In the last few decades, the number of studies on the microbiota and microbiome of living organisms inhabiting the skin has grown rapidly, and the contribution of the microbial community to the realization of skin functions and the pathogenesis of dermatoses is of great scientific and public interest. Understanding the contribution of skin dysbiosis to skin aging, sensitization, and the pathogenesis of chronic dermatoses has prompted the development of strategies aimed at correcting the skin microbiota. One of the directions of bacteriotherapy of skin diseases is the use of biotic complexes, which include metabiotics of human commensal bacteria and prebiotics. The use of biotic complexes allows to effectively modulate the skin microbiome and its barrier functions. A practical embodiment of the use of metabiotics of probiotic bacteria as part of biotic complexes was the development of active skin care systems containing lysates of probiotic microorganisms Lactococcus, Lactobacillus and Bifidobacterium and prebiotics trehalose and inulin. These products can be enhanced with active ingredients with proven efficacy, such as panthenol, jojoba oil, shea butter and others that provide skin cleansing, moisturizing and nourishing. The conducted studies have demonstrated the effectiveness and safety of products with enhanced formula as part of complex treatment of patients with atopic dermatitis. Their clinical effects are based on the restoration of the skin barrier (according to the dynamics of pH-metry, transepidermal water loss and skin elasticity), as well as normalization of the microbial composition of the skin (reduction in the frequency of identification of phylum, which belong to opportunistic microorganisms, and reduction in the frequency of identification of the Staphylococcaceae family, pathogenic representatives of which lead to increased inflammation and allergic reactions on the skin). © 2025 Elsevier B.V., All rights reserved.