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Eczema and Inflammation: The Inner Ecosystem Connection

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Eczema—also called atopic dermatitis—is a skin disorder that affects the outermost layers of the skin.

Research shows that those with eczema are likely to have leaky gut or a wounded inner ecosystem.

In the United States, about 10–20% of children have eczema. (1) It often appears in infancy.

And, if you have eczema, you may have flare-ups well into adulthood.

Children and babies with eczema tend to have food sensitivities. Their inner ecosystem is often out of balance. Babies with eczema are also more likely to go on to develop respiratory allergies, like asthma. (2)

So, what causes childhood eczema?

While a doctor will often treat eczema with topical creams and even steroids, the root cause of eczema isn’t in the skin. Instead, research tells us that eczema begins in the gut. (3)(4)

What Is Eczema?

With eczema, skin becomes red, swollen, scaly, and itchy. Blisters may form. In severe situations, you see the skin crack, ooze clear fluid, and sometimes even bleed.

Despite appearances, eczema is not just a skin disorder. Eczema means the breakdown of your barrier systems. And very often, eczema is a gut disorder that shows up in the skin.

As it turns out, the gut and the skin have something in common.

Eczema is an inflamed, painful, and itchy skin condition that can affect babies, children, and adults. Eczema is a sign that barrier systems have broken down in the body and gut ecology is desperately in need of support.

Both are designed to protect the body. Both contain specialized cells (called dendritic cells) that belong to the immune system. Besides the skin and the digestive tract, dendritic cells are also found in the nose and lungs. These specialized immune cells help make up your barrier systems. They filter and tag anything from the outside that does not belong in the body.

This can mean:

  • Harmful bacteria, viruses, fungi—and their waste
  • Food
  • Pollutants in the air
  • Environmental chemicals and toxins

When dendritic cells are “turned on” in one part of the body, it can trigger an alarm in other areas of the body that have dendritic cells. To you and me, this alarm looks like inflammation. (5)

Research shows that those with eczema are likely to have leaky gut or a wounded inner ecosystem. (6)(7) And often, the two go hand-in-hand.

3 Factors That Influence Your Baby’s Inner Ecosystem

There are 3 universal factors that influence the inner ecosystem and the skin of babies. These are:

1. Birth Route. Before a baby is born into the world, it lives in a sterile environment. Baby’s first exposure to bacteria (and first inoculation) begins during the birthing process.

Babies that are born through the birth canal are exposed to a different set of bacteria than those babies that are born via C-section. Those born through the birth canal are coated with beneficial lactobacillus bacteria.

Babies that are born via C-section do not have the opportunity to slide through mom’s birth canal—the first bacteria that they come into contact with are bacteria from the immediate environment, like the bacteria living on the skin. Unfortunately, the bacteria that live in the gut and those that live on the skin are different.

2. Breast or Formula Fed. Breast milk contains good bacteria, and it also feeds the good bacteria that are already living in baby’s gut. A breastfed baby mostly harbors bifidobacteria.

A study recently published in the Canadian Association Medical Journal found that how a baby is delivered into the world and what the baby consumes during the first several months of life may have important consequences. (8) For example, researchers discovered that babies born by C-section were lacking a specific group of bacteria—even if they were breastfed. Babies that were strictly formula-fed also had differences in their gut bacteria.

According to Canadian researchers, babies born by C-section are at an increased risk of asthma, obesity, and type 1 diabetes. Breastfeeding seems to protect against these and other disorders, although the level of protection is unique to each child.

3. Antibiotic Use. Antibiotics kill bacteria; they are designed to wipe out all bacteria, not just the harmful ones. This is bad news for babies that receive antibiotic therapy.

A study published in November 2012 found that short-term antibiotic use affects the type of bacteria living in a baby’s gut. (9) In other words, antibiotic therapy will not only get rid of an infection, but it also disrupts good bacteria. Worse, it seems that even short-term antibiotic use reduces microbial diversity—or, the number of different species of bacteria living in the gut.

Is microbial diversity such a big deal? Maybe.

Research suggests that microbial diversity affects health. And studies show that when you give antibiotics to a baby, you may affect the long-term evolution of that baby’s inner ecosystem. The implications of this are still unknown. One more reason to look for an alternative to antibiotic therapy: We know that babies with eczema also tend to have low microbial diversity. (10)

Probiotics to the Rescue

When it comes to eczema, be proactive about your health.

Studies show that lactobacillus probiotics, as found in the Body Ecology cultures and probiotic beverages, encourage intestinal cells to produce a thin, healthy mucus. This healthy mucus prevents harmful bacteria—like E. coli and Clostridium difficile—from taking up residence in the gut. (11)

Other studies point out that too much E. coli and C. difficile show up in stool samples before the development of eczema in babies. (12) Further research confirms that babies with eczema have an inner ecosystem that is similar to an adult’s—in other words, not enough bifidobacteria and too much C. difficile. (13)

There are more reasons to consider probiotic therapy if you or your child struggle with eczema:

  • Probiotics have been reported to help seal a leaky gut. (14) Remember, leaky gut is associated with eczema.
  • Good bacteria also help the gut to mature. In fact, research shows that babies receiving probiotic treatment have a stronger gut barrier. (15)
  • Lactobacillus probiotics have been found to regulate dendritic cells­—as we mentioned earlier, dendritic cells are a part of the immune system that are activated in babies with eczema. (16)
  • In a 2011 study, researchers concluded that probiotics can influence the ecosystem of the skin. This can help control infections that are related to eczema. (17)
  • Good bacteria like lactobacillus and bifidobacteria have been shown to improve eczema in children and in adults. (18)(19)(20)

The Best Form of Probiotics

The best way to get living lactobacillus bacteria is from fermented foods.

TIP: If you child is still too young to enjoy cultured foods, like kefir and sauerkraut, we recommend giving a dropper full of cultured vegetable juice.

In addition to fermented foods, we strongly recommend following the 7 Universal Principles of the Body Ecology Diet. This is because the Body Ecology Diet is gluten-free, casein-free, and sugar-free. It is specially designed to nurture the inner ecosystem of the gut and repair the intestinal lining.

What To Remember Most About This Article:

Eczema, otherwise known as atopic dermatitis, affects 10-20% of children and can develop as early as infancy. Eczema can continue to flare-up throughout adulthood. Children with eczema may have other related health issues, like food sensitivities and asthma.

Researchers have linked eczema with a wounded inner ecosystem or leaky gut. There are 3 main factors that can influence the health of your baby's inner ecology to cause this irritating, chronic skin condition:

  1. Birth Route. A baby is exposed to bacteria in birth, either vaginally or via C-section. Babies born C-section may first come into contact with bacteria found on the skin instead of protective bacteria from the birth canal.
  2. Breast or Formula Fed. Breast milk is teeming with good bacteria that can support the health of a baby's gut. Strictly formula-fed babies have differences in gut bacteria.
  3. Antibiotic Use. Antibiotics wipe out both good and bad bacteria, which can be detrimental to a baby. Antibiotic use could affect the long-term health of a baby's inner ecology.

Probiotic therapy could provide a solution to the problem of childhood eczema. Body Ecology fermented foods and probiotic beverages are chock full of friendly bacteria that can help to seal a leaky gut, strengthen the gut barrier, and even influence the ecosystem of the skin.

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  • The Body Ecology Diet

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  1. Leung DYM, Bieber T. (2003). Atopic dermatitis. Lancet, 361:151–60.
  2. Dunstan, J. A., Hale, J., Breckler, L., Lehmann, H., Weston, S., Richmond, P. and Prescott, S. L. (2005), Atopic dermatitis in young children is associated with impaired interleukin-10 and interferon-γ responses to allergens, vaccines and colonizing skin and gut bacteria. Clinical & Experimental Allergy, 35: 1309–1317.
  3. Majamaa H, Isolauri E. (1996). Evaluation of the gut mucosal barrier: evidence for increased antigen transfer in children with atopic eczema. J Allergy Clin Immunol, 97:985–90.
  4. Rosenfeldt V, Benfeldt E, Valerius NH, Paerregaard A, Michaelsen KF. (2004). Effects of probiotics on gastrointestinal symptoms and small intestinal permeability in children with atopic dermatitis. J Pediatr, 145:612–6.
  5. Novak N, Gros E, Bieber T and Allam J-P (2010). Human skin and oral mucosal dendritic cells as ‘good guys’ and ‘bad guys’ in allergic immune responses. Clinical & Experimental Immunology, 161: 28–33.
  6. Pike MG, Heddle RJ, Boulton P, Turner MW, Atherton DJ. (1986). Increased intestinal permeability in atopic eczema. J Invest Dermatol, 86:101–4.
  7. Duchmann R, Neurath MF, Meyer zum Buschenfelde KH. (1997). Responses to self and non-self intestinal microflora in health and inflammatory bowel disease. Res Immunol, 148: 589–94.
  8. Azad, M. B., Konya, T., Maughan, H., Guttman, D. S., Field, C. J., Chari, R. S., ... & Kozyrskyj, A. L. (2013). Gut microbiota of healthy Canadian infants: profiles by mode of delivery and infant diet at 4 months. Canadian Medical Association Journal.
  9. Fouhy, F., Guinane, C. M., Hussey, S., Wall, R., Ryan, C. A., Dempsey, E. M., ... & Cotter, P. D. (2012). High-throughput sequencing reveals the incomplete, short-term recovery of infant gut microbiota following parenteral antibiotic treatment with ampicillin and gentamicin. Antimicrobial agents and chemotherapy, 56(11), 5811-5820.
  10. Abrahamsson, T. R., Jakobsson, H. E., Andersson, A. F., Björkstén, B., Engstrand, L., & Jenmalm, M. C. (2012). Low diversity of the gut microbiota in infants with atopic eczema. Journal of Allergy and Clinical Immunology, 129(2), 434-440.
  11. Mack DR, Michail S, Wei S, McDougall L, Hollingsworth MA. (1999).Probiotics inhibit enteropathogenic E. coli adherence in vitro by inducing intestinal mucin gene expression. Am J Physiol Gastrointest- inal Liver Physiol, 276:G941–50.
  12. Penders, J., Thijs, C., van den Brandt, P. A., Kummeling, I., Snijders, B., Stelma, F., ... & Stobberingh, E. E. (2007). Gut microbiota composition and development of atopic manifestations in infancy: the KOALA Birth Cohort Study. Gut, 56(5), 661-667.
  13. Nylund, L., Satokari, R., Nikkilä, J., Rajilić-Stojanović, M., Kalliomäki, M., Isolauri, E., ... & de Vos, W. M. (2013). Microarray analysis reveals marked intestinal microbiota aberrancy in infants having eczema compared to healthy children in at-risk for atopic disease. BMC microbiology, 13(1), 12.
  14. Ramakrishna BS. (2009).Probiotic-induced changes in the intestinal epithelium: implications in gastrointestinal disease. Trop Gastroenterol, 30:76–85.
  15. Hooper LV, Gordon JI. (2001). Commensal host–bacterial relationships. Science, 292:1115–8.
  16. Christensen HR, Frkiær H, Petska JJ. (2002). Lactobacillli differentially modulate expression of cytokines and maturation surface markers in murine dendritic cells. J Immunol, 168:171–8.
  17. Nermes, M., Kantele, J. M., Atosuo, T. J., Salminen, S., & Isolauri, E. (2011). Interaction of orally administered Lactobacillus rhamnosus GG with skin and gut microbiota and humoral immunity in infants with atopic dermatitis. Clinical & Experimental Allergy, 41(3), 370-377.
  18. Sistek, D., Kelly, R., Wickens, K., Stanley, T., Fitzharris, P. and Crane, J. (2006), Is the effect of probiotics on atopic dermatitis confined to food sensitized children. Clinical & Experimental Allergy, 36: 629–633.
  19. Weston, S., Halbert, A., Richmond, P., & Prescott, S. L. (2005). Effects of probiotics on atopic dermatitis: a randomised controlled trial. Archives of disease in childhood, 90(9), 892-897.
  20. Iemoli, E., Trabattoni, D., Parisotto, S., Borgonovo, L., Toscano, M., Rizzardini, G., ... & Drago, L. (2012). Probiotics reduce gut microbial translocation and improve adult atopic dermatitis. Journal of clinical gastroenterology, 46, S33-S40.

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  • Andree

    So what happens if you are unable to eat fermented foods due to an histamine and Tyramine intolerance along with having a leaky gut. I am at the moment trying to heal my gut staring with natural supplements and enzymes. Sadly though I am reacting to those too. Any ideas please. Thank you for the summit it's brilliant!

  • Maria Sireci

    I would love to give my child, 3 now, cultured veggie jiuce. How do I make that? Do I juice some veggies and add a culture or might that be the liquid from my cultured vegetables?

    My son did have mild eczema, born c-section, and had a small amount of antibiotics when he was a wee infant, he also had leaky gut that we "healed" with glutamine. Luckily he was breastfed until 2 but I'm on the lookout for ways to help him be healthier.

    Thank you,
    Maria Sireci

  • Joseph T. Malak MD

    In 30 years of practice, I see more infant eczema than ever before. Poor babies!

    Donna has real insight here into a major, major factor behind this increase. And an elegant, practical solution -- cultured vegetable juice.

  • Megan

    Hi Yushan,

    Recently, scientists determined that a shift in the follicular ecosystem may cause a shift in the health of the hair follicle. This may be one factor that leads to folliculitis decalvans.

    Other recent studies on folliculitis decalvans show the immune system found at the level of the skin is especially responsive to the mineral zinc.

    Overall, adopting the Body Ecology principles can *only* help-- especially since recent studies show that folliculitis decalvans involves balancing the ecosystem of the skin and supporting immune system balance.

    If you are taking oral antibiotics that you swallow, this is destroying the inner ecosystem of the gut-- these antibiotics act on the gut first, since you must digest them. This is more reason to adopt Body Ecology principles.

    Besides removing gluten and casein from your diet, you may want to see if you can find fresh oysters (oysters on the half shell). They are a natural source of zinc!

    Here are links to the studies I mentioned, both published in Journal of the European Academy of Dermatology and Venereology:
    doi: 10.1111/j.1468-3083.2012.04591.x
    doi: 10.1111/j.1468-3083.2010.03934.x

  • Yushan

    Hi, I've been diagnosed with Folliculitis Decalvants of the scalp I'm currently on antibiotics. Do you think this disease has anything to do with my gut? Because my dermatologist said it doesn't matter what I would have eaten it just happens and it's something I'm going to have to live with. Help!

  • Kim

    Do not forget Celiac disease - highly under-diagnosed - cured with diet - causes dermatitis herpetiformis.

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