1 MILD ACIDITY PROMOTES HEALTHY SKIN MICROFLORA & DERMAL LONGEVITY

MILD ACIDITY
PROMOTES HEALTHY
SKIN MICROFLORA &
DERMAL LONGEVITY
REPORT WRITTEN AND PREPARED BY:
H.G. FINCH &
KAREN SINCLAIR DRAKE



EXECUTIVE SUMMARY

An awareness of dermal acidity has been
well documented in published research and
literature. Until recently, the clinical
relevance and application of this research
has not been well defined and has left
medical clinicians and consumers/patients
seeking alternative skin interventions with
the prospect of reversing inflammatory skin
conditions, skin damage caused from poor
lifestyle choices, and skin aging. A review
of the scientific background, literature, and
data regarding skin surface pH and the
stimulation of beneficial skin microflora
resulting in dermal longevity was conducted
for this report.


BACKGROUND

Skin Anatomy and Function

The integumentary system is an organ system
comprising of the skin, hair, nails, and exocrine
glands.
1
The system is the vital barrier protecting
the internal organ tissues from the external
world. The system provides a multiplicity of
functions including maintaining the bodys
internal homeostasis by thermoregulatory
secretory activity, waste excretion, regulates
hydration, padding for internal tissue protection,
sensory receptors, and vitamin D synthesis.
2

The exocrine glands generate sweat, oils, and
waxes to cool, shield, and nourish the skins
surface. As the largest and most visible organ,
the appearance of skin, hair, and nails has been
used as social signals and clues to the general
state of a persons well-being for hundreds of
years.
3


Only a few millimeters thick, the skin is by far the
largest organ in the body accounting for about
one-twelfth of total body mass and a surface
area of approximately 20 square feet.
4
Skin is
comprised of three major layers of tissue which
include the epidermis, dermis, and hypodermis.

The epidermis is the external layer of the skin
and covers nearly the bodys entire surface. This
layer is considered an avascular area of the
body, indicating that it does not contain any
blood or blood vessels.
5
The cells of the
epidermis obtain nutrients through diffusion of
fluids from the dermis. The epidermis is
composed of 90% keratinocytes (produce the
protein keratin), 8% melanocytes (produce
melanin pigment), 1% Merkel cells (responsible
for sensory touch), and 1% Langerhans cells
(detect and fight pathogens).
6
This layer
contains essential skin flora or microorganisms
that provide beneficial immune regulation.
7


The dermis is a deeper layer of the skin located
under the epidermis. The dermis consists of
thick asymmetrical connective tissue, areolar
connective tissue (collagen and elastin), nerve
tissue, blood, and blood vessels.
8
This layer is
denser than the epidermis and contributes to the
strength, flexibility, elasticity, and support of the
skin.
9
The dermis contains two layers, the
papillary layer and the reticular layer. The
papillary layer adjoins the epidermis and
contains numerous finger-like projections called
dermal papillae that extend towards the
epidermis.
10
The dermal papillae enhance the
surface area of the dermis and hold nerves and
blood vessels.
11
Nutrients and oxygen from
blood vessels flow through the dermal papillae
to the cells of the epidermis.
12
The reticular layer
is the deepest layer of the dermis. Dense and
sturdy, the reticular layer is made of compressed
asymmetrical connective tissue that contains
strong collagen and flexible elastin fibers
extending in every direction which impart
strength and elasticity to the skin.
13


The hypodermis is a layer of loose connective
tissue located under the dermis. The
hypodermis functions as the adaptable
connection between the skin and the underlying
tissues and contains adipocytes or fat cells.
14

Fatty adipose tissue in the hypodermis insulates
2 MILD ACIDITY PROMOTES HEALTHY SKIN MICROFLORA & DERMAL LONGEVITY

the body by entrapping body heat generated by
the muscles.
15


Healthy Skin Microflora and Acidity

Skin microflora or the skin microbiome refers to
the microorganisms which inhabit the skin
(epidermis).
16
Approximately 1000 different
bacterium species can be found existing on the
human skin.
17
It is estimated that the average
human has 1 trillion bacteria inhabiting their
epidermis and hair follicles at any given
moment.
18
Skin microflora is typically non-
pathogenic. In healthy dermal environments
these bacteria are considered not harmful or
offer specific benefits including the prevention of
transient pathogenic organisms from colonizing
the skin surface.
19
Good skin microfloras defend
their territory through nutrient competition,
chemical secretion, and by prompting the skin's
immune system to respond. The most common
microorganisms found on the skin are
categorized in the phylum groups:
actinobacteria, firmicutes, proteobacteria, and
bacteroidetes.
20


The epidermis is naturally acidic (pH 4-4.5) as a
result of lactic acid produced in sweat by skin
microorganisms.
21
In mildly acidic skin
environments, mutualistic flora (microorganisms
that produce a mutual benefit for host and
bacteria) such as Staphylococci, Micrococci,
Corynebacterium and Propionibacteria flourish.
However, transient bacteria such as
Escherichia, Pseudomonas, Staphylococcus
aureus or Candida albicans do not grow or
thrive.
21
Antimicrobial substances secreted by
the skin are enhanced in acidic conditions and
thus, stop the growth of harmful bacteria.
Research has shown when skin is in an alkaline
state bacteria detach from the skin and are more
easily discarded from the dermis.
21


In vitro, Propionibacterium acnes (P. acnes)
have been found to flourish at pH values
between 6 and 6.5, whereas its growth is
considerably decreased at pH values less than
5.5.
22
Researchers conducted a randomized,
open, comparative three month trial assessing
the use of acidic or conventional soap in the
prevention of acne lesions in acne-prone
patients.
23
Participants were asked to apply an
acidic soap (syndet) or an alkaline/conventional
soap to facial skin for 1 minute in the morning
and in the evening. This study evaluated 120
adolescents and young adults who had been
diagnosed with inflammatory acne lesions. The
participants inflammatory acne lesions, itching,
redness, and scaling were evaluated and
analyzed.
23
The alkaline/conventional soap
participant group had an increase in
inflammatory lesions, while the group using the
acidic soap found their inflammatory acne
lesions to decrease to statistically significant
levels. The alkaline/conventional soap
participant group reported a 40.4% increase in
symptoms of irritation whereas the mildly acidic
soap group experienced only 1.8% in symptoms
of irritation. The researchers stated that the
number of inflammatory acne lesions is clearly
lower when an acidic soap is regularly used for
cleansing the face as compared to an
alkaline/conventional soap.
23


FACTORS CAUSING DERMAL DAMAGE

Natural Aging and Genetics

The natural aging process of the skin begins in
the early 20s for most people and subtly
becomes more noticeable later in life.
24

Depending on genetics, natural skin aging can
result from reduced collagen and elastin
production, decreased exfoliation, reduced
cellular rejuvenation, and loss of adipose cells in
the hypodermis.
252627
Skin quality and longevity
are influenced not only by extrinsic influences
such as diet, stress, climate, and exposure to
environmental toxins, but also by intrinsic
genetic influences. Research has determined
the genetics of Northern European populations
compared to the genetics of African and Asian
populations are sharply differentiated by the
quality and durability of their skins natural aging
process.
28


Ultraviolet Radiation

Chronic sun exposure and ultraviolet (UV)
radiation leads to premature skin aging and skin
cancers.
29
UV radiation increase oxidative
stress, mitochondrial damage, telomere DNA
damage, and free radical production by
decreasing collagen synthesis and increasing
collagen degradation.
30
UV radiation generates
an inflammatory cascade by stimulating
receptor-initiate signaling.
31
Increased
inflammation decreases gene expression of
collagens in fibroblasts resulting in a reduction of
collagen synthesis. There is up to a 10 fold
increase in mitochondrial damage in skin
exposed to UV radiation as compared to skin
3 MILD ACIDITY PROMOTES HEALTHY SKIN MICROFLORA & DERMAL LONGEVITY

that has been protected from UV radiation.
32

Furthermore, excess UV radiation prevents
telomeres (protective ends of chromosomes)
from replicating and can cause apoptosis.
33
The
shortening of telomere length leads to premature
aging.
34
Over time, chronic exposure to UV
radiation leads to the classic appearance of
extrinsically aged skin, including fine lines,
wrinkles, hyperpigmentation, and sagging skin.
35


Endocrine Regulation

The endocrine system produces and regulates
hormones which are affected by normal aging.
Hormonal changes can impact the health of the
skin and have a significant impact on skin
aging.
36
The natural aging process causes a
decline in sex hormones.

Estrogens (the principal female hormone)
increases collagen production in the skin which
promotes epidermal thickness, anti-wrinkle
formation, and hydration.
37
Estrogens bind to
receptors located on skin cells which modulate
skin cell renewal. For women, menopause
causes their estrogen levels to decline,
sometimes drastically, causing slow skin cell
renewal and the loss of dermal collagen
production. As a result, the epidermis and
dermis layers begin to thin leading to decreased
capillary blood circulation and nutrient
depletion.
38
The skin is unable to maintain its
hydration levels, strength, and flexibility causing
skin aging.

Testosterone (the principal male hormone)
increases skin sebum production.
39
Aging can
affect estrogen-androgen (in particular
testosterone) balance causing an increase in
oiliness and adult acne. Androgens (including
testosterone) help to increase the epidermis and
dermal thickness by producing more collagen
fibers as compared to female skin.
40
The male
skin benefits from the presence of hair follicles
and additional collagen fibers providing dermal
thickening for increased skin aging protection.
41


Oxidative Stress

The skin is exposed to oxidative stress daily
through environmental factors including diet,
toxic inhalants, environmental pollution, by-
products of metabolism, and UV radiation.
Oxidative stress impedes the production of
collagen and impairs DNA by fueling the
production of reactive oxygen species (ROS) or
free radicals.
42
These reactive molecules are
generated as by-products of metabolism and the
environmental toxin. Free radicals cause
cellular destruction and mutilation; specifically,
damaging the cell membrane (unsaturated fatty
acids), thus, altering the cell replication cycle.
43

Research suggests free radicals stimulate the
production of pro-inflammatory cytokines which
could initiate inflammatory skin conditions,
diseases, and allergic reactions.
44
Chronic
exposure to free radicals and oxidative stress
can accelerate skin aging.
43


Protein Glycation

Collagen proteins are critical for the structure
and function of the extracellular matrix in the
dermis. Protein glycation accelerates skin aging
by damaging the collagen by crosslinking.
45

Protein glycation (non-enzymatic process) affect
collagen proteins more severely because their
half-lives are long and the process happens
slowly.
46
Therefore, more damage can be
caused to the collagen protein. Glycation leads
to stiffer and more brittle collagens which
decrease the ability of collagen monomers to
form fibers, inhibit cell to cell communication,
proliferation, and gene expression.
46


People who have poorly controlled blood sugars,
such as diabetics, may notice hastened skin
aging due to high serum glucose levels resulting
from increased glycation.
47
A study published in
The American Journal of Clinical Nutrition found
higher intakes of vitamin C and linoleic acid and
lower intakes of fats and carbohydrates
correlated to better skin-aging appearance.
48

This study suggested healthy dietary behaviors
may have additional benefit for skin
appearance.
48


Recent studies have suggested a link between
Mediterranean foods/diet and melanoma cancer
rates.
49
Melanoma cancer rates are significantly
lower in Mediterranean populations than
compared to northern Europe, Australia, and the
United States.
49
Research has found diets high
(more than five times a week) in citrus fruits,
such as oranges or lemons, and green leafy
vegetables were 50 percent less likely to
develop cancer.
49
Research has also found
eating oily fish, such as sardines or salmon,
more than once a week has been shown to
decrease the risk of developing melanoma by 35
percent.
49
Polyphenol antioxidants found in
many Mediterranean type foods are known to be
4 MILD ACIDITY PROMOTES HEALTHY SKIN MICROFLORA & DERMAL LONGEVITY

powerful anti-cancer compounds; consequently,
protecting the cell against oxidative stress and
protein glycation.
50


Tobacco Use

Cigarette (tobacco) smoking is associated with
premature aging and wrinkles.
51
Smoking has
been connected with severe skin conditions,
such as squamous cell carcinoma of the skin
and psoriasis.
52
Cigarette smoking reduces
dermal capillary and arteriolar blood flow by
augmenting the release of the hormone,
vasopressin.
53
Studies have found
concentrations of vasopressin in the blood rise
instantaneously after an individual smokes a
cigarette.
53
The reduction of dermal blood flow
by cigarette smoke limits necessary oxygen and
nutrients needed for dermal fibroblasts growth
and repair.
54
Several studies have found
cigarette smoking causes the skin to age quicker
than skin exposed to sunlight and ultraviolet
radiation.
55
Moreover, it has been reported that
exposure to cigarette smoke and sunlight at the
same time could be more hazardous than the
combined effect of either exposure alone;
suggesting cigarette smoke is phototoxic.
56


Premature wrinkling has been long associated
with smoking. Researchers have discovered
individuals who are considered heavy smokers
have significantly more premature wrinkles than
those individuals who only smoke
intermittently.
57
Cigarette smoking has been
linked to elastosis (loss of elasticity as a result of
connective tissue degeneration) and
telangiectasia.
58
Telangiectasia is a skin
condition depicted by red fine lines in the skin
which are caused from the dilation of small
blood vessels. These conditions are directly
related to an increase in the number of
cigarettes inhaled in smokers and non-
smokers.
58


CONCEPT OF ACIDITY

For over a century, skin pH has been garnering
awareness and interest from researchers,
physicians, and product development
companies. In 1892, Heuss, a German
researcher, was the first to discover the acidic
nature of the skins surface.
59
Years later
(1928), Heuss work was validated by Schade
and Marchionini who established the term,
Sauremantel or acid mantle of the skin.
59
The
acid mantle concept explains the significance of
an acidic skin surface pH which serves as the
protective barrier, influences homeostasis, and
regulates skin microflora.
60


The acid mantle is formed by secretions from
sweat and sebaceous glands as well as the
breakdown of fatty acids by beneficial
microflora.
61
The acid mantle acts as a barrier
and allows lipids and moisture onto the skin
while protecting the skin from environmental
pollution and non-beneficial bacterial.
60
The
acid mantle is at its strongest and most effective
when the skin is slightly acidic.
60
Researchers
have found the optimal pH range of acidity is
between 4.2 and 5.6.
22


Maintaining a mildly acidic skin surface allows
the skin to be in proper balance for nutrients to
nourish skin cells and aid in the growth of
beneficial skin flora while inhibiting non-
beneficial skin flora growth.
19
Studies have
shown women whose skin is in an alkaline state
developed more fine lines and crow's-feet
around their eyes than those with acidic skin
over an eight-year period.
62
Skin in an alkaline
state tends to be drier, more brittle, and more
susceptible to sun damage than in a mildly
acidic skin surface.
62
Mildly acidic skin has been
found to have a 50 percent lower rate of
wrinkling than those with alkaline skin.
62


ACIDITY OF SKIN

Recently, researchers published a pilot study to
assess the increased barrier function of the skin
in elderly participants when a topical 4.0 pH skin
care formula is applied.
63
As a person ages,
their skin surface pH has been shown to
increase, becoming more alkaline.
60
Research
has found increased skin pH is associated with a
reduction in the protective barrier of the skin
which can lead to inflammatory skin disorders,
growth in non-beneficial bacteria, and
accelerated skin aging.
60
This study determined
baseline skin surface pH in all participants
(elderly 80+ years old; n = 15 and middle aged
adults 31 - 50 years old; n = 15).
63
Baseline skin
surface pH in all participants ranged from 5.5 to
6.0. As expected, baseline skin surface pH was
higher in elderly participants compared to the
middle aged participants. The participants were
then given a 4.0 pH skin care formula and after
4 weeks of treatment, their skin surface was
analyzed and evaluated for skin hydration and
barrier integrity. The data showed a decrease in
baseline skin surface pH of the elderly. The
5 MILD ACIDITY PROMOTES HEALTHY SKIN MICROFLORA & DERMAL LONGEVITY

elderly groups pH normalized to 4.5 - 5.0 pH
over 7 hours after given a single application of
the topical skin care formula. After 4 weeks of
treatment using the pH 4.0 skin care formula,
data showed significant improvements in the
skin barrier integrity in the elderly participant
group. The researchers concluded skin care
formulas for the elderly should be adjusted to
the pH range of 3.5 to 4.0 to help reduce the
increased skin surface pH of the elderly and
improve skin barrier integrity.
63


Skin pH and skin aging has been shown to be
affected by various factors. Researchers
evaluated the connection between skin surface
pH and wrinkle formation that was directly
related to aging.
64
Three hundred participants
were chosen from three countries: Korea,
Vietnam, and Singapore. The participants skin
(facial cheek) was assessed based upon
hydration levels, sebum excretion rate, melanin
index, transepidermal water loss (TEWL), and
skin temperature.
64
Wrinkle length and depth
were also analyzed and compared with skin
surface pH variation. After the data was
analyzed, the researchers found skin hydration,
melanin, wrinkle length, wrinkle depth, and skin
temperature were all significantly correlated with
skin surface pH. The data found skin hydration,
sebum excretion rate, and skin temperature,
were negatively associated with skin surface pH.
Whereas, wrinkle length and wrinkle depth
significantly decreased as skin surface pH
became more acidic.
64


In another study, researchers assessed the skin
surface pH in 330 participants in an effort to
determine the natural skin surface pH.
21
This is
of importance to researchers as inconsistent
skin pH levels have been reported throughout
literature. Many articles report an acidic range;
however, the range is broad and inconsistent
many times fluctuating from pH 4.0 to 7.0. This
study measured the skin surface pH of the
forearm before and after abstaining from
showering and cosmetics for 24 hours.
21
The
average pH decreased from 5.12 to 4.93. This
data suggests the approximate natural skin
surface pH is on average 4.7. Currently,
approximately half of all recent literature
published confirms the natural pH of skin falls
below 5.0.
21
Furthermore, it has been
determined that skin with pH values below 5.0
are in better condition with regards to skin
barrier function, hydration, and scaling than skin
with pH values above 5.0.
21

CONCLUSION

For over a century, the connection existing
between skin surface pH and microflora has
been extensively investigated throughout
published literature. Naturally designed as a
protective barrier from environmental stressors,
the skin is a complex organ that, under mildly
acidic conditions, maintains proper homeostasis
and microflora which promote dermal longevity.
2

Externally and internally, a variety of elements
can inhibit the skins ability to maintain proper
pH. Natural aging process, genetics, ultraviolet
radiation, hormones, oxidative stress, diet, and
tobacco use all contribute to the degradation of
the skins acid mantle; thus rendering the skin
susceptible to inflammatory disease and
accelerated aging.
19
Mounting research is
indicating the significance of assessing skin
surface pH and the likelihood of future
inflammatory skin conditions.
48
It is prudent to
readily identify elements that affect skin surface
pH and use skin care formulas that protect and
preserve the skins delicate acid mantle when
restoring and treating dermatologic conditions.
Our research has uncovered overwhelming
evidence that reinforces the concept and
significance of an acidic skin surface pH. These
parameters should always be the gold standard
when formulating topical products in order to
support healthy skin microflora and dermal
longevity.


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