Atopic dermatitis : probiotics to support you

According to the results of several studies, taking biotics in adults, pregnant women and children can prevent and reduce the symptoms of atopic dermatitis.

Atopic dermatitis, more commonly known as eczema, is a chronic inflammatory skin disease in which the immune system dysfunctions.

Atopic eczema is characterised by alternating flare-up and lull phases.

During flare-ups, patients suffer from a range of symptoms that affect their quality of life, including :

• Itching
• Redness
• Dryness
• Swelling
• Eczematous lesions.

Usually affecting around 10% of children, this condition starts before the age of 2 and disappears completely by adolescence. However, it may persist or, more rarely, develop in adulthood.

It is thought to be caused by a genetic predisposition and/or environmental factors (pollution, allergens, stress, irritating cosmetics, perfume, food allergies, etc.).

Genetic predisposition is a major factor. Between 50 and 70% of those affected have a parent who is also affected. If both parents are suffering from the condition, the risk of the child developing atopic eczema is around 80%. 

People with atopic dermatitis have a dysbiosis of their skin microbiota, observed by a reduction in bacterial diversity. During flare-ups, this leads to the proliferation of Staphylococcus aureus, a bacterium partly responsible for :

• Local inflammation
• Over-stimulation of immunity
• Superinfection of the stratum corneum, altering the skin barrier
• Skin hyperpermeability
• Easier penetration for allergens.

Once the flare-up is over, the skin microbiota rediversifies and Staphylococcus aureus regresses.

Studies have shown that newborns with a less diverse intestinal microbiota have a higher risk of developing atopic dermatitis.

Compared to children with a healthy microbiota, those suffering from eczema had :

• Disappearance of Lactobacilli (protective bacteria)
• Decrease in Bifidobacteria (protective bacteria)
• Reduction in Akkermensia municiphila (protective bacteria)
• Increase in Clostridium difficile and Escherichia coli (pathogenic bacteria).

Yet Lactobacilli and Bifidobacteria are essential for the body to function properly, as they help to protect the intestinal mucosa and support the immune system.

This intestinal dysbiosis leads to intestinal barrier hyperpermeability, allowing pathogenic bacteria and their metabolites to enter the bloodstream, potentially causing :

• A surge in the immune system
• Pro-inflammatory cytokine production
• Systemic inflammation
• Modification of skin homeostasis: recent evidence points to an intestine-skin axis.

Probiotic supplementation for adults, pregnant women and children could be a strategy for preventing and improving the symptoms of atopic dermatitis.

The effectiveness of probiotics taken during pregnancy and breastfeeding has been scientifically proven. They reduce the risk of atopic dermatitis developing in newborns. Their consumption by adults and children has shown similar results.

They also act on the cytokine balance, by reducing the synthesis of pro-inflammatory cytokines and/or stimulating anti-inflammatory ones.

Their consumption restores the balance of intestinal flora, which helps to reduce the symptoms of atopic dermatitis. More specifically, they help to :

• Maintain the skin’s moisture content
• Reduce SCORAD* score
• Reduce the incidence and prevalence of atopic dermatitis
• Improve skin condition: less swelling, redness, dryness and lesions.

Taking care of your microbiota with probiotics can help you maintain healthier, more balanced skin. Moreover, they prevent the onset of the disease and improve the associated symptoms.

PP

Picture : Freepik

ISMAIL IH, OPPEDISANO F, JOSEPH SH, BOYLE RJ, LICCIARDI PV, ROBINS-BROWNE RM, TANG M. Reduced gut microbial diversity in early life is associated with later development of eczema but not atopy in high-risk infants. Pediatr Allergy Immunol. 2012, 23 (7):674-81.

KENNEDY EA, CONNOLLY J, O’B HOURIHANE J, FALLON PG, MCLEAN I, MURRAY D, JO JH, SEGRE JA, KONG HH, IRVINE AD. Skin microbiome before development of atopic dermatitis: Early colonization with commensal staphylococci at 2 months is associated with a lower risk of atopic dermatitis at 1 year. J Allerg Clin Immunol. 2016, 139(1):166-172.

PRAKOESWA CRS, HERWANTO N, PRAMESWARI R, ASTARI L, SAWITRI S, HIDAYATI AN, INDRAMAYA DM, KUSUMOWIDAGDO ER, SURONO IS. Lactobacillus plantarum IS-10506 supplementation reduced SCORAD in children with atopic dermatitis. Benef Microbes. 2017, 8(5):833-840.

WANG I-J, WANG J-Y. Children with atopic dermatitis show clinical improvement after Lactobacillus exposure. Clin Exp Allergy. 2015, 45(4):779-87.

*SCOring Atopic Dermatitis, severity scale (from 0 to 103) for AD. There are several degrees of severity depending on the nature of the areas affected, the intensity and extent of the lesions, the intensity of itching and the impact on quality of life (insomnia).