Eczema & Leaky Gut: What You Need To Know

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This article is contributed by health writer Max Chuen.

Probiotics and prebiotics have been a significant trend and research interest in recent years – these microbes have been linked to lowering the risk of many chronic diseases, such as cardiovascular disease, diabetes, and obesity. And the results are quite promising.

More importantly, what is the level of evidence for probiotics and prebiotics on benefiting eczema?

A quick recap – What are probiotics and prebiotics?

Probiotics refer to foods that contain living microorganisms that can reach our intestines when consumed and live in our gut without harming us, collectively known as our gut microbiota. Our gut microbiota comprises 100 trillion microorganisms and the probiotics we consume from food are just some parts of it. The most common probiotic found in food is the Lactobacillus and Bifidobacterium family.

‍Prebiotics are substrates that we cannot digest but can be selectively utilized by our host microorganisms (i.e gut microbiota) providing health benefits. Essentially, prebiotics are ‘fertilizers’ for your gut microbiota. Our probiotic population in the gut will feed on them and alter our gut composition into a healthier state. The specific nutrients we want from prebiotics are dietary fibre, resistant starch, polyphenols and inulin.

Food-gut-skin Connection

It has been discovered that eczema patients have a reduction of gut and skin microbiota diversity.‍

Eczema and gut health are strongly related. An overall unhealthy microbiota is known as ‘dysbiosis’. Under dysbiosis, our anti-infection barrier weakens and we experience the infamous condition called the leaky gut – which means our gut which is responsible for the induction, training and function of our immune system is compromised.

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With a leaky barrier, pathogens can easily enter our bloodstream and our immune system will initiate inflammation in our gut and throughout our body. This contributes to skin inflammation and eczema flares.

But how are probiotics and prebiotics related to reducing eczema severity?

The species of Lactobacillus and Bifidobacterium will lower pro-inflammatory cytokines, effectively reducing the eczema inflammation, flare and itchiness.

The immunomodulatory effect of probiotics and the anti-inflammatory effects of prebiotics help to alleviate eczema. By consuming probiotics, we can restore the diversity of our gut microbiota, which will improve our intestinal barrier and immune system.

Probiotic supplementation research has shown eczema symptoms improve in adults. The well-cited strains are Lactobacillus, Bifidobacterium or a combination of them, which you should be mindful of to select when purchasing.

Furthered with a diet rich in prebiotics which can be sourced from food directly, our friendly gut microbiota will produce short-chain fatty acids (SCFAs) which produce anti-inflammatory effects. These SCFAs are also an energy source for our gut lining, which keeps our gut barrier strong, thus strengthening our immune system.

Where and how to consume probiotics and prebiotics?

With all these benefits that probiotics and prebiotics bring to eczema patients, consuming enough probiotics and prebiotics are important.

Currently, there is no recommended daily intake for probiotics, but for prebiotics with dietary fiber being the most accessible source – the recommended daily intake is 25-30 grams. This is equivalent to a healthy diet comprising cooked grains, beans, fruits and vegetables.

So where can we find food with high probiotics and prebiotics?

Probiotics: yoghurt, cheese, kimchi, sauerkraut, kefir, kombucha, raw apple cider vinegar, natto. 

Prebiotics: common fruits, vegetables, whole grains, nuts, seeds and legumes.

Most probiotic-rich foods have undergone the fermentation process, which is a tricky situation for eczema patients because this food production process increases the food chemical load of the food like salicylates. Also, common fermented foods are dairy products which are only workable into an eczema diet if you are 100% you have no dairy sensitivity. 

So please make sure how you incorporate probiotics into your diet is safe and free of potential allergens. Otherwise you may have to resort to probiotic supplements which you can easily purchase online – but then only select those with evidence-based strains. Always check the labels!

So be good to your gut microbiota, keeping them healthy and happy, and they will return the favour back to us.

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References

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