2020 SPECIALTY SUPPLEMENT OF THE YEAR
October 27, 2023 2 Comments
New research indicates that specific bacteria on the skin and in the gut can complicate or even cause eczema.
Staphylococcus aureus on the skin has been indicated in up to 90% of eczema cases. It damages up the skin barrier, flares up the immune system, and causes itching and inflammation. Effectively managing this chronic overgrowth can be extremely challenging if not impossible.
Why is it so challenging?
Scientists are just beginning to understand why managing S. aureus is so difficult. First, it has been observed that eczema sufferers have less commensal bacteria, or good bacteria, on their skin to fight off or balance the typical S. aureus overgrowth. This creates a chronic imbalance and an unfair, losing battle. Typically, a cocktail of steroids and antibiotics can be prescribed to fight the infection.
However, this does not always work because other friendly bacteria can be killed off in the process. Some of the most common commensal skin bacteria in healthy skin are S. epidermidis, R. mucosa, and S. hominis. In healthier skin, these bacteria keep our skin balanced and healthy, and protect us from invaders like S. aureus.
However, in the case of eczema, not only do patients have less of these good bacteria, but scientists now believe these commensal bacteria have been permanently altered by pollution. And top scientists at The National Institutes of Health have presented evidence that this alteration of bacteria by pollution is the cause of eczema. They are changing from health promoting to disease causing.
This pollution, largely from catalytic converters exhaust from automobiles, makes our commensal bacteria less effective at fighting bad bacteria like S. aureus.
To further complicate the problem, the skin isn’t the only place our once helpful bacteria are adopting to our modern world. Altered bacteria in our gut are also to blame.
For example, beneficial gut bacteria Faecalibacterium prausnitzii is a commensal human gut bacteria that makes anti-inflammatory butyrate. However, it has been observed that eczema patients have a variant, Faecalibacterium prausnitzii L2-6, which doesn't produce enough butyrate. This disrupts the gut, causing leaky gut and an overactive immune response, harming the skin.
Eczema is complicated. And now evidence shows it is caused by a microbial imbalance that disrupts both the gut and skin, leading to an endless cycle of itching and inflammation.
Understanding bacteria's role in the progression and complication of eczema can help researchers and patients better understand what is causing the problem so hopefully better solutions can be realized.
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October 27, 2023
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