by 55 · see citing works
Development of 3D skin-equivalent in a pump-less microfluidic chip
Song, H. J., Lim, H. Y., Chun, W., Choi, K. C., Lee, T.-Y., Sung, J. H., & Sung, G. Y. (2017) · Journal of Industrial and Engineering Chemistry · doi:10.1016/j.jiec.2017.11.022 · Cited by 54 · see citing works
Self-citationThe emerging utility of the cutaneous microbiome in the treatment of acne and atopic dermatitis
Woo, T. E., & Sibley, C. D. (2020) · Journal of the American Academy of Dermatology · doi:10.1016/j.jaad.2019.08.078 · Cited by 51 · see citing works
Side-effect test of sorafenib using 3-D skin equivalent based on microfluidic skin-on-a-chip
Jeon, H. M., Kim, K., Choi, K. C., & Sung, G. Y. (2019) · Journal of Industrial and Engineering Chemistry · doi:10.1016/j.jiec.2019.09.044 · Cited by 51 · see citing works
Self-citationWeiss, A., Delavenne, E., Matias, C. S. S., Lagler, H., Simon, D., Li, P., Hansen, J. U., dos Santos, T. P., Jana, B., Priemel, P. A., et al. (2022) · Clinical and Translational Medicine · doi:10.1002/ctm2.790 · Cited by 51 · see citing works
ExploringStaphylococcus epidermidisin atopic eczema: friend or foe?
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AL-Ishaq, R. K., Skariah, S., & Büsselberg, D. (2020) · Viruses · doi:10.3390/v13010051 · Cited by 48 · see citing works
Jeong, S., Kim, J., Jeon, H. M., Kim, K., & Sung, G. Y. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms222312788 · Cited by 46 · see citing works
Self-citationShimamori, Y., Pramono, A. K., Kitao, T., Suzuki, T., Aizawa, S.-I., Kubori, T., Nagai, H., Takeda, S., & Ando, H. (2021) · Current Microbiology · doi:10.1007/s00284-021-02395-y · Cited by 45 · see citing works
Guéniche, A., Périn, O., Bouslimani, A., Landemaine, L., Misra, N., Cupferman, S., Aguilar, L., Clavaud, C., Chopra, T., & Khodr, A. (2022) · Pathogens · doi:10.3390/pathogens11020121 · Cited by 45 · see citing works
Coenzyme Q10 Efficacy Test for Human Skin Equivalents Using a Pumpless Skin-On-A-Chip System
Kim, J., Kim, K., & Sung, G. Y. (2020) · International Journal of Molecular Sciences · doi:10.3390/ijms21228475 · Cited by 44 · see citing works
Self-citationSkin bacterial transplant in atopic dermatitis: Knowns, unknowns and emerging trends
Hendricks, A. J., Mills, B. W., & Shi, V. Y. (2019) · Journal of Dermatological Science · doi:10.1016/j.jdermsci.2019.07.001 · Cited by 40 · see citing works
Kim, K., Kim, H., & Sung, G. Y. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms232113520 · Cited by 40 · see citing works
Self-citationStudying the Human Skin Microbiome Using 3D <i>In Vitro</i> Skin Models
Bojar, R. A. (2015) · Applied In Vitro Toxicology · doi:10.1089/aivt.2015.0002 · Cited by 36 · see citing works
Pécastaings, S., Roques, C. G., Nocera, T., Peraud, C., Mengeaud, V., Khammari, A., & Dréno, B. (2018) · Journal of the European Academy of Dermatology and Venereology · doi:10.1111/jdv.15042 · Cited by 35 · see citing works
Ubags, N. D. J., Trompette, A., Pernot, J., Nibbering, B., Wong, N. C., Pattaroni, C., Rapin, A., Nicod, L. P., Harris, N. L., & Marsland, B. J. (2020) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2020.06.030 · Cited by 30 · see citing works
Colucci, R., & Moretti, S. (2021) · Dermatology and Therapy · doi:10.1007/s13555-021-00485-0 · Cited by 28 · see citing works
Migacz-Gruszka, K., Branicki, W., Obtułowicz, A., Pirowska, M. M., Gruszka, K., & Wojas‐Pelc, A. (2019) · International Journal of Trichology · doi:10.4103/ijt.ijt_76_19 · Cited by 27 · see citing works
Schmidt, C. (2020) · Nature Biotechnology · doi:10.1038/s41587-020-0473-8 · Cited by 24 · see citing works
Biotherapeutic Approaches in Atopic Dermatitis
Tham, E. H., Koh, E., Common, J., & Hwang, I. Y. (2020) · Biotechnology Journal · doi:10.1002/biot.201900322 · Cited by 24 · see citing works
Skin‐on‐a‐chip strategies for human hair follicle regeneration
Jeong, S., Na, Y., Nam, H., & Sung, G. Y. (2022) · Experimental Dermatology · doi:10.1111/exd.14699 · Cited by 24 · see citing works
Self-citationKim, K., Jeong, S., & Sung, G. Y. (2022) · BioChip Journal · doi:10.1007/s13206-022-00092-x · Cited by 19 · see citing works
Self-citationMicrobiome research in food allergy and atopic dermatitis
Kim, M., Suh, D. I., Lee, S., Kim, Y.-K., Cho, Y.-J., & Cho, S. (2016) · Allergy Asthma & Respiratory Disease · doi:10.4168/aard.2016.4.6.389 · Cited by 11 · see citing works
Pedrosa, A. F., Lisboa, C., Faria‐Ramos, I., Silva, R. M., Miranda, I. M., & Rodrigues, A. G. (2018) · British Journal of Dermatology · doi:10.1111/bjd.16521 · Cited by 8 · see citing works
Flagged first, then by citations
3 of the 145 references couldn’t be matched to a known paper.
Research works printed but not linked: 3
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Cited by
Sorted by citations
Update on the pathogenesis of atopic dermatitis.
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Armari, M., Zavattaro, E., Trejo, C. F., Galeazzi, A., Grossetti, A., Veronese, F., Savoia, P., & Azzimonti, B. (2024) · Antibiotics · doi:10.3390/antibiotics13080697 · Cited by 13 · see citing works
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“31,32 Meanwhile, skin sensitivity is associated with severe acne in mature women.”
BackgroundRetractedOptimization of hair follicle spheroids for hair-on-a-chip
Jeong, S., Nam, H., & Sung, G. Y. (2024) · Biomaterials Science · doi:10.1039/d3bm02012f · Cited by 8 · see citing works
Self-citationVitamin D in Atopic Dermatitis: Role in Disease and Skin Microbiome
Blady, K., Pomianowski, B., Strugała, M., Smółka, L., Kursa, K., & Stanek, A. (2025) · Nutrients · doi:10.3390/nu17223584 · Cited by 8 · see citing works
“This results in upregulated transcription of AMPs such as LL-37 and human β -defensin 2 (HBD-2) [90], leading to reduced S. aureus colonization and attenuated skin inflammation [91].”
Kim, K., Jang, H., Kim, E., Kim, H., & Sung, G. Y. (2025) · Lab on a Chip · doi:10.1039/d5lc00606f · Cited by 7 · see citing works
Self-citationEngineered Tissue Models to Decode Host–Microbiota Interactions
Adelfio, M., Callen, G. E., He, X., Paster, B. J., Hastürk, H., & Ghezzi, C. E. (2025) · Advanced Science · doi:10.1002/advs.202417687 · Cited by 6 · see citing works
Unlocking the molecular pathway of atopic dermatitis: journey so far and roads ahead
Kumar, S., Sharma, R. R., Komal, K., Kumar, D., Ghosh, R., & Kumar, M. (2025) · Inflammopharmacology · doi:10.1007/s10787-025-01900-0 · Cited by 6 · see citing works
“AD serves as a model in which the regulatory chemical agents produced by the microbiota affect immune reactions, including indole-3-aldehyde (IAId) (Kim et al. 2023).”
Firmansyah, F., Budiman, A., Muchtaridi, M., Chabib, L., Syaputri, F. N., Afandi, F., Elamin, K. M., Mohammed, A., & Wathoni, N. (2026) · Drug Design Development and Therapy · doi:10.2147/dddt.s591505 · Cited by 4 · see citing works
“41,42,49 71 Table 2 shows a clear maturity gap between FFGs made using synthetic medications and those made with natural products when looked at from a therapeutic point of view.”
Lee, Y.-S., Noh, D.-I., Lee, S.-J., Jeon, M.-H., Kim, Y.-R., Jang, W. J., & Lee, E.-W. (2025) · Journal of Applied Microbiology · doi:10.1093/jambio/lxaf256 · Cited by 3 · see citing works
Vukoičić, A., Milivojević, A., Paša‐Tolić, L., Grujić, S., Vujisić, L. V., Tešević, V., & Bezbradica, D. I. (2024) · Process Biochemistry · doi:10.1016/j.procbio.2024.11.021 · Cited by 3 · see citing works
Clinical Potential of Novel Microbial Therapeutic LP51 Based on Xerosis-Microbiome Index
Kim, S., Rahim, M. A., Tajdozian, H., Barman, I., Park, H., Yoon, Y., Jo, S., Lee, S., Shuvo, M. S. H., Bae, S. H., et al. (2024) · Cells · doi:10.3390/cells13232029 · Cited by 4 · see citing works
“Maintaining a balanced skin microbiota is crucial for healthy skin and is also linked to beauty [8,9].”
Self-citationThe relationship between the skin microbiome and probiotics in the healing of burn injuries
Teymouri, S., Pourhajibagher, M., & Bahador, A. (2025) · Folia Microbiologica · doi:10.1007/s12223-025-01262-8 · Cited by 3 · see citing works
“For instance, in patients with atopic dermatitis, interventions could focus on addressing the overgrowth of S. aureus through the use of tailored probiotic strains (Kim et al. 2023).”
Kohta, M., & Sugama, J. (2024) · Journal of Multidisciplinary Healthcare · doi:10.2147/jmdh.s492458 · Cited by 2 · see citing works
“31 A recent study applied metagenomic DNA sequencing techniques to assess the taxonomic diversity of microorganisms associated with the skin.”
Zhou, H., Wang, J., Ding, Y., Liang, H., Qin, T., Wang, P., Gao, X., & He, X. (2026) · Tissue and Cell · doi:10.1016/j.tice.2026.103469 · Cited by 2 · see citing works
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“Previous studies have shown success in treating inflammatory skin conditions through microbiome-based approaches [32, 33], suggesting similar strategies might benefit CAD patients.”
Адаскевич, В. П., Gorodovich, A. N., Zaslavsky, D. V., Okhlopkov, V. A., Smirnova, I. O., Таганов, А. В., Тамразова, О. Б., Леонидовна, Ш. И., & Khazhomiya, K. D. (2025) · Russian Journal of Skin and Venereal Diseases · doi:10.17816/dv642248 · Cited by 1 · see citing works
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Citrobacter koseri inhibits the growth of Staphylococcus epidermidis by suppressing iron utilization
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Dermatological Associations of Neurodegenerative Disorders
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Recent Progress in Extracellular Vesicles Therapeutics for Atopic Dermatitis Treatment
Jeong, S., Kim, H. J., Oh, M. J., Song, Y., Kim, J., Kim, T. G., Shin, Y. J., Cho, S. H., Park, J. M., Park, M., et al. (2026) · BioChip Journal · doi:10.1007/s13206-026-00273-y
“Moreover, dysbiosis of the skin microbiome plays a significant role in the onset and exacerbation of AD, and it has been reported to influence inflammatory responses and immune regulation [238].”
Self-citationBighetti, S., Zerbinati, N., Carugno, A., Scaramuzzino, M., Bonsignori, F., Bettolini, L., Rossi, M., Maione, V., Calzavara‐Pinton, P., Venturini, M., et al. (2026) · Dermato · doi:10.3390/dermato6030027
- Authors
- Kim, K., Jang, H., Kim, E., Kim, H., & Sung, G. Y.
- Affiliations
- Interdisciplinary Program of Nano‐Medical Device Engineering Hallym University Chuncheon Korea
- Hallym University (KR)
- Corresponding author
- Sung, Gun Yong
- Venue
- Experimental Dermatology
- Publisher
- Wiley
- Published
- 2023-09-28
- Volume
- 32
- Issue
- 12
- Pages
- 2048-2061
- ISSN
- 0906-6705 (ISSN-L)
- 1600-0625
- OpenAlex
- W4387114314
- Semantic Scholar
- a212f4004bef0a29558f5b6654cbd6abcabb2a0a
- Cited by
- 24
- References
- 145
- Citations by year
- 2026: 6 · 2025: 10 · 2024: 7 · 2023: 1
- FWCI
- 1.10
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Experimental Dermatology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Ministry of Science, ICT and Future Planning ((NRF‐ 2020R1A2C2009928))
- Topics
- Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
- Health Sciences › Medicine › Dermatology › Contact Dermatitis and Allergies
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmaceutical Science › Advancements in Transdermal Drug Delivery
- Keywords
- skin microbiome, atopic dermatitis, skin barrier function, microbiota-host interactions, skin diseases, microbiome-targeted therapy, skin-on-a-chip, skin appendages, symbiosis
- MeSH terms
- Dermatitis, Atopic, Epidermis, Humans, Skin, Skin Diseases, Microbiota
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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