Skin is the largest organ of the body. It is as a massive fortified barrier to protect our body regulating temperature and keeping out foreign pathogen microorganisms, such as bacteria and viruses.

Notably, this last aim is achieved also by the alliance between the immune system and a wide and complex population of microorganisms residing on the skin, the so-called “Skin Microbiota”. (1) (2)

Multiple environmental and genetic factors can disturbe this delicate balance, altering the skin barrier. This dysregulation predisposes our body to a number of cutaneous infectious and inflammatory conditions contributing to the dramatic and rapid increase in chronic inflammatory cutaneous diseases. (3) (4)

Most common chronic inflammatory skin disorders, such as atopic and seborrheic dermatitis; psoriasis and acne can differ significantly in symptoms, manifestations, severity and duration. They have all been associated with the microbial imbalance of skin microbiota (5).

“Microbes found on the skin are usually regarded as pathogens, potential pathogens or innocuous symbiotic organisms. Advances in microbiology and immunology are revising our understanding of the molecular mechanisms of microbial virulence and the specific events involved in the host-microbe interaction. Current data contradict some historical classifications of cutaneous microbiota and suggest that these organisms may protect the host, defining them not as simple symbiotic microbes but rather as mutualistic.” Indeed, Atopic Dermatitis (eczema), caused by a dysregulation of the adaptive and innate immune response (6), it has long been associated with S. Aureus skin infection (7). Typically, the onset occurs in 15-20% of children below 10 years and 1-3% of adults worldwide affecting more than 330 million patients (8).

Symptoms include itchy, redness, swollen, cracked skin and sensitization to allergens with a dramatic impact on patient’s quality life (9).

Therapies available for Atopic Dermatitis are based mostly on steroid drugs, immunomodulating drugs and moisturizing creams (10). Regarding the Mild to moderate grade, around 80% of the total patients, many of them are affected by “The Corticosteroid phobia” and upset about the side effects of unspecific immunosuppressant drugs (11) (12). Develop alternative and less invasive strategy is quite important to enhance patient’s satisfaction, reminding that almost all users are in pediatric age.