The gut microbiome and eczema: how are probiotics beneficial?

The gut microbiome and eczema: how are probiotics beneficial?

Microbiome intestinal et eczéma

The microbiome, or microbiota, is the current name given to the organisms living on the surface of the skin, in our intestine, our lungs, mouth, and more. We couldn’t survive without this incredible medley of bacteria, viruses and fungi, and vice versa. There are 10 million per cm2 on our skin, and 100,000 billion in a single digestive tract! Our immune system needs these microbiomes in order to function properly.

It therefore makes sense to consider an anomaly or imbalance in the microbiomes in the case of an inflammatory disease like atopic dermatitis, in which the immune systems (innate and adaptive) are a bit overzealous.

A number of recent discoveries have shed some light on atopic dermatitis:

  • A link between a skin microbiome imbalance and a disruption in the skin’s immune system, thus forming a couple on the skin
  • A link between an intestinal microbiome imbalance and a disruption in the intestine’s immune system, thus forming a couple in the intestine
  • A vicious cycle perpetuated by inflammation itself within each couple
  • And notably a link between the intestine couple and the skin couple!

In other words: An imbalance in the gut microbiome may trigger eczema flare-ups


What could disrupt the balance in these microbiomes, throw everything off and thus cause atopic dermatitis flare-ups? Well, a number of things could, especially in our modern world :


  • Genetic factors
  • Diet
  • Medications, especially antibiotics
  • Caesarean section
  • Overly clean houses and living spaces, often in urban settings
  • Ambient air that is overly polluted
  • Stress


The common denominator in all of these imbalances is depleting biodiversity in the microbiomes, leading to one species become dominant.

This phenomenon occurs on the skin as well as in the digestive tract.


  • A dominance of Staphylococcus aureus on atopic skin, which would explain the bouts of superinfections producing yellowish scabs on the skin.    
  • Near disappearance of lactobacilli in the gut microbiome in favor of other bacteria, as well as a reduction in bacteria overall compared to other groups


How can you avoid such imbalances or repair the gut microbiome and thus alleviate eczema?


  • Eat better: avoid fast, refined sugar and saturated fats. Fast sugar is found in sodas, breakfast cereals, candies, cakes, etc. Saturated fats are found in all industrial foods, red meat (limit to 1 or 2 servings a week to prevent overconsumption) and what is commonly referred to as “junk food”.


  • When treatment with antibiotics is necessary, feel free to take food supplements containing iron, manganese and copper, in doses according to your age, for the entire winter


  • Repair the gut flora by regularly taking probiotics suitable for atopic dermatitis. Probiotics are good bacteria, such as lactobacilli which are deficient in cases of atopic dermatitis. Too often, probiotics are recommended to “boost” immunity to avoid falling ill in the winter. In the case of atopic dermatitis, the immune system hardly needs “boost”; it is already overactive. Probiotic strains specifically adapted to atopic dermatitis are therefore required. (Lactobacillus rhamnosus GG). Other strains are still being identified, and the current recommendations will surely evolve in the future. Science has proven that taking probiotics during pregnancy and breastfeeding can help prevent the onset of atopic dermatitis in babies.


  • To be taken during pregnancy and breastfeeding, by babies, by families at-risk or not , and after each antibiotic treatment • Treat digestion issues, such as bloating, abdominal pains, diarrhea, etc. All of these issues cause damage and inflammation in the wall of the small intestine. Which should be avoided at all costs! This is why milk and gluten intake should be reduced. Try it for a month. If you feel better, continue eating these foods in smaller quantities. If you have noticed no changes, then go back to your previous diet.


  • Identify other ways to care for your digestive system, such as repairing the wall of the small intestine which may have been irritated by a poor diet or poor digestion. This “repair” is possible thanks to prebiotics, plant fibers found in fruits and vegetables. They also provide nourishment for probiotics, and the two are often prescribed together.

Unless you follow a balanced diet and take care of your digestive health, taking pre- and/or probiotics provides no benefit!


A balanced gut microbiome is essential for a balanced immune system in the skin.

This balance can be disrupted by a high-sugar, high-fat diet, antibiotics, and even stress.

A holistic approach is needed to maintain this balance:

  • Eat less fast sugar and eat more fresh, seasonal fruits and vegetables
  • Prevent bloating by reducing your consumption of cow’s milk and gluten
  • Take probiotics for every antibiotics treatment

By Dr Magali Bourrel-Bouttaz - Dermatologist at Chambéry
Contributor to the LYON atopy school (Pierre Bénite Hospital Center)

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