Maintaining Bacterial Health for Facial Psoriasis

The obsession with leaky gut and the importance of good bacteria has been popular for a good many years. The discussion has been constant among those of us with chronic inflammatory conditions like psoriasis.

You cant walk down the dairy aisle in a supermarket or take a stroll down a supplement aisle without coming across probiotic blends of 'good' bacteria. The thing is, bacteria do not only live in our guts.

There are more bacteria on and in your body than there are human cells. Think about that for a minute.

Connecting bacterial health to facial psoriasis

There is a range of bacterial populations in the gut that provide healthy anti-inflammatory benefits such as lactobacilli and bifidobacteria. These health-promoting bacteria require particular environmental conditions. We often try to achieve these by eating the right foods and taking the 'right' supplements.

The same goes for your skin. Bacterial populations that promote healthy skin have particular requirements, only it's not what you're eating so much, but what you're adding. And the most often overlooked - what you are taking away.

So what do we need to add, and what do we need to stop taking away to help our skin have a healthy bacterial population?

Improving your bacterial health and facial psoriasis

Wash your face, less. What! I heard you scream internally. I get you. We are taught from early childhood that cleanliness is next to godliness, so cleansing our bodies less seems outright mental.

The thing is, washing our face changes how much acid there is on the surface of the skin (what we know as the pH), and it takes up to six hours for this to normalize again.

What should my bacterial health be?

Your skin should be slightly acidic. This means it has a pH of less than seven (pH7 is classed as neutral in the middle of the pH scale which runs from pH1-pH14). Skin generally falls between a pH of 4.2-5.5, which can be surprising. Hydrochloric acid in the stomach is between pH1-2 for comparison - so your skin is pretty acidic, and this is great for keeping it healthy as lots of bacteria and yeasts hate living in acidic conditions.

A study in 2006 showed that after 24 hours without showering or cosmetic use the pH of the skin dropped from pH 5.12 to pH4.7. This aligns with other research findings that identify that the skin's natural pH is below pH5 and it is the pH we should think about when choosing products for our skin.

When identifying that a pH of below pH5 is better for skin, the study reported improved barrier function, moisturization, and flaking.

Acid keeps the skin healthy

The problem with washing your face a lot is this: water and cleaners have a higher pH. In Europe for example, it's not uncommon for the water to have a pH of pH8.0 (1) which means that when you put water on your skin, you make the skin less acidic. Even if you just splash water on your face on a morning. Less acidic = less healthy.

Research shows that the ideal pH to keep the bacterial flora attached to the skin is pH4-4.5. However, when the skin gets more alkaline - its harder to maintain the skin's bacterial population. At a mildly alkaline pH of pH8-pH9 bacterial dispersal from the skin was promoted (1).

Maintaining an oil layer

So to improve skin health; barrier function, moisture levels, flaking, and the skins flora and fauna then it's important to try to maintain the skins naturally mildly acidic pH. The top layers of your skin are oil-based. This helps to form a barrier that keeps environmental water out and internal water in.

An oily layer on the skin also helps to protect you from pathogens (the wrong bacteria and fungi) by making it harder for them to get in. Think about when it rains, or when you take a shower. Water runs off your skin, right?

How do we clean the skin?

We traditionally use foaming products that help to get rid of the oil so we can 'clean' the top layers of the skin. These products are known as surfactants, and they usually include one of my least favorite ingredients - Sodium Laureth Sulfate (SLS).

If you want to see how this works, then take a jam jar and add some water. Then add oil and see how the oil sits on the surface. That's like the oily layers on the skin protecting internal hydration. Now put the lid on and shake the jar, the oil briefly mixes with the water but rapidly settles back out onto the top.

Now, let's see what happens when you add a small amount of washing up liquid, which contains a surfactant. Put the lid on and shake. What happens? It makes the oil particles mix with the water so it can be washed away down the plughole. You can let the mixture sit, but the oil won't return to the surface. That protective layer is gone.

How often do you need to clean your face?

I definitely need to cleanse on an evening, I feel dirty, plus a toddler will have smeared their dirty hands on me many times, my skin often feels dry and I often have make-up to remove. Yet in a morning? If I have slept on clean sheets how dirty is my face going to be?

So now I am experimenting with a full cleansing routine in the evening, which involves an oil-based cleanser (instead of using the alkaline water in my taps and an alkaline surfactant filled face wash), a vitamin-filled serum and a ceramide based night cream to see if helps with my wrinkles. The products are designed to absorb into my skin without leaving a residue that needs to be cleaned off.

In the morning, I am experimenting with minimal cleansing. I like to feel fresh so I use a pH adjusted alcohol-free toner to quickly wipe my face before adding an oil-based moisturizer. I use a hydrating mist before the oil-based moisturizer if my skin is feeling particularly dry.

Protect your psoriasis. Protect your bacterial health.

The take-away here? If you wash your face too much, you remove the protective oil layer on your face and risk exposing your skin to harmful bacteria and increase the risk of dehydrating your skin (and your psoriasis) leading to more cracking, flaking, and pain.

What can you use instead? I, for one, am not avoiding cleaning my face. Options depend on your skin type. My skin type is dehydrated. For me, maintaining the oil layer is paramount. I am not your dermatologist so you may need to adjust this to work with you and your skin type.