Emerging research suggests that the balance of bacteria in our guts (the micro biome) has a considerable influence on our immune system and therefore skin conditions like eczema.
In this blog post, I will explore the potential role of various probiotic strains in reducing incidences and severity of childhood eczema.
Eczema, also known as atopic dermatitis, is a chronic inflammatory skin condition that affects around 43 million children under the age of five, worldwide. (1)
Characterized by red, itchy and dry skin, eczema often causes considerable discomfort and irritation, which can significantly impact a child’s quality of life.
The root causes of childhood eczema remain unclear and can differ from child to child. What we do know is that genetics, environmental factors and an overactive immune system are key drivers in most types of childhood eczema.
As a nutritional therapist, I’m particularly interested in the immune responses that drive and affect eczema.
With approximately 70-80% of the immune system residing in the gut (2), researchers have been looking at the connection between gut bacteria, a critical component of our immune system, and its relationship to childhood eczema.
In particular, some promising research suggests that the use of Lactobacillus and Bifidobacteria probiotics may play a significant role in preventing and managing the condition.
Lactobacillus and Bifidobacterium probiotics are known to improve gut health by promoting the growth of beneficial bacteria and therefore inhibiting the growth of harmful, inflammatory bacteria. This in turn, can modulate the immune system and reduce inflammation, potentially impacting the development and severity of childhood eczema.
Researchers in a 2021 study combining over 2000 children found that infants under the age of three, receiving Lactobacillus and Bifidobacterium containing probiotics, may be 40% less likely to develop eczema. The benefit was observed regardless of family history or the amount of bacteria, even when followed up for 2 years. Interestingly, when expectant mums introduced these probiotics during pregnancy, there was also a 41% lower risk of the baby developing eczema.
However, while a mix of a Lactobacillus rhamnosus GG (LGG) and Bifidobacterium Lactis showed promise, combining LGG with Bifidobacterium Longum wasn’t as clearly beneficial. The role of these probiotics in infant eczema requires further investigation. (3)
In 2022, a new analysis reaffirmed earlier findings: taking Lactobacillus Rhamnosus probiotics during pregnancy and breast-feeding may reduce a child’s risk of developing eczema. By ages 6-7, these children had a 38% lower risk of developing the condition. However, by the time they reached ages 10-11, this benefit became less clear. Over time, as with many long-term studies, family drop-out rates increased. Importantly, the positive outcomes were apparent whether Lactobacillus Rhamnosus was used alone or paired with other probiotic strains. (4)
A 2023 study reviewed 14 trials involving 1124 children to see whether any single-strain of lactobacillus may have a unique advantage. The single-strain use of L. fermentum, appeared to improve children’s eczema symptoms the most. Whereas strains like L. paracasei, L. plantarum, and L. rhamnosus did not show significant benefits. An interesting exception to this, was in babies under one year old, when given Lactobacillus rhamnosus GG for three months.
The amount of time that children took the probiotic, as well as the severity of their eczema symptoms, seemed to be important. A 12-week regimen seemed to be most effective. It appeared that among children with moderate to severe eczema, the probiotics were not consistently beneficial. (5)
More research is needed to fully understand the actual link between probiotics and childhood eczema. However, recent studies show promising results and indicate that the supplementation of lactobacillus and potentially with bifidobacterium probiotics, from early pregnancy, through to the first year of breast-feeding may significantly reduce the incidence of childhood eczema.
Expectant parents interested in supplementing with probiotics should consult with their pediatricians or a nutritionist first. Probiotics come in various forms, including capsules, powder and in foods like yogurt. Additionally, maintaining a healthy, balanced diet and avoiding potential triggers are essential for the management of eczema in all age groups.
Contact Tamla Anderson, registered nutritionist, if you would like to discuss your own or your child’s eczema.
(1) International League of Dermatological Societies (ILDS). Global Report on Atopic Dermatitis 2022 [Internet]. Eczema Council. London, UK: International League of Dermatological Societies (ILDS); 2022 [cited 2023 Sep 4]. Available from: https://www.eczemacouncil.org/assets/docs/global-report-on-atopic-dermatitis-2022.pdf
(2) Wiertsema SP, van Bergenhenegouwen J, Garssen J, Knippels LMJ. The Interplay between the Gut Microbiome and the Immune System in the Context of Infectious Diseases throughout Life and the Role of Nutrition in Optimizing Treatment Strategies. Nutrients. 2021 Mar 9;13(3):886. doi: 10.3390/nu13030886. PMID: 33803407; PMCID: PMC8001875.
(3) Sun M, Luo J, Liu H, Xi Y, Lin Q. Can Mixed Strains of Lactobacillus and BifidobacteriumReduce Eczema in Infants under Three Years of Age? A Meta-Analysis. Nutrients. 2021 Apr 25;13(5):1461. doi: 10.3390/nu13051461. PMID: 33923096; PMCID: PMC8145948.
(4) Voigt J, Lele M. Lactobacillus rhamnosus Used in the Perinatal Period for the Prevention of Atopic Dermatitis in Infants: A Systematic Review and Meta-Analysis of Randomized Trials. Am J Clin Dermatol. 2022 Nov;23(6):801-811. doi: 10.1007/s40257-022-00723-x. Epub 2022 Sep 26. PMID: 36161401; PMCID: PMC9576646.
(5) Fijan S, Kolč N, Hrašovec M, Jamtvedt G, Pogačar MŠ, Mičetić Turk D, Maver U. Single-Strain Probiotic Lactobacilli for the Treatment of Atopic Dermatitis in Children: A Systematic Review and Meta-Analysis. Pharmaceutics. 2023 Apr 17;15(4):1256. doi: 10.3390/pharmaceutics15041256. PMID: 37111741; PMCID: PMC10146705.