Understanding Eczema and The Microbiome

Understanding the role of gut health in eczema 

Eczema is a chronic inflammatory skin condition that causes skin itchiness, redness, and dryness, along with blisters and skin infections in more severe cases. 

Although eczema affects the skin, the underlying root of eczema is often imbalances in the gut. This is due to the gut-skin axis where gut health impacts skin health, and vice versa. 

Research has found that people with eczema often have a significantly different gut microbiome structure and composition compared to individuals without eczema. 

The role of gut permeability in eczema 

Gut hyperpermeability, also known as leaky gut, occurs when the lining of the small intestine becomes damaged or weakened, which allows larger molecules (like toxins, bacteria, and undigested food particles) to leak into the bloodstream. This contributes to increased low-grade inflammation throughout the body which can aggravate eczema. Additionally, gut hyperpermeability can impact the immune cells and proteins responsible for maintaining the skin barrier, which can exacerbate skin dryness and irritation.

Gut hyperpermeability also affects nutrient absorption. Nutrients including zinc, calcium, magnesium, B vitamins, and iron are vital for maintaining skin health. Zinc, in particular, plays a crucial role in immune system regulation, skin barrier repair, and reducing inflammation—key factors for people with eczema. 

A zinc deficiency impacts gut lining integrity and contributes to gut permeability, then the permeability further impacts zinc absorption. It becomes a vicious cycle with both factors exacerbating the eczema presentation. We recommend using BB Kids Repair to support repairing the gastrointestinal cells. 

Histamine: A common trigger for eczema 

Histamine is a chemical released by immune cells, and can be introduced into the body from foods and drinks with a high histamine content . Excess levels of histamine in the body can make the skin itchy, irritated, red and inflamed, which contributes to eczema flareups. Gut imbalances can contribute to higher levels of histamine - this includes: 

• Overgrowths of histamine-producing bacteria (Klebsiella, Citrobacter, Pseudomonas etc.). BB Kids Eliminate contains ingredients found to clear these histamine-producing bacteria. 
• Gut hyperpermeability - this is due to the enzyme which breaks down histamine being produced in the gut lining
• Low levels of beneficial gut bacteria which break down histamine (Lactobacillus rhamnosus, Bifidobacterium species etc.) BB Kids Repair contains probiotics to support the break down of histamine. 

Low butyrate and its impact on eczema 

Butyrate is a short chain fatty acid in the gut which is produced by the beneficial gut bacteria, and butyrate is a key fuel source for the cells lining the gut. Low butyrate levels can have a significant impact on eczema by:

• Impairing immune regulation
• Contributing to intestinal hyperpermeability (leaky gut)
• Reducing the production of ceramides - these are essential lipids that help to maintain a healthy skin barrier. Without enough ceramide production, the skin barrier weakens, leading to dryness, irritation, and inflammation

 

Gut inflammation 

Chronic gut inflammation can trigger the release of inflammatory mediators into the bloodstream, which can reach the skin and contribute to its inflammation, redness, and irritation. The body’s immune response, which is often heightened in those with eczema, can be further aggravated by gut inflammation.

Secretory IgA 

Secretory IgA  is the most abundant immunoglobulin (also known as antibodies) in the body. It is produced and released in the gut, and plays a critical role in defending the body against viral, parasitic, fungal & bacterial infections, toxins and allergens. 

Low secretory IgA levels in the gut can allow overgrowths of bacteria, parasites, fungi and viruses in the gut microbiome, along with increasing the likelihood of food allergies and intolerances - all of which can trigger and exacerbate eczema. 

The link between food allergies and eczema 

Food allergies can also be a contributing factor to eczema. When the body is exposed to allergens, it triggers the production of IgE antibodies, which can lead to inflammation throughout the body. This, in turn, increases histamine production, causing itching, redness, and swelling associated with eczema.

Interestingly, imbalances in the gut are a major contributing factor to food allergies, so optimising gut health can help with reducing food allergies and eczema at the same time. 

In summary, gut health is an important factor to consider when addressing eczema. At Balanced Beings, we run comprehensive gut testing to understand what’s contributing to the eczema presentation, and to develop an individualised treatment to achieve eczema-free skin.

The comprehensive gut testing shows critical markers of gut health including: 

• Gut permeability (zonulin)
• Gut inflammation (calprotectin)
• Butyrate and other short chain fatty acids
• Secretory IgA
• Overgrowths of pathogenic bacteria, parasites, worms and fungus
• Imbalances of  beneficial gut bacteria. 

Research study links:

Atopic Dermatitis: Beyond the Skin and Into the Gut, study link here.

The role of short-chain fatty acids in inflammatory skin diseases, study link here.

Allergy & the Microbiome: Current Understandings and Future Directions, study link here.

Changes in gut microbiota for eczema: Implications for novel therapeutic strategies, study link here.