Published 7th February 2022

How is eczema linked to gut health?

Eczema is a chronic skin condition that causes itchy, dry, and often painful patches of skin. The exact causes are not completely understood, but emerging research suggests there could be a link between eczema and gut health.  

Some scientists think your skin health and gut health may be connected and that the makeup of your gut microbiome — the community of bugs that live in your gut — could play a part. 

Researchers have also looked at whether probiotics can help with eczema. Probiotics are microorganisms similar to the “good” bacteria in your microbiome and may improve your gut health.

You can buy them as supplements, but they are also found naturally in certain fermented foods.

At ZOE, we run the largest nutrition and gut microbiome study of its kind and can help you find the best foods for your gut health.

You can take our free quiz to learn more about how the ZOE program can help you.

Below, we’ll consider the possible links between your gut microbiome and the most common type of eczema, atopic dermatitis. We’ll also look at whether boosting the health of your gut with probiotic foods and supplements can help.  

What is eczema and what causes it?

Eczema is a condition that makes your skin dry, itchy, and cracked. It often starts in babies or children but can continue into adulthood. Eczema can cause severe discomfort and can significantly affect your quality of life. 

There are several different forms of eczema, which may have different triggers:

  • Atopic dermatitis: This is the most common form of eczema. It is the result of an inappropriate response by your immune system and may be linked to stress. Your genes impact your risk of developing it.

  • Contact dermatitis: This is an inflammation caused by exposure to allergens or irritants, like soap or household cleaning products. 

  • Seborrheic dermatitis: This is a type of eczema that affects areas of your body with sebaceous glands, like your scalp. The exact cause is unknown, but it may be due to particular yeast species that live on your skin.

  • Discoid dermatitis: This is a type of eczema that causes round patches of dry skin.

  • Dyshidrotic dermatitis (or pompholyx): These are itchy blisters — usually on your hands and feet — that can be triggered by stress or allergy. 

Moisturizers, steroid creams, or antihistamines can help with symptoms like itching and dryness. 

Atopic dermatitis and gut health

Atopic dermatitis is the most common type of eczema and the most researched.

People with atopic dermatitis often also have a food allergy and may experience flare-ups as a reaction to a specific food, such as cow’s milk. In recent years, scientists have also found multiple links between atopic dermatitis and gut health

Your gut microbiome is involved in regulating your immune system, which may, in turn, affect the health of your skin.  

Some studies have shown that people with atopic dermatitis may have a smaller range of gut bugs than those who don’t have eczema.

Many researchers agree that a more diverse gut microbiome with many beneficial bacteria is generally a healthier one. 

A small number of studies have found that people with atopic dermatitis are more likely to have higher or lower amounts of certain types of bacteria in their gut microbiomes.

However, there’s still a long way to go before scientists understand exactly how much of an influence the composition of your gut microbiome might have on eczema. 

Can probiotic supplements help with eczema?

If your gut health is linked to the health of your skin, could probiotic supplements help with eczema by boosting your gut microbiome? 

One study found that infants who took probiotics called Lactobacillus rhamnosus and Bifidobacterium animalis every day for 6 months were less than half as likely to develop eczema during that time as those who didn’t take the supplements. 

A review of seven other studies found that children whose mothers took Lactobacilli probiotics during pregnancy had a lower chance of developing eczema between the ages of 2 and 7. 

However, for those who took a blend of other types of probiotic bacteria, there was no less risk of developing eczema.  

These findings suggest that probiotic supplements may reduce the risk of developing eczema if taken at a young age. However, it is questionable whether probiotics can help if you already have eczema symptoms.

A review of 39 clinical studies involving people who already had eczema found that the probiotics they took made little or no difference to symptoms such as itching or loss of sleep, and it led to no improvements in their overall quality of life. 

Can foods that boost gut health help with eczema? 

Fermented foods like yogurt, kimchi, miso, sauerkraut, and aged cheeses — like cheddar and parmesan — are naturally rich in probiotics that are good for your gut health

Eating significant amounts of fermented foods appears to be linked to a lower risk of having eczema as an adult.

One study with almost 10,000 participants from Korea found that adults who ate a diet high in fermented foods were significantly less likely to have eczema.

However, it’s worth noting that this meant eating fermented foods an average of at least three times a day over the course of a month.

Supporting these results, a study in Japan showed that the babies of mothers who had eaten natto (fermented soybeans) every day during their pregnancy were less likely to have developed eczema than those whose mothers ate it only two to three times per week. 

How to eat to improve your gut health

ZOE’s scientific co-founder Prof. Tim Spector recommends eating a small amount of probiotic-rich foods each day to help maintain your general gut health. 

You should also eat plenty of plants containing fiber, called prebiotics, which feed your gut microbes and help them to thrive. 

Examples of prebiotic foods include onions, bananas, asparagus, legumes like chickpeas and lentils, and whole grains.

These are broad guidelines everyone can follow, but at ZOE, we know that there’s no one-size-fits-all approach to gut health and nutrition.

Our scientists identified 15 “good” gut bugs linked to markers of better health and 15 “bad” bugs that are indicators of worse health. 

With the ZOE at-home test, you find out which of these “good” and “bad” bugs live in your gut. The test also analyzes your unique blood sugar and blood fat responses, which are all important aspects of your metabolic health

The ZOE program gives you personalized nutrition advice to help you pick the best foods for your gut and your overall health. 

Take our free quiz to find out what ZOE can do for you. 

Summary

Eczema is an inflammatory skin condition that causes dry, itchy, often painful patches of skin. The specific causes of eczema are unknown, but emerging research suggests that some forms may be linked to gut health. 

Studies have found that people with atopic dermatitis — the most common form of eczema — may have a less diverse gut microbiome than people who don’t have eczema.

Research also suggests that the presence of specific types of gut microbes is associated with eczema.

Adults who eat a diet very high in fermented foods containing natural probiotics may be less likely to have eczema. Eating fermented foods every day while pregnant could significantly reduce the chance of your child developing eczema.

Taking probiotic supplements containing Lactobacilli bacteria regularly during pregnancy, or as an infant, might also lower the risk of eczema in children.

However, probiotic supplements have little or no effect on symptoms in people who already have eczema.

With the ZOE program, you can find the best foods to improve your gut health.

Take our free quiz to learn more.

Sources

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Diagnosis and treatment of seborrheic dermatitis. American Family Physician. (2015). https://www.aafp.org/afp/2015/0201/p185.html

Does atopic dermatitis cause food allergy? A systematic review. The Lancet. (2017). https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30491-9/fulltext 

Eczema: the spectrum of clinical presentations. Current Allergy and Clinical Immunology. (2019). https://journals.co.za/doi/10.10520/EJC-10955e048d

Effects of gut microbiome and environment on the development of eczema in Chinese infants. Medicine. (2020). https://pubmed.ncbi.nlm.nih.gov/32481318/

Fermented food intake is associated with a reduced likelihood of atopic dermatitis in an adult population (Korean National Health and Nutrition Examination Survey 2012–2013). Nutrition Research. (2016). https://www.sciencedirect.com/science/article/abs/pii/S0271531715002912

Gut microbiota, probiotics, and their interactions in prevention and treatment of atopic dermatitis: a review. Frontiers in Immunology. (2021). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8317022/ 

Impact of maternal supplementation with probiotics during pregnancy on atopic eczema in childhood – a meta-analysis. British Journal of Nutrition. (2011). https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/impact-of-maternal-supplementation-with-probiotics-during-pregnancy-on-atopic-eczema-in-childhood-a-metaanalysis/0DD5C549F687188AC97E9E1EB10AEEE9 

Influence of atopic dermatitis on cow's milk allergy in children. Medicina. (2019). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6723735/

Maternal intake of Natto, Japan's traditional fermented soybean food, during pregnancy and the risk of eczema in Japanese babies. Allergology International. (2014). https://pubmed.ncbi.nlm.nih.gov/24759553/

Microbiome in the gut-skin axis in atopic dermatitis. Allergy, Asthma & Immunology Research. (2018). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6021588/ 

Pathophysiology of atopic dermatitis: Clinical implications. Allergy and Asthma Proceedings. (2019). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399565/

Probiotics for treating eczema. Cochrane. (2018). https://www.cochrane.org/CD006135/SKIN_probiotics-treating-eczema 

Probiotics in late infancy reduce the incidence of eczema: a randomized controlled trial. Pediatric Allergy and Immunology. (2019).  https://onlinelibrary.wiley.com/doi/10.1111/pai.13018

Probiotics: What you need to know. (2019) https://www.nccih.nih.gov/health/probiotics-what-you-need-to-know 

Psychoneuroimmunology of psychological stress and atopic dermatitis: pathophysiologic and therapeutic updates. Acta Dermato-Venereologica. (2012). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3704139/

The gut microbiome as a major regulator of the gut-skin axis. Frontiers in Microbiology. (2018).  https://www.frontiersin.org/articles/10.3389/fmicb.2018.01459/full 

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