During both short- and long-duration spaceflight, several health problems can occur, including those of the skin. Astronauts in space and after returning to earth experience erythematous, burning, itchy, dry, sensitive, and thinning skin. Other skin problems, such as infections, abrasions, lacerations, delayed wound healing, and accelerated skin aging, are also common. Human skin is an ecosystem composed of a wide range of habitats for bacteria, fungi, and viruses called microbiome, which not only show a strong skin site-specific preference but also serve as microbial fingerprints that are highly unique to individuals. These human skin-associated microorganisms make a substantial contribution to the microbial ecosystems that inhabit the closed environments in space. On the other hand, human skin microbiome is also subject to change during spaceflight, which may lead to skin infections or the flare up of skin diseases. This review highlights some of the interactions between the space environment and the skin.

Keywords:
Spaceflight, International Space Station, Microgravity, Astronaut, Skin, Immune system, Microbiome
1.
Gentry GJ, Cover J. International space station (ISS) environmental control and life support (ECLS) system overview of events: 2010–2014. 45th International Conference on Environmental Systems; 2015. p. 1–12 [Online]. Available from: https://ntrs.nasa.gov/api/citations/20150022318/downloads/20150022318.pdf. Accessed 2020 Dec 8.
2.
Demontis GC, Germani MM, Caiani EG, Barravecchia I, Passino C, Angeloni D. Human pathophysiological adaptations to the space environment.
Front Physiol
. 2017;8:547.
3.
De la Torre GG. Cognitive neuroscience in space.
Life
. 2014;4(3):281–94.
4.
Wotring VE. Recent pharmacology studies on the International space station. 2014 [Online]. Available from: https://ntrs.nasa.gov/api/citations/20140012420/downloads/20140012420.pdf. Accessed 2020 Dec 8.
5.
Tronnier H, Wiebusch M, Heinrich U. Change in skin physiological parameters in space: report on and results of the first study on man.
Skin Pharmacol Physiol
. 2008;21(5):283–92.
6.
Gontcharov IB, Kovachevich IV, Pool SL, Navinkov OL, Barratt MR, Bogomolov VV, et al. In-flight medical incidents in the NASA-Mir program.
Aviat Space Environ Med
. 2005;76(7):692–6.
7.
Wotring VE. Medication use by U.S. Crewmembers on the International space station.
FASEB J
. 2015;29(11):4417–23.
8.
Crucian B, Johnston S, Mehta S, Stowe R, Uchakin P, Quiriarte H, et al. A case of persistent skin rash and rhinitis with immune system dysregulation onboard the International space station.
J Allergy Clin Immunol Pract
. 2016;4(4):759–62.e8.
9.
Crucian B, Babiak-Vazquez A, Johnston S, Pierson DL, Ott CM, Sams C. Incidence of clinical symptoms during long-duration orbital spaceflight.
Int J Gen Med
. 2016;9:383–91.
10.
Braun N, Thomas S, Tronnier H, Heinrich U. Self-reported skin changes by a selected number of astronauts after long-duration mission on iss as part of the skin B project.
Skin Pharmacol Physiol
. 2019;32(1):52–7.
11.
Lowrey CR, Perry SD, Strzalkowski ND, Williams DR, Wood SJ, Bent LR. Selective skin sensitivity changes and sensory reweighting following short-duration space flight.
J Appl Physiol
. 2014;116(6):683–92.
12.
Antonsen E, Bayuse T, Blue R, Daniels V, Hailey M, Hussey S, et al. Evidence report: risk of adverse health outcomes and decrements in performance due to in-flight medical conditions. 2018:1–80 [Online]. Available from: https://humanresearchroadmap.nasa.gov/evidence/reports/Medical.pdf. Accessed 2020 Dec 8.
13.
Scheuring RA, Mathers CH, Jones JA, Wear ML. Musculoskeletal injuries and minor trauma in space: incidence and injury mechanisms in US astronauts.
Aviat Sp Environ Med
. 2009;80:117–24.
14.
Scheuring R. Sports injuries and space injuries: prevention and treatment comparable populations? 2018 [Online]. Available from:https://ntrs.nasa.gov/api/citations/20160002368/downloads/20160002368.pdf. Accessed 2020 Dec 8.
15.
Charvat CM, Norcross J, Reid CR, McFarland SM. Spacesuit Glove-induced hand trauma and analysis of potentially related risk variables. 45th International Conference on Environmental Systems; 2015. p. 1–44 [Online]. Available from: https://ntrs.nasa.gov/citations/20150003049. Accessed 2020 Dec 8.
16.
Diaz A, Anderson A, Kracik M, Trotti G, Hoffman J, Newman D. Development of a comprehensive astronaut spacesuit injury database. 63rd International Astronautical Congress. Naples, Italy [Online]. Available from: https://www.researchgate.net/publication/279200129_Development_of_a_Comprehensive_Astronaut_Spacesuit_Injury_Database. Accessed 2020 Dec 8.
17.
Hawkins W, Zieglschmid J. SP-368 Biomedical results of apollo. Section II, chapter 1: clinical aspects of crew health [Online]. Available from: http://history.nasa.gov/SP-368/s2ch1.htm. Accessed 2020 Dec 8.
18.
Burgdorf WH, Hoenig LJ. Dermatology and the American experience in space.
JAMA Dermatol
. 2015;151(8):877.
19.
Crucian B, Sams CF. Evidence report : risk of crew adverse health event due to altered immune response human health countermeasures element. 2015 [Online]. Available from: https://ntrs.nasa.gov/api/citations/20140002769/downloads/20140002769.pdf. Accessed 2020 Dec 8.
20.
Taylor GR. Recovery of medically important microorganisms from Apollo astronauts.
Aerosp Med
. 1974;45(8):824–8.
21.
Mehta SK, Laudenslager ML, Stowe RP, Crucian BE, Sams CF, Pierson DL. Multiple latent viruses reactivate in astronauts during Space Shuttle missions.
Brain Behav Immun
. 2014;41:210–7.
22.
Rooney BV, Crucian BE, Pierson DL, Laudenslager ML, Mehta SK. Herpes virus reactivation in astronauts during spaceflight and its application on earth.
Front Microbiol
. 2019;10:16–9.
23.
Cohrs RJ, Mehta SK, Schmid DS, Gilden DH, Pierson DL. Asymptomatic reactivation and shed of infectious varicella zoster virus in astronauts.
J Med Virol
. 2008;80(6):1116–22.
24.
Longnecker DE, Manning FJ, Worth MH, Institute of Medicine (US) Committee on the Longitudinal Study of Astronaut Health.
Review of NASA’s Longitudinal Study of astronaut health
. Washington: National Academies Press; 2004.
25.
Braun N, Binder S, Grosch H, Theek C, Ülker J, Tronnier H, et al. Current data on effects of long-term missions on the international space station on skin physiological parameters.
Skin Pharmacol Physiol
. 2019;32(1):43–51.
26.
Theek C, Tronnier H, Heinrich U, Braun N. Surface evaluation of living skin (SELS) parameter correlation analysis using data taken from astronauts working under extreme conditions of microgravity.
Skin Res Technol
. 2020;26(1):105–11.
27.
Neutelings T, Nusgens BV, Liu Y, Tavella S, Ruggiu A, Cancedda R, et al. Skin physiology in microgravity: a 3-month stay aboard ISS induces dermal atrophy and affects cutaneous muscle and hair follicles cycling in mice.
NPJ Microgravity
. 2015;1:15002.
28.
Terada M, Seki M, Takahashi R, Yamada S, Higashibata A, Majima HJ, et al. Effects of a closed space environment on gene expression in hair follicles of astronauts in the International space station.
PLoS One
. 2016;11:1–17.
29.
Mao XW, Pecaut MJ, Stodieck LS, Ferguson VL, Bateman TA, Bouxsein ML, et al. Biological and metabolic response in STS-135 space-flown mouse skin.
Free Radic Res
. 2014;48(8):890–7.
30.
Reidt U, Helwig A, Plobner L, Lugmayr V, Treutlein U, Kharin S, et al. Study of initial colonization by environmental microorganisms in the russian segment of the international space station (ISS).
Gravit Sp Res
. 2014;2:46–57.
31.
Novikova ND. Review of the knowledge of microbial contamination of the Russian manned spacecraft.
Microb Ecol
. 2004;47(2):127–32.
32.
Novikova N, De Boever P, Poddubko S, Deshevaya E, Polikarpov N, Rakova N, et al. Survey of environmental biocontamination on board the International space station.
Res Microbiol
. 2006;157(1):5–12.
33.
Taylor PW. Impact of space flight on bacterial virulence and antibiotic susceptibility.
Infect Drug Resist
. 2015;8:249–62.
34.
Castro VA, Thrasher AN, Healy M, Ott CM, Pierson DL. Microbial characterization during the early habitation of the international space station.
Microb Ecol
. 2004;47(2):119–26.
35.
Yamaguchi N, Roberts M, Castro S, Oubre C, Makimura K, Leys N, et al. Microbial monitoring of crewed habitats in space-current status and future perspectives.
Microbes Environ
. 2014;29(3):250–60.
36.
Satoh K, Nishiyama Y, Yamazaki T, Sugita T, Tsukii Y, Takatori K, et al. Microbe-I: fungal biota analyses of the Japanese experimental module KIBO of the International space station before launch and after being in orbit for about 460 days.
Microbiol Immunol
. 2011;55(12):823–9.
37.
Ichijo T, Hieda H, Ishihara R, Yamaguchi N, Nasu M. Bacterial monitoring with adhesive sheet in the International space station-“Kibo”, the Japanese experiment module.
Microbes Environ
. 2013;28(2):264–8.
38.
Schiwon K, Arends K, Rogowski KM, Fürch S, Prescha K, Sakinc T, et al. Comparison of antibiotic resistance, biofilm formation and conjugative transfer of staphylococcus and enterococcus isolates from international space station and antarctic research station concordia.
Microb Ecol
. 2013;65(3):638–51.
39.
Fajardo-Cavazos P, Nicholson WL. Cultivation of Staphylococcus epidermidis in the human spaceflight environment leads to alterations in the frequency and spectrum of spontaneous rifampicin-resistance mutations in the rpoB gene.
Front Microbiol
. 2016;7:999–10.
40.
Venkateswaran K, Vaishampayan P, Cisneros J, Pierson DL, Rogers SO, Perry J. International space station environmental microbiome: microbial inventories of ISS filter debris.
Appl Microbiol Biotechnol
. 2014;98(14):6453–66.
41.
Checinska A, Probst AJ, Vaishampayan P, White JR, Kumar D, Stepanov VG, et al. Microbiomes of the dust particles collected from the International space station and spacecraft assembly facilities.
Microbiome
. 2015;3:50.
42.
Sugita T, Yamazaki T, Makimura K, Cho O, Yamada S, Ohshima H, et al. Comprehensive analysis of the skin fungal microbiota of astronauts during a half-year stay at the International space station.
Med Mycol
. 2016;54(3):232–9.
43.
Mora M, Perras A, Alekhova TA, Wink L, Krause R, Aleksandrova A, et al. Resilient microorganisms in dust samples of the International Space Station-survival of the adaptation specialists.
Microbiome
. 2016;4(1):65.
44.
Be NA, Avila-Herrera A, Allen JE, Singh N, Checinska Sielaff A, Jaing C, et al. Whole metagenome profiles of particulates collected from the International space station.
Microbiome
. 2017;5(1):81.
45.
Lang JM, Coil DA, Neches RY, Brown WE, Cavalier D, Severance M, et al. A microbial survey of the International space station (ISS).
PeerJ
. 2017;5:e4029–20.2017
46.
Singh NK, Wood JM, Karouia F, Venkateswaran K. Succession and persistence of microbial communities and antimicrobial resistance genes associated with International Space Station environmental surfaces.
Microbiome
. 2018;6(1):1–23.
47.
Singh NK, Wood JM, Karouia F, Venkateswaran K. Correction to: succession and persistence of microbial communities and antimicrobial resistance genes associated with International Space Station environmental surfaces.
Microbiome
. 2018;6.
48.
Checinska Sielaff A, Mohan G, Karouia F, Minich J, Tran Q, Urbaniak C, et al. Characterization of the total and viable bacterial and fungal communities associated with the International Space Station surfaces.
Microbiome
. 2019;7:50.
49.
Vaishampayan A, Grohmann E. Multi-resistant biofilm-forming pathogens on the International space station.
J Biosci
. 2019;44(5):1–5.
50.
Avila-Herrera A, Thissen J, Urbaniak C, Be NA, Smith DJ, Karouia F, et al. Crewmember microbiome may influence microbial composition of ISS habitable surfaces.
PLoS One
. 2020;15:1–20.
51.
Voorhies AA, Mark Ott C, Mehta S, Pierson DL, Crucian BE, Feiveson A, et al. Study of the impact of long-duration space missions at the International Space Station on the astronaut microbiome.
Sci Rep
. 2019;9(1):9911–7.
52.
Ohnishi K, Ohnishi T. The biological effects of space radiation during long stays in space.
Biol Sci Space
. 2004;18(4):201–5.
53.
Weinstein R, Mermel LA. Infection prevention and control during prolonged human space travel.
Clin Infect Dis
. 2013;56(1):123–30.
54.
Crucian BE, Choukèr A, Simpson RJ, Mehta S, Marshall G, Smith SM, et al. Immune system dysregulation during spaceflight: potential countermeasures for deep space exploration missions.
Front Immunol
. 2018;9:1–21.
55.
Schwendner P, Mahnert A, Koskinen K, Moissl-Eichinger C, Barczyk S, Wirth R, et al. Preparing for the crewed Mars journey: microbiota dynamics in the confined Mars500 habitat during simulated Mars flight and landing.
Microbiome
. 2017;5(1):129.
56.
Garrett-Bakelman FE, Darshi M, Green SJ, Gur RC, Lin L, Macias BR, et al. The NASA twins study: a multidimensional analysis of a year-long human spaceflight.
Science
. 2019;12(6436):364.
© 2021 S. Karger AG, Basel
2021
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.