Good Bugs Help Conquer Eczema

A Growing number of studies suggest good bacteria may be good for eczema.

Supplements of good bacteria may help ease the itchy and inflamed skin of eczema in infants and young children, according to a growing body of research.

Finnish researchers first reported in 2001 that bacteria called Lactobacillus GG -- now sold in the U.S. as Culturelle -- halved the chance of at-risk babies developing eczema when taken by expectant moms. Now a new study by a team of researchers from the University of Western Australia has found that a different probiotic from the same group of bacteria -- Lactobacillus fermentum VRI-033 PCC -- can actually treat eczema in small children. This study appears in the Aug 22 issue of Archives of Disease in Childhood.

Literally meaning "for life," probiotics or good bacteria help maintain the natural balance of organisms (microflora) in the intestines. The theory is that an imbalance between the strains of bacteria in the intestines can lead to a variety of health problems including gastrointestinal woes and even eczema.

So why should bacteria help kids with eczema? It's called the hygiene hypothesis. In a nutshell, we evolved in environments crawling with bacteria and we learned to live with them at a very early age -- and they helped us by giving us a robust immune system. However in today's much more hygienic, sanitized environment, we see far fewer bugs and as a result, children's developing immune system don't get the right kind of stimulation and immune responses are not protective, but allergic. About 15 million Americans, many of whom are children, have eczema. The majority of children with eczema will present before they turn one.

In the latest study of 53 children aged 6 months to 18 months with moderate or severe eczema, half the kids were given two daily doses of the probiotic dissolved in water and the other children took an identical-looking, dummy or placebo powder for eight weeks.

More than 90% of children taking the probiotics improved, compared with 63% of their counterparts given placebo. What's more, eczema became mild in more than half of the treated children. By contrast, just 30% of the kids who got placebo developed more moderate disease.

"This is the first study to show a benefit following administration of probiotics in children with moderately severe [eczema]," the researchers conclude. "[It] provides further evidence for a role of probiotics in the management of this condition."

In yet another study published earlier this year, researchers investigated whether giving babies probiotics could improve their eczema. There were 230 babies in the study, ranging in age from 6 weeks to just under one year old. All of the babies in the study were suspected of having a cow's milk allergy and were switched to diets free of cow's milk as were their nursing moms, according to the study in the April 2005 issue of the journal Allergy.

All of the babies were treated with topical medicines, but some of the babies also received daily supplements of probiotics. All of the babies in the study improved by an average of 65 percent, but those babies with either a positive skin test or blood test for food allergy showed a 32 percent greater improvement if they got the probiotic Lactobacillus GG (LGG) supplement than if they got the placebo capsules. Food allergies and eczema are inextricably linked. In fact, eczema is often the first sign of food allergies.

However promising the new studies, many question and caveats remain about the use of good bacteria in general as well as in eczema in infants. For example, there are many species of lactobacillus so when you buy a supplement or food, it's hard to tell which strain you are purchasing. A second major problem is that you can never be sure how many colony-forming units of the bacteria you are or should be getting. (The numbers of living bacteria, yeast and fungi contained in a product are expressed as colony-forming units.)

Still the news is welcome in light of the recent decision by the federal Food and Drug Administration (FDA) to issue its strong warning against the use of some of the newest weapons in the war on eczema -- Elidel (pimecrolimus) and Protopic (tacrolimus).

Until the approval of these new topical immunomodulators, steroid creams applied to the skin were the only available treatment. While still considered the treatment standard for eczema, these creams can cause thinning of the skin, stretch marks, easy bruising, and an increased risk of infection. These side effects are even more common when used for an extended period of time.

But now, research in mice, rats and monkeys has found that the immunomodulators may increase the risk of certain cancers (namely skin cancer and non-Hodgkin's lymphoma) and this risk goes up as the amount of the drug given increases. The manufacturers of these products have agreed to conduct research to determine whether there is an actual risk of cancer in humans.

So what's a mom to do?

Talk to your doctor about probiotics and whether they may be useful for your child.

Discourage scratching because that can lead to infection. Instead, apply a cold compress to the area that itches. Topical anti-itch products can be beneficial and decrease scratching. Try items like Aveeno Oatmeal Anti-itch Concentrated Lotion or Prax Lotion.

Limit contact with anything that irritates the skin. This means fragrance and dyes found in soaps, bubble bath, perfumes, cosmetics, laundry detergents, household cleaners, etc. Lukewarm soaking baths without soap are good ways to treat the dry skin of eczema. Gently pat your child dry after the shower or bath to avoid irritating the skin with rubbing. Then, apply moisturizing cream. Vanicream is ideal for those with atopic dermatitis.

Use laundry products that are free of dyes and perfumes and double-rinse clothes, towels and bedding. Avoid fabric softener.

Dress your infant properly as sweating and overheating are common triggers of the scratch/itch.

Dress him or her in loose-fitting cotton clothes as synthetic fabrics, wool, and other materials that feel rough to the touch often irritate the skin and trigger a flare-up. Long-sleeved sleepwear may also help prevent nighttime scratching.

Launder new clothes thoroughly before your child wears them.

Talk to your doctor about prescribing an antihistamine medication to relieve the itching and help break the itch-scratch cycle. Oral antihistamines, whether prescription or OTC (like Children's ZYRTEC Allergy Liquid Grape Flavor) are also helpful in reducing itching.

Ask your doctor about new non-steroidal anti-inflammatory creams or ointments which can be used for itching and redness and decrease the need for steroid creams. But as long as steroid creams are used sparingly and at the lowest effective strength, they can be safe and effective.

Thank you for taking the time to read my newsletter. I hope you have found it informative.

Denise Mann
DERMAdoctor Staff Writer

(Any topic discussed in this article is not intended as medical advice. If you have a medical concern, please check with your doctor.)

www.dermadoctor.com
Copyright 2000-2010, DERMAdoctor, Inc., All rights reserved.

Click here for permission to use this copyrighted content.