The rise in cesarean deliveries and evolving disease patterns necessitate comparing conditions in individuals born through normal vaginal delivery (NVD) and cesarean section (CS). The shift in delivery preferences has prompted recent research, particularly in the past few decades, exploring the connection between the increased occurrence of atopic and allergic diseases and the chosen method of delivery.

Multiple studies have examined the link between delivery method and atopic-allergic diseases (e.g., asthma, allergic rhinitis, atopic dermatitis, food allergy). CS is commonly identified as a risk factor for them [1, 2]. Additionally, some studies propose that CS could also increase the risk of immune-related conditions like inflammatory bowel diseases, immune deficiencies, and connective tissue disorders [3].

Microbiota play crucial roles in shaping the immune system, defending against pathogens, and forming a protective barrier [4]. However, if the microbiome balance is disrupted (known as dysbiosis), these functions can be affected, leading to various disorders. Extensive research has focused on the connection between dysbiosis of gut microbiota and chronic conditions like inflammatory bowel disease, endocrine disorders, and neurodegenerative diseases [5, 6]. But, microorganisms also form the skin microbiota, acting as a protective barrier and influencing the immune function of the skin [7]. Imbalances in the commensal bacteria of the skin microbiota can alter the number and diversity of microorganisms on the skin. Consequently, this disruption can impair the skin’s physical and immune barrier functions, potentially leading to the development of skin disorders.

Studies on the relationship between skin microbiota and diseases have increased recently, paralleling the research on gut microbiota. Diseases such as atopic dermatitis (AD), seborrheic dermatitis, acne vulgaris, rosacea, and infectious skin diseases (ISD) have been the focus [7, 8]. Considering the shared immune response system influenced by gut and skin microbiota, it is more accurate to assess their effects on diseases together. The significance of the gut-skin axis is evident in conditions like AD associated with food allergy, dermatitis herpetiformis linked to celiac disease, and psoriasis related to gluten intolerance [8]. Therefore, the interaction between the skin and gut is likely modulated by the common host immune system.

Both skin and gut microbiota can be affected by various factors such as age, gender, genetic structure, chronic disease status, diet, drug use, method of delivery, etc. [9]. The method of delivery is one of the most important factors. Infants delivered via CS are primarily colonized by commensal skin bacteria (such as Staphylococcus, Streptococcus, Corynebacterium, and Propionibacterium), while infants born vaginally acquire organisms from the vaginal flora (including Lactobacillus, Prevotella, Sneatia, Corynebacterium, and Candida albicans) [10]. These microbiota variations, based on exposure to the mother’s birth canal microflora, impact the Th1/Th2 balance and the anti-inflammatory cytokine response through interactions between bacterial/viral components and immune cell structures [11]. Consequently, besides the local and physical effects of microbiota composition, altered immune responses can lead to chronic systemic inflammatory conditions. This highlights how the delivery method, including microbiota, can contribute to a wide range of diseases.

Existing studies have primarily focused on exploring the link between delivery method and allergic diseases, leaving a research gap regarding its association with skin diseases. In this study, a unique approach is taken by investigating the impact on skin diseases while simultaneously considering sociodemographic factors that can influence the skin microbiota, in conjunction with the delivery method.