Atopic dermatitis, also known as eczema, is a chronic, inflammatory skin condition. Most patients with eczema require long-term treatment to manage the appearance, itchiness, and scaling from their lesions.
The human gut microbiome, a collection of microorganisms within the digestive tract, consists of billions of bacteria and their byproducts. When they are in a good balance, they may protect against pathogens and support the immune system. When the proportion of “good” bacteria to “bad” bacteria is unbalanced, it can lead to more disease and in severe cases, it can lead to severe infections.
Probiotics vs Probiotics vs Synbiotics
Probiotics: People typically take probiotics (live, “good” bacteria) in hopes of restoring the balance of their microbiome
Prebiotics: The growth of these “good” bacteria can be promoted by prebiotics, which is food for the bacteria.
Synbiotics: Synbiotics are a combination of probiotics and prebiotics
Gut Microbiome in Eczema
As mentioned earlier, an imbalance of bacteria in the gut microbiome may lead to inflammatory conditions such as eczema. Several studies found that infants with eczema had decreased amounts of the Bifidobacteria bacteria, which are considered “good” bacteria, in their stool.[1,2] These findings suggest that eczema may be associated with an altered gut microbiota since the amount of “good” bacteria is lower in eczema patients. Researchers looked to understand how the use of synbiotics may help in the treatment of eczema and if early use of synbiotics could prevent the development of eczema. To do this, the researchers looked through the medical literature database to perform a meta-analysis based review.
Meta-analysis Based Review
A meta-analysis is a specialized way of reviewing the literature so that different high-quality studies can be combined together into one analysis. In this case, the researchers combined studies that looked at how synbiotics could affect eczema.
The researchers found that synbiotics significantly reduced the severity of eczema under the following conditions:
Overall: Synbiotics were more effective than placebo but two studies showed that synbiotics were not better than prebiotics
Mix of bacteria: The use of several different types of bacterial species had a greater effect than the studies that used a single-strain of bacteria
Age: Synbiotics improved eczema in children that were 1 year and older but not in those that were younger than 1 year.
Early exposure: Two of the reviewed studies showed that early supplementation during pregnancy or soon after birth was protective against the development of atopic dermatitis.
Overall, the researchers’ findings suggest that synbiotics may be effective as an eczema treatment but more studies are needed to continue to build the knowledge and the evidence in this area.
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Bjorksten B, Sepp E, Julge K, et al. Allergy development and the intestinal microflora during the first year of life. J Allergy Clin Immunol.2001;108(4):516-520; PMID: 11590374 Link to research.
Murray CS, Tannock GW, Simon MA, et al. Fecal microbiota in sensitized wheezy and non-sensitized non-wheezy children: a nested case-control study. Clin Exp Allergy.2005;35(6):741-745; PMID: 15969664 Link to research.
Chang YS, Trivedi MK, Jha A, et al. Synbiotics for Prevention and Treatment of Atopic Dermatitis: A Meta-analysis of Randomized Clinical Trials. JAMA Pediatr.2016;170(3):236-242; PMID: 26810481 Link to research.
Kukkonen K, Savilahti E, Haahtela T, et al. Probiotics and prebiotic galacto-oligosaccharides in the prevention of allergic diseases: a randomized, double-blind, placebo-controlled trial. J Allergy Clin Immunol.2007;119(1):192-198; PMID: 17208601 Link to research.