Are probiotics useful in children with eczema?

Eczema is the most common inflammatory skin disease in childhood, affecting between 5-20% of children of any age.

Around 2% of adults have eczema and many tend to have it very severely. Eczema is such a difficult condition to live with and often people may feel desperate in the attempt to find some relief. The use of probiotics in treating eczema is a controversial issue with conflicting evidence. 

Studies have found that people with eczema may have a less diverse gut microbiome than people who don’t have eczema. For example, Bifidobacterium has been shown to be reduced in the gut microbiota of infants, children, and young adults with eczema. Bifidobacteria are bacteria that are incredibly important for our health. 

The Evidence:

Probiotics can help regulate the immune system by increasing regulatory T cells and inhibiting a Th2 response. This means that probiotics may play an anti-inflammatory role in the body.

A lot of studies show that probiotics may help to prevent and treat eczema in children.

However, some evidence also suggests that probiotics make little or no difference in improving eczema symptoms. Limited research in pregnancy and breastfeeding mothers has also shown that probiotic supplementation reduced eczema in children, suggesting that maintaining a healthy, balanced intestinal microbiota during pregnancy is an important factor that positively influences the newborn’s intestinal microbiota.

The problem with the evidence on probiotics is that studies use different probiotic strains and different dosages. It is therefore difficult to determine the overall benefit of probiotics in the prevention and treatment of eczema.

Eczema and Food

Food doesn’t cause eczema, however, certain foods may trigger a flare-up. In practice, I tend to see dairy and soya causing eczema flare-ups, and often these children have been (or not yet) diagnosed with cow’s milk protein allergy.

If you think perhaps food is triggering a reaction, then try keeping a food and symptom diary as this will help you detect any possible trigger(s). Please note that it’s not just food that may trigger an eczema flare-up and not all people with eczema have a food allergy.

If there is a family history of eczema then this predisposes a child to eczema. Over 200.000 new chemicals have been introduced to our lives in the last 60 years. Research suggests that detergents and food emulsifiers may disrupt the epithelial barrier causing a “leaky gut”. A leaky gut allows bacteria and toxins to “leak” through the intestinal wall. 

Therefore, consider making your own environment toxin-free. Swap your laundry detergents and cleaning products for fewer toxin ones. You could also make your own. 

I personally use lots of white wine vinegar, baking soda + essential oils to make my own cleaning products. The internet has wonderful recipes.  

The verdict:

Probiotics may or may not improve eczema symptoms so if you want to include a probiotic, please consult your dietitian or doctor. In the meantime, focus on enhancing the overall quality of your own diet (and environment) and that of your family.

Increase fibre and include food sources of probiotics and prebiotics as these factors may all help shift gut microbiota toward a more healthful profile.

Did a probiotic supplement work for your child? Please comment below.

 

 

References

Akdis, C. A. and Platz, D. (2022) ‘The epithelial barrier hypothesis proposes a comprehensive understanding of the origins of allergic and other chronic noncommunicable diseases’, Journal of Allergy and Clinical Immunology. Elsevier, 149(1), pp. 41–44. doi: 10.1016/J.JACI.2021.11.010.

Aldaghi, M. et al. (2022) ‘The effect of multistrain synbiotic and vitamin D3 supplements on the severity of atopic dermatitis among infants under 1 year of age: a double-blind, randomized clinical trial study’, The Journal of dermatological treatment. J Dermatolog Treat, 33(2), pp. 812–817. doi: 10.1080/09546634.2020.1782319.

Makrgeorgou, A. et al. (2018) ‘Probiotics for treating eczema’, The Cochrane Database of Systematic Reviews. John Wiley and Sons, Inc. and the Cochrane Library, 2018(11), p. 6135. doi: 10.1002/14651858.CD006135.PUB3.

Rautava, S. et al. (2012) ‘Maternal probiotic supplementation during pregnancy and breast-feeding reduces the risk of eczema in the infant’, Journal of Allergy and Clinical Immunology. Mosby, 130(6), pp. 1355–1360. doi: 10.1016/J.JACI.2012.09.003.

Schmidt, R. M. et al. (2019) ‘Probiotics in late infancy reduce the incidence of eczema: A randomized controlled trial’, Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology. Pediatr Allergy Immunol, 30(3), pp. 335–340. doi: 10.1111/PAI.13018.

Tan-Lim, C. S. C. et al. (2021) ‘Comparative effectiveness of probiotic strains on the prevention of pediatric atopic dermatitis: A systematic review and network meta-analysis’, Pediatric Allergy and Immunology. John Wiley and Sons Inc, 32(6), pp. 1255–1270. doi: 10.1111/PAI.13514.

Vitaliti, G. et al. (2014) ‘The immunomodulatory effect of probiotics beyond atopy: an update’, The Journal of asthma : official journal of the Association for the Care of Asthma. J Asthma, 51(3), pp. 320–332. doi: 10.3109/02770903.2013.862259.

Zheng, H. et al. (2016) ‘Altered Gut Microbiota Composition Associated with Eczema in Infants’, PloS one. PLoS One, 11(11). doi: 10.1371/JOURNAL.PONE.0166026.