Frequent observations about disease-characteristic alterations in the cutaneous microbiome of skin diseases have led to an increasing clinical interest to find microbiome-targeting treatment strategies, especially topical products. In recent years, topical microbiome products have been explored as novel therapeutic options, however, the used microbial composition (e.g., lactobacilli), underlying therapeutic strategy (e.g., postbiotics) and topical formulations (e.g., emollient creams) have varied substantially and limited their comparability. Significant heterogeneity also accounts for reported efficacy, tolerability, and adverse effects. Atopic dermatitis has been studied most deeply, but latest research indicates that topical microbiome products may be useful in large number of other relevant chronic skin disorders, e.g., acne vulgaris and skin barrier dysfunction. The underlying theoretical concepts and preliminary clinical data suggest that they may contain a high potential as novel treatment and prevention options in chronic skin diseases.