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Eczema is a very common skin condition in Singapore. About 1 in 5 children and 1 in 10 adults in Singapore may be suffering from eczema.
What is eczema?
Eczema is a condition where the skin is inflamed and angry looking. It causes skin redness, itchiness, dryness, skin peeling and sometimes pain and infection. There are many types of eczema and the most common of all is atopic dermatitis.
The exact cause of eczema is still not fully understood. Genetics and environmental factors comes into play. However the main cause is still a faulty immune response to external stimuli, resulting in the skin becoming inflamed.
With recent advances in medical technology, there is now evidence to possibly suggest that gut dysbiosis may play an important role in the development of allergic diseases including atopic dermatitis.
A 2010 study found that children with allergic diseases such as atopic dermatitis have a very different intestinal flora from healthy children. Those with eczema tend to have high levels of clostridia and lower levels of Bifidobacterium and lactobacillus. Therefore its been suggested that high levels of bad bacteria and lower levels of good bacteria in the gut may trigger the Immune system the wrong way, resulting in allergic conditions.
Gut-skin axis and probiotics
As such, the gut-skin axis has been proposed and the use of probiotics to prevent and treat allergic conditions like eczema are being tested. The current theory is that administering probiotics may reduce the immune imbalance within the body, hence reducing the sensitivity of the skin. Probiotics has a direct effect in reducing inflammatory biochemicals within our body and in doing so , reduce the severity of eczema.
There is a small scale study from Spain which demonstrated that administering probiotics including Bifidobacterium and lactobacillus may be effective in reducing eczema symptoms and reducing the use of topical steroids in patients with moderate atopic dermatitis.
There was another study published in 2014 which administered Bifidobacterium probiotics prenatally to mother and postnatally to infants for 6 months. The data suggested that this probiotics supplementation may have reduced the risk of developing eczema in infants.
Mainstay of eczema treatment
In essence, the mainstay of eczema treatment is still
- Allergen avoidance
- Moisturizers and emollients to reduce dryness and restore skin protective barrier
- Topical steroids to reduce inflammation and itchiness
- Topical calcineurin inhibitors like tacrolimus
- Wet dressings and even phototherapy
However, in time to come, probiotics may become a safe and effective method intreating eczema on top of the traditional treatments.
By : Dr Chen Yiming
Family Physician, MBBS (Singapore), GDFM (NUS), GDFP Dermatology (NUS)