In the special environment of plateau, adaptive responses and pathological changes occur in the skin of organisms, which include skin barrier dysfunction, skin vasoconstriction disorder, abnormal thickening of the stratum corneum, and fibrous pigment deposition, leading to a high incidence of skin diseases in plateau areas. In the plateau environment, the composition and diversity of skin microbiota change, which may be related to the occurrence and development of skin diseases. This paper reviews the effects of plateau environments on the skin, common skin diseases in plateau environments, and the effects of skin microbiota on skin diseases and discusses the mechanisms by which skin microbiota influences skin diseases in plateau environments.