The Microbiome in Vitiligo

The human “microbiome” refers to the collection of trillions of organisms (such as bacteria and yeast) and the molecules they produce that live naturally in and on our body. Some of the important functions of these organisms include vitamin production, digestion, and protection against foreign invaders. You have most likely heard of the gut microbiome, but another important microbiome is the skin microbiome, which we are realizing plays a crucial role in skin health.^[1] Scientists have shown that multiple skin diseases, including acne, eczema, and seborrheic dermatitis are associated with abnormal changes in the skin microbiome.^[2]

Vitiligoskin microbiomeis a skin disease involving loss of skin color, which usually results in the progressive development of light patches on the skin. This skin condition is relatively common, affecting around 2% of the population worldwide.^[3] Although the exact cause of vitiligo remains unknown, it most likely involves an abnormal immune system and excessive free radical damage.^[4] Recently, there has been investigation into whether the skin microbiome is different in vitiligo compared to people without vitiligo.

Is the Skin Microbiome Altered in Vitiligo?

Scientists studied the skin of 10 people with vitiligo to see if there were differences in the organisms that live on the skin affected by vitiligo versus patches of skin without vitiligo.^[5] The results from this study were the first in the world to show that the microbiome does indeed differ between the skin of a vitiligo patch compared to skin without. Specifically, the diversity of the skin microbiome appeared to be higher in normal skin compared to vitiligo skin. Microbiome diversity refers to how many different types or strains of bacteria are measured. In these patients, areas of skin without vitiligo had many more different strains of bacteria compared to the vitiligo patches. Having a more diverse microbiome is considered healthier by providing more balance and preventing one species from predominating over others.^[6] However, more research needs to be done to know if creating a more balanced microbiome will help improve vitiligo.

How Is the Skin Microbiome Changed in Vitiligo?

The authors of this research study concluded that in the vitiligo patches of skin, there was skin microbiome dysbiosis, and the diversity of the groups of species was much less rich compared to normal areas of skin. There was a larger amount of bacteria belonging to Actinobacteria species in the vitiligo skin compared to normal skin, in which there was a relatively higher amount of Firmicutes species.^[5] While the significance of these particular bacteria is still undergoing research, it is known that other inflammatory skin diseases including acne, atopic dermatitis, and psoriasis have also been associated with less diverse skin microbiomes compared to people with healthy skin.^[8-10] 

This research looking at the skin microbiome in vitiligo is exciting because it offers a step forward in understanding possible mechanisms behind vitiligo and even potential new treatment options. However, these results are only based on one study and future research is needed to provide a better understanding of the importance of the microbiome in skin health.