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Broderick, C.* ; Poulsen, C.S.* ; Hjelmsø, M.H.* ; Marrs, T.* ; Radulovic, S.* ; Logan, K.* ; Li, X.* ; Wu, Z.* ; Sørensen, S.J.* ; Ezzamouri, B.* ; Alexander, H.* ; Fyhrquist, N.* ; Alenius, H.* ; Bhattacharyya, M.* ; Neumann, A.U. ; Lack, G.* ; Perkin, M.* ; Bønnelykke, K.* ; Stokholm, J.* ; Flohr, C.*

Associations between early-life exposures and the infant skin microbiome.

Br. J. Dermatol., DOI: 10.1093/bjd/ljaf524 (2026)
DOI PMC
BACKGROUND: Factors influencing the early-life skin microbiome, and the association with atopic dermatitis (AD), are relatively unexplored. OBJECTIVE: To evaluate associations with the infant skin microbiome during the first year of life. METHODS: 3-month-old infants from the Enquiring About Tolerance (EAT) birth cohort were examined for AD at enrolment, 1 and 3 years of age. Parent-completed questionnaires, trans-epidermal water loss (TEWL), and filaggrin mutation status were evaluated. Bacterial swabs were collected from the elbow crease and volar forearm in 148 infants at 3 months and 1 year of age, and the microbiome composition was characterized using 16S rRNA gene sequencing (V3-V4 region). RESULTS: Shannon diversity was significantly higher at the forearm compared to the elbow. Staphylococcus, Acinetobacter, and Streptococcus were the most abundant genera across time and body-site. Microbiome community composition was primarily associated with body-site and age (p≤0.001, both). Other significant associations were found with ethnicity (p=0.009), filaggrin status (p≤0.001), urban-vs-rural residence (p=0.005), older siblings (p=0.041), bath product usage at 3 months (p=0.011), but not with pets (p=0.159), systemic antibiotics (p=0.27) nor with bathing frequency (p=0.109). The microbiome was associated with elevated TEWL (3-months p=0.004, 1-year p≤0.001) and with concurrent AD (3-months p=0.027, 1-year p≤0.001). Streptococcus parasanguinis was significantly less abundant in non-lesional skin of infants with AD at 3 months. CONCLUSION: In addition to age and body-site, the infant skin microbiome is associated with heritable factors, the home environment, hygiene practices, and with the presence of AD.
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Publication type Article: Journal article
Document type Scientific Article
ISSN (print) / ISBN 0007-0963
e-ISSN 1365-2133
Journal British Journal of Dermatology - BJD
Publisher Wiley
Reviewing status Peer reviewed
Institute(s) Institute of Environmental Medicine (IEM)