FOR INTERNAL USE ONLY. NOT FOR DISTRIBUTION.

FOR INTERNAL USE ONLY. NOT FOR DISTRIBUTION.

YOUR MICROBIOME
is an ecosystem as unique to you as your DNA,
largely determined by your age, gender, diet,
hygiene and environmental factors such as
climate and pollution.1

The human microbiome is a

source of genetic diversity, a
modifier of disease and an
essential component of

IMMUNITY2 MICROBIOME
plays a critical role in health
and healthy skin.1

1. Grice EA, Segre JA. The skin microbiome. Nature reviews Microbiology. 2011;9(4):244-253.
2. Grice EA, Segre JA, The human microbiome: our second genome. Annu Rev Genomics Hum Genet. 2012;13:151-70. FOR INTERNAL USE ONLY. NOT FOR DISTRIBUTION.
The SKIN MICROBIOME
is the diverse community of microorganisms,
including bacteria, coexisting at the skin surface.1 1 BILLION
BACTERIA
inhabit a typical square
centimeter of skin2

A Balanced Microbiome pH Balance Bacterial diversity differs by body

zone
The skin microbiome is a habitat of billions The skin microbiome prefers a relatively Differences in skin temperature, texture,
of beneficial and harmful bacteria. An acidic environment (pH around 5.0) thickness, humidity and chemistry help
imbalance of these bacteria can lead to a which also inhibits growth of pathogens.1 determine which kinds of microbes live
variety of skin conditions including acne, where on the skin.1
eczema, rosacea and ageing.1

1. Grice EA, Segre JA. The skin microbiome. Nature reviews Microbiology. 2011;9(4):244-253.
2. Grice EA, Kong HH, Renaud G, Young AC, Bouffard GG, Blakesley RW, et al. A diversity FOR INTERNAL USE ONLY. NOT FOR DISTRIBUTION.
profile of the human skin microbiota. Genome Res 2008
The SKIN MICROBIOME Changes Over Time

An infant experiences its first

major exposure to microbes at
birth.1

IN INFANTS IN ADULTS

These initial microbial

populations evolve over time,
adapting to characteristics of
each body site.1 Staphylococcus +
Streptococcus + Staphylococcus
Propionibacteriumdominate the skin
dominate the skin microbiota.1 microbiota.2

1. Capone KA, Dowd SE, Stamatas GH, Nikolovski J. Diversity of the human skin microbiome
early in life. J Invest Dermatol. 2011 Oct;131(10):2026-32. FOR INTERNAL USE ONLY. NOT FOR DISTRIBUTION.
2. Grice EA, Segre JA. The skin microbiome. Nature reviews Microbiology. 2011;9(4):244-253.
HEALTHY vs ATOPIC SKIN

HEALTHY SKIN ATOPIC SKIN

has a balanced microbiome has an unbalanced microbiome and
and preserved skin barrier. an altered skin barrier, allowing
vulnerability to irritants which
can cause inflammation,
flare-ups and itching.

Lesional atopic skin is Enhancing the skin barrier in AD The use of specific emollients can optimize the
dominated by S. aureus and improving bacterial diversity skin barrier and balance the microbiome,
could potentially avoid flares.1 helping to improve itchiness sensation.2-3

1. Grice EA, Kong HH, Conlan S, et al. Topographical and temporal diversity of the human skin microbiome. Science. 2009;324:1190-2.
2. Gallo RL, Nakatsuji T, Microbial symbiosis with the innate immune defense system of the skin. J Invest Dermatol. 2011;131(10):1974-1980.
3. Stamatas GN, Capone K. New findings and the impact of infant skin microbiota on product development. Cosmetics and Toiletries. 2014;129(2):54.
FOR INTERNAL USE ONLY. NOT FOR DISTRIBUTION.
IMPROVE THE BALANCE IN AD
New study results show regular use of AVEENO® Eczema Therapy Moisturizing Cream
helps to balance the microbiome and improve itchy, dry skin1

Skin barrier function significantly

improved from Day 11

Both atopic prone skin and damaged atopic

prone skin had significant increases in
hydration along with reduced pH, TEWL
and itchiness sensation following use of
AVEENO® ECZEMA THERAPY
MOISTURIZING CREAM.1

1. Capone KA, Klein SL, Kirchner F, Tierney NK, Effects of topical lotions on the atopic dermatitis skin microbiome and associations
with itch and skin barrier function. Johnson & Johnson Consumer Inc. poster presentation at the 76th Annual Society for Investigative FOR INTERNAL USE ONLY. NOT FOR DISTRIBUTION.
Dermatology (SID) Meeting: April 26-29, 2017; Portland, OR, USA.
MICROBIAL DIVERSITY OF LESIONAL SKIN
NORMALIZED AT DAY 11

Skin barrier function significantly improved

from Day 1

At baseline, lesional skin had a higher pH, TEWL,

and lower skin hydration than nonlesional skin. For
subjects treated with AVEENO® Eczema Therapy
Moisturizing Cream, disease severity significantly
improved from baseline throughout the 14-day
treatment. Both lesional and nonlesional skin had
significant increases in hydration, reduced pH,
TEWL and itch.

1. Capone KA, Klein SL, Kirchner F, Tierney NK, Effects of topical lotions on the atopic dermatitis skin microbiome and
associations with itch and skin barrier function. Johnson & Johnson Consumer Inc. poster presentation at the 76th FOR INTERNAL USE ONLY. NOT FOR DISTRIBUTION.
Annual Society for Investigative Dermatology (SID) Meeting: April 26-29, 2017; Portland, OR, USA.
IMPROVE ATOPIC DERMATITIS
DISEASE SEVERITY FROM DAY 11
of subjects showed

90% significant improvement in

EASI scores by Day 3* RESULTS

The skin care regimen consisting of AVEENO® ECZEMA

THERAPY MOISTURIZING CREAM and AVEENO® BABY
CLEANSING THERAPY MOISTURIZING WASH resulted in
~50% improvement EASI clinical scoring at Day 14
(p<0.05). Despite the withdrawal of treatment at Day 14, EASI
clinical scores remained improved from Baseline at Day 21,
and were approximately equivalent to Day 3 and Day 7 values,
respectively.

1. Capone KA, Klein SL, Kirchner F, Tierney NK, Effects of topical lotions on the atopic dermatitis skin microbiome and associations
with itch and skin barrier function. Johnson & Johnson Consumer Inc. poster presentation at the 76th Annual Society for Investigative FOR INTERNAL USE ONLY. NOT FOR DISTRIBUTION.
Dermatology (SID) Meeting: April 26-29, 2017; Portland, OR, USA.
IMPROVE ATOPIC DERMATITIS
DISEASE SEVERITY FROM DAY 11
of subjects showed

97% significant improvement in

ADSI scores by Day 3* RESULTS

The skin care regimen consisting of AVEENO® ECZEMA

THERAPY MOISTURIZING CREAM and AVEENO® BABY
CLEANSING THERAPY MOISTURIZING WASH resulted in
~50% improvement in ADSI clinical scoring at Days 7, and
14 (p<0.05). Despite the withdrawal of treatment at Day 14,
ADSI clinical scores remained improved from Baseline at Day
21, and were approximately equivalent to Day 3 and Day 7
values, respectively.

1. Capone KA, Klein SL, Kirchner F, Tierney NK, Effects of topical lotions on the atopic dermatitis skin microbiome and associations
with itch and skin barrier function. Johnson & Johnson Consumer Inc. poster presentation at the 76th Annual Society for Investigative FOR INTERNAL USE ONLY. NOT FOR DISTRIBUTION.
Dermatology (SID) Meeting: April 26-29, 2017; Portland, OR, USA.
SIGNIFICANT IMPROVEMENTS IN SKIN pH

RESULTS

Use of AVEENO® Eczema Therapy Moisturizing Cream

resulted in a statistically significant decrease in pH from
Baseline to Day 14 on lesional and non-lesional skin.
Removal of treatment resulted in the pH rebounding.

FOR INTERNAL USE ONLY. NOT FOR DISTRIBUTION.

SIGNIFICANT REDUCTION IN TEWL

RESULTS

Use of AVEENO® Eczema Therapy Moisturizing Cream

resulted in a statistically significant improvement in barrier
function, as measured by a decrease in TEWL values for
lesional skin at Days 3, 7, and 14.

FOR INTERNAL USE ONLY. NOT FOR DISTRIBUTION.

SIGNIFICANT INCREASE IN SKIN HYDRATION

RESULTS

Treatment with AVEENO® Eczema Therapy Moisturizing

Cream resulted in a statistically significant increase in skin
hydration of lesional and non-lesional skin at Days 1, 3, 7, and
14. Treatment with AVEENO® Eczema Therapy Moisturizing
Cream demonstrated a 266% improvement in skin hydration
(p<0.05).

FOR INTERNAL USE ONLY. NOT FOR DISTRIBUTION.

SIGNFICANT REDUCTION IN ITCH

RESULTS

Itch Severity improves starting at Day 1 (p<0.05)

and continues throughout treatment, with a 60%
improvement after 14 days. After 1 week
withdrawal, itch severity worsened vs. Day 14
but was still improved vs. Baseline (p<0.05).

FOR INTERNAL USE ONLY. NOT FOR DISTRIBUTION.

Probiotics & Prebiotics – newest skincare “it words”
Probiotics are ‘LIVE bacteria which when administered in adequate
amount confer a health benefit to the host’, i.e. “good bacteria”

Probiotic Extracts are non-living probiotic lysates, that can also

exert health potentials. Yogurt is made by living probiotics “eating”
the milk.

Prebiotics are FOOD for probiotics. Prebiotics help

probiotics GROW and produce beneficial byproducts.
In skincare, prebiotics help to create a healthy environment
for the skin microbiome.

FOR INTERNAL USE ONLY. NOT FOR DISTRIBUTION.

Competitive Activity in the Microbiome Space
LIPIKAR BAUME AP+
Restoring long-term balance to the
microbiome. Reconstructing the
cutaneous barrier. Suppressing
inflammation.
TOLERAINE
A new generation of cleansers and
moisturizers that work together to help
restore healthy looking skin. These gentle
formulas replenish moisture and help
restore skin’s natural protective barrier.
Restore and maintain
good bacteria on the skin
Lipid-replenishing skin care that directly
targets the cause and source of itching,
redness and irritation associated with skin
prone to atopic dermatitis (eczema).
FOR INTERNAL USE ONLY. NOT FOR DISTRIBUTION.
Competitive Activity in the Microbiome Space
La Roche Posay (L’Oreal) LaRoche Posay (L’Oreal) Mother Dirt Avene (Pierre Fabre)
LIPIKAR AP+ TOLERAINE LINE AO+ Mist XeraCalm A.D
( AOBiome)

LIPIKAR BAUME AP+ TOLERIANE LINE AO+ Mist XeraCalm A.D Lipid-
PRODUCTS

• Lipid-Replenishing balm 2 hydrating creams: Double Repair Moisturizer (hero product, which has Live probiotic spray for the skin. Replenishing Cream, balm,
• Syndet AP+ (cleanser) the highest concentration of the thermal water) and Double Repair Cleansing Oil
For very dry, irritated skin prone to itching. Extreme Moisturizer UV Broad Spectrum SPF 30 and 2 cleansers: Purifying Targets itching, redness and
dryness. Foaming Cleanser (for normal to oily skin) and the Hydrating Gentle irritation for skin prone to atopic
Sensitive and atopy-prone skin. Cleanser (for normal to dry skin dermatitis and eczema
TECHNOLOGY

• Aqua Posae Filliformis helps restore balance to • Ceramide-3: One of the most important ceramides for barrier • Live probiotic (AOB) consumes • I-modula®, a biotechnological
microbiome diversity function. It helps reinforce the natural water retention barrier in dry ammonia in sweat thus active created from a
• Combination of actives to replenish moisture & skin by promoting moisturization. reducing body odor microflora found in Avene
RTB

soothe skin • Niacinamide: A form of vitamin B3 with soothing properties. • Probiotic linked to nitric oxide aquafer
• La Roche-Posay Prebiotic Thermal Water: contains prebiotic known to have anti-
ingredients thanks to its unique mineral composition and trace inflammatory benefit
elements.

• Helps restore long-term balance to the • Replenishes moisture with Glycerin and La Roche-Posay Prebiotic • Restores balance to dry, oily, • Restores balance to the
microbiome taking effect during outbreaks and Thermal Water. and sensitive skin types. cutaneous flora in patients
CLAIMS

stabilizing it during periods of remission, to • Helps restore skin's natural protective barrier with essential • Improves skin clarity by 35% in with atopy
prevent relapses ceramides. 4 weeks. • Inhibition of inflammation and
• high concentration of La Roche-Posay Prebiotic Thermal Water: • Improves the look and feel of itch
with hydrating, soothing, and antioxidant properties. dry and uneven skin by 35% in • Stimulation of innate immunity
4 weeks.
COMMENTS

• Weak link between technology, microbiome
modification, and skin health benefits
• Benefits perceivable only after ~80 days of using
lotion
• Primary benefits linked to skin barrier
strengthening
• No additional clinical work or claims related to skin and microbial • Observational data, yet to be • No clinical evidence related to
balance, clinical work referenced is based on atopic eczema and proven in RCT, for any benefits technology vs Placebo
microbiome (LIPIKAR AP+ line) claimed. • No placebo-controlled clinical
• No data shown on prebiotic RTB trial in AD to support benefit
of I-modula over established
AD efficacy of barrier creams

FOR INTERNAL USE ONLY. NOT FOR DISTRIBUTION.

LaRoche Posay Microbiome Clinicals
FLORES et al
Moderate AD population
One treatment: 20% shea butter, 4%
niacinamide, LRP thermal spring water (LRP-
TSW)
Lotion tested does NOT contain Vf extract.
Microbiome diversity differs on lesional and
nonlesional skin at baseline, at Day 84, they are
not statistically sig.
No differences in the skin MB after treatment.
SCORAD decreased in 26 of 36 patients
76% patients improved SCORAD
Other patients SCORAD stayed the same or
INCREASED ay Day 84.
NO SIGNIFICANT STAPH REDUCTION
Stenotrophomonas increased in
RESPONDERS – water borne organism
found in LPY water
GUENICHE et al
Moderate AD population
Vehicle control study on Vf extract.
No difference in TEWL from placebo vehicle
Improved SCORAD vs placebo vehicle
Significant itch reduction, was not observed in
placebo
Cup scrubs were taken and cultured for staph
species. No microbiome endpoints.
“Taken together, although there was a decline
in bacterial colonization, this reduction did not
reach a significant level in this study”.
NO SIGNIFICANT STAPH REDUCTION
FOR INTERNAL USE ONLY. NOT FOR DISTRIBUTION.
SEITE et al.
Moderate AD
Received corticosteroids for 15 days to reduce
SCORAD by 25% - is this still moderate AD?
Tested Lipikar balm AP+ with addition of mannose
in a moderate AD population microbiome study for
28 days
Mannose – prebiotic for Xanthamonas
Microbiome Diversity was the SAME in unaffected
vs affected skin at Baseline - so they can’t say
they improved diversity index at the end
Increased Xanthamonas, found in the LPY water,
on skin by using mannose – Not the WATER itself
NO SIGNIFICANT STAPH REDUCTION
KEY TAKEAWAYS
• This is not an ingredient story (Oat vs thermal water)
• Any lotion may help to rebalance the microbiome. There’s more to the story than that.
• It’s about providing the right environment for the organisms on the skin to do their best work
• pH reduction is important to healing eczema
• Improving hydration / reducing TEWL enhances barrier function
• Reducing itch is essential to breaking the AD cycle.
• We’re doing fundamental research that others are not doing to show real skincare benefits.
• We want to understand how our formulas affect the skin barrier and the microbiome
and the mechanism by which our products work.
• In our study, we not only confirmed the link between microbial diversity and AD disease
severity, but we proved our product helps to balance the microbiome and improves itchy,
dry skin with statistically significant improvements at much earlier timepoints (Day 1 vs
competitor studies at 30 and 80 days).

FOR INTERNAL USE ONLY. NOT FOR DISTRIBUTION.

Q&A

FOR INTERNAL USE ONLY. NOT FOR DISTRIBUTION.

LAUNCH MATERIALS AveenoMD
Derm eblast series
Oct-Nov-Dec
landing page &
Sales Aid – Sept 19
clinical poster –
Oct 16

Upcoming
Conferences
iRep – Oct 16 Oct-Nov

FOR INTERNAL USE ONLY. NOT FOR DISTRIBUTION.