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The Connection Between Eczema, the Skin Microbiome, and Gut Health



Eczema or atopic dermatitis (AD) is a hard one to deal with day in and out and specially when we see our little ones suffer. Itching, redness and general sensitive skin can be such a burden. Many kids can have eczema throughout childhood and up to their early teens and some well just have it all their life. The traditional medical approach to eczema typically involves the use of topical corticosteroids and sometimes immunosuppressants to alleviate inflammation and itching. Moisturisers are often recommended to manage dry skin, and in severe cases, oral medications may be prescribed. Antihistamines may be used to reduce itching. However, these treatments may come with potential side effects, and the focus is often on symptom management rather than addressing underlying causes. Did you know there is a link between gut health, the skin microbiome, and eczema?


What is eczema and how does it present

Eczema, or atopic dermatitis, is a common skin disorder that is characterised by inflammation, redness, and itching. It can affect people of all ages, but it is often seen in infants and young children. Eczema is a chronic condition, meaning it can persist over time with periods of flare-ups and remissions.


Key signs and symptoms of eczema

Itching: Intense itching is a hallmark symptom of eczema. Scratching the affected areas can

lead to further irritation and may contribute to the development of thickened, leathery skin.


Inflammation: The skin becomes inflamed, leading to redness and swelling. In severe cases, the skin may develop blisters that can ooze and crust over.


Dryness: Eczema is associated with dry skin, and affected areas may appear scaly or rough.


Rashes: Eczema often presents as rashes in specific areas of the body, such as the face,

hands, feet, elbows, and knees. The appearance of the rash can vary depending on the

individual and the stage of the condition.


There are many triggers or worsen eczema symptoms, including allergens, irritants, stress,

climate changes, and certain foods. And every person has different triggers.


Introduction to the skin microbiome

The skin microbiota is an ecosystem made up of various microbial species interacting with each other, including the host epithelial and immune cells. There is a diverse community of

microorganisms that inhabit the surface of the skin. These microorganisms include bacteria,

fungi, viruses, and other microbes. The skin microbiome plays a crucial role in maintaining skin health and contributes to the overall well-being of the body.


Key functions of the skin microbiome

Barrier Function: The skin microbiome contributes to the maintenance of the skin barrier, which acts as a protective shield against external threats like pathogens and environmental stressors.


Immune System Support: Microorganisms on the skin can interact with the immune system,

helping to educate and modulate immune responses. A balanced microbiome is essential for a well-regulated immune system.


Metabolic Functions: Certain microbes on the skin can contribute to the breakdown of sweat

and sebum, producing byproducts that may have protective or nourishing effects.


Staphylococcus Aureus and the eczema link

Picture your skin as a thriving community with a mix of helpful microbes. These microbes, working on the skin's surface and in hair follicles, process the skin's proteins and fats, creating useful substances like fatty acids, antimicrobial peptides, and antibiotics. These substances play a crucial role in preventing harmful invaders and supporting the skin's immune system. However, when there's too much of a particular microbe, Staphylococcus aureus (S. aureus), it disrupts this harmony. This overgrowth leads to the production of harmful substances, triggering inflammation and contributing to eczema. Fortunately, other friendly microbes, coagulase-negative staphylococci (CoNS), come to the rescue by producing antibiotics to control the overgrowth of S. aureus. Additionally, compounds derived from the skin's microbes help strengthen the skin's barrier, playing a key role in maintaining healthy skin. This intricate interplay showcases how the skin microbiome acts as a guardian, striving to maintain a delicate balance for our skin's well-being.



The link between gastrointestinal function, the skin microbiome and eczema

The gastrointestinal system plays a key role in the management and treatment of skin disorders like eczema. This is predominantly due to intestinal hyperpermeability, which is where the tight junctions that line the small intestine do not work optimally. Weakness in these gap junctions allow toxins to accumulate into the circulation of intestinal lumen. These toxins are processed and expelled through the skin causing changes to dermal physiology and leading to the development of skin disorders.


A key focus on the treatment and management of eczema should be on gastrointestinal support to encourage healthy permeability and decrease the absorption of undigested peptides and food antigens.


Addressing gut dysbiosis

Imbalance or dysbiosis in the bacterial population residing in the gut has been linked to the

development of eczema. An imbalance of bacteria leads to inflammation and decreased

mucous membrane activity in the digestive tract, contributing to its pathogenesis.

Probiotic bacteria leads to an inflammatory response within the intestinal epithelial cells,

therefore, playing a role in the healing of eczema.


A meta-analysis on the use of probiotics for the treatment of eczema in children and adults

found that a combination of species of Lactobacillus bacteria had greater success with

treatment than Bifidobacterium bacteria on its own. Recent evidence also indicates that

unsuccessful treatment of eczema with probiotics is often a result of vitamin D deficiency.

Vitamin D helps with the signalling between gut microbiota and the individual.


There are many ways we can help manage and reduce the symptoms of eczema by using a

holistic and natural approach to healthcare. At Solace Health we are here to support you on

your own unique health journey. Don’t hesitate to reach out if you have any questions.



References

Drvar, D., Hadžavdić, S., Hrestak, D., Matijašić, M., Paljetak, H., & Peric, M. (2022). Skin

Microbiota in Atopic Dermatitis. International Journal of Molecular Sciences, 23(7). doi:

10.3390/ijms23073503

Hong, S., Lee, E., Lee, S., & Park, Y. (2018). Microbiome in the Gut-Skin Axis in Atopic

Dermatitis. Allergy, Asthma and Immunology Research, 10(4), 354-362. doi:

10.4168/aair.2018.10.4.354

Kim, K., Jang, H., Kim, E., Kim, H., & Sung, G. Y. (2023). Recent advances in understanding the role of the skin microbiome in the treatment of atopic dermatitis. Experimental Dermatology.

Sarris, J., & Wardle, J. (2019). Clinical naturopathy (2nd ed.). Elsevier Australia.

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