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What is Microbial Imbalance?
Microbial imbalance, also known as dysbiosis, is a fundamental aspect contributing to the development and exacerbation of eczema. Within the intricate ecosystem of our skin, a delicate balance exists between various microorganisms, including bacteria, fungi, and viruses. This balance is crucial for maintaining skin health and function.
Disruptions to this equilibrium can lead to dysbiosis or microbial imbalances, where harmful microorganisms proliferate, while beneficial ones diminish. This dysregulated microbial community can trigger immune responses and inflammation, potentially aggravating eczema symptoms.
THE SCIENCE
Numerous studies have shed light on the intricate relationship between microbial imbalance and eczema, highlighting the diverse mechanisms through which microorganisms influence the development and severity of this chronic inflammatory skin condition. These studies offer insights into the role of various microbial species, both on the skin and within the gut, in modulating immune responses, exacerbating inflammation, and impacting the integrity of the skin barrier.
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The Role of the Microbiome in Eczema
The microbiome of both the skin and gut plays a crucial role in the pathophysiology of eczema. While factors such as genetics and environmental influences contribute to eczema, disruptions in the microbial composition of the skin and gut are increasingly recognized as significant contributors to disease development. Studies have consistently shown that individuals with eczema exhibit altered microbial diversity and composition in their skin and gut compared to healthy controls (Kim & Kim, 2019). Emerging evidence highlights a bidirectional relationship between commensal microbes and the immune system, suggesting that alterations in microbial communities may influence the maturation of both innate and adaptive immunity, particularly during early life stages.
Staphylococcus aureus Colonization
One of the most extensively studied aspects of microbial imbalance in eczema involves the colonization of Staphylococcus aureus (S. aureus) on the skin. Research dating back to 2008 reveals that approximately 90% of patients with eczema harbor S. aureus on their skin (Leung et al., 2008). This bacterium exacerbates eczema by secreting superantigens and structural molecules within its cell wall, which trigger skin inflammation. Furthermore, S. aureus biofilms, bacterial assemblages enclosed in an extracellular matrix, significantly influence the severity of eczema by promoting immune evasion, inducing inflammation, and disrupting the skin barrier.
Mold, Parasites & Eczema
Environmental factors, such as exposure to indoor mold during infancy and fetal periods, have been linked to an increased risk of developing eczema (Karvonen et al., 2015; Lee et al., 2020). Mold exposure triggers allergic inflammation mediated by reactive oxygen species (ROS) generation and Th2-promoting inflammatory cytokines. Additionally, insights from evolutionary perspectives suggest that the allergic response, including eczema, may have originally evolved as a protective mechanism against parasitic infections (Yazdanbakhsh et al., 1999).
HOW TO EVALUATE IF YOU
HAVE MICROBIAL IMBALANCE
Understanding the intricacies of gut health and microbiome balance is essential for healing eczema. While symptoms may manifest on the skin's surface, the root causes often lie within the gut microbiome. Evaluating gut health through evaluating your stool and getting comprehensive testing can provide valuable insights into microbial composition, digestive function, and potential imbalances that may contribute to eczema and other inflammatory conditions.
Evaluate Your Stool
Assessing bowel movements and stool health through simple observations can offer valuable insights into digestive function and gut health. One commonly used tool for evaluating stool characteristics is the Bristol Stool Chart (see above), which categorizes stools into seven types based on their appearance and consistency.
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What to Look For:
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Frequency: Ideally, individuals should have at least one bowel movement per day. Consistent, regular bowel movements are indicative of healthy digestive function.
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Consistency: Stools should fall within the Type 3 to Type 5 range on the Bristol Stool Chart, indicating a balanced level of moisture and fiber intake. Any extremes, such as Types 1 or 7, may signal underlying digestive issues that need attention.
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Color: While stool color can vary based on diet and other factors, persistent changes in color, particularly to dark or pale shades, may warrant further investigation.
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Odor: Foul-smelling stools may indicate an imbalance in gut microbiota or incomplete digestion, while odorless stools are generally considered normal.
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Additional Symptoms: Pay attention to accompanying symptoms such as abdominal pain, bloating, gas, or changes in appetite, as these may provide further clues about digestive health.
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When we work with patients at Cleanbody, we ask them to journal pictures of their stool so that we can assess the health of their stool and provide personalized recommendations for improving gut health. This information, combined with dietary assessments and other evaluations, can help us develop a comprehensive plan to support digestive function and overall well-being. If you are interested in getting evaluated, book a consultation here.
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Get Your Stool Tested
At Cleanbody, we offer a comprehensive approach to evaluating gut health through our stool analysis services. You are able choose to order a stool analysis directly or work with our experienced team for evaluation to ensure that you receive the right test for your specific needs. When you opt to work with our team for evaluation, you gain access to our experienced professionals who specialize in gut health and microbial balance. Our team will carefully review your medical history, symptoms, and any existing test results to determine the most appropriate stool test for you. Once your stool analysis is complete, our team will interpret the results and provide personalized recommendations to support microbial balance and improve gut health.
The benefits of getting your gut microbiome tested are numerous:
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Identifying Microbial Imbalances: Microbial imbalances, such as an overgrowth of harmful bacteria or a deficiency of beneficial ones, can contribute to inflammation and immune dysfunction, both of which are implicated in eczema. By identifying these imbalances, targeted interventions can be implemented to restore microbial balance and alleviate symptoms.
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Personalized Treatment Approach: Every individual's microbiome is unique, and what works for one person may not necessarily work for another. Microbiome testing allows for personalized treatment approaches tailored to the specific microbial composition and needs of each individual. This can lead to more effective and targeted interventions, optimizing outcomes for eczema management.
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Understanding Gut Function: Gut health goes beyond just the composition of microorganisms. Testing can also provide insights into digestive function, gut barrier integrity, immune function, and inflammation levels. Understanding these aspects of gut health can uncover underlying factors contributing to eczema and guide treatment strategies accordingly.
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Monitoring Progress: Microbiome testing is not only valuable for initial assessment but also for monitoring progress over time. By retesting periodically, individuals can track changes in their microbiome composition and evaluate the effectiveness of interventions. This allows for adjustments to treatment plans as needed, ensuring ongoing support for gut and skin health.
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If you are interested in ordering a gut microbiome test directly, you can order our Gut Zoomer test here. It comes with a discovery consultation to help you understand your labs and your next steps. If you want to get evaluated by our Cleanbody Team before ordering testing, then book a consultation here to get evaluated directly by Dr. Fong!
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HOW TO FIX MICROBIAL IMBALANCE
Addressing microbial imbalance requires a multifaceted approach that targets both the skin and gut microbiomes. The old paradigm of treating microbial imbalances with antibiotics is being replaced with a different mindset in the naturopathic, as well as conventional medical community (Schmidt, 2020). Instead of eliminating microbes such as Staphylococcus aureus with antibiotics, dysbiosis is be better addressed by reseeding the gut and skin with beneficial microbes, and using natural antimicrobials to keep dysbiosis at bay.
Topical Antimicrobials
Topical antimicrobials can help control the overgrowth of harmful bacteria on the skin, thereby reducing inflammation and preventing flare-ups of eczema. Our favorite safe and effective topical antimicrobial is Hypochlorous Acid. This is because Hypochlorous acid is made in our bodies by our white blood cells, then they send it out on missions when you’re sick or you have an infection to kill the germs, viruses, and other bad things invading your body. Since it is naturally occurring, it is a safe, non-toxic antimicrobial agent, demonstrating efficacy against bacteria, viruses, and fungi while maintaining skin gentleness.
Studies have shown its effectiveness in managing conditions like eczema by reducing inflammation and itchiness (Anagnostopoulos et al., 2018, Wat et al., 2018, Fukuyama et al., 2018, Fukuyama et al., 2018, Natarelli et al., 2022). Hypochlorous acid has been found to be particularly effective in killing Staphylococcus aureus, a bacterium commonly associated with skin infections and eczema flare-ups. Moreover, it is considered safe for topical use, making it an effective option for individuals seeking gentle yet potent antimicrobial solutions. Pre-order our hypochlorous acid product, CleanSKIN Rescue, now to harness the benefits of hypochlorous acid!
Topical Probiotics
Topical probiotics represent a promising avenue for managing eczema. Eczema is associated with an increased abundance of Staphylococcus aureus and reduced overall bacterial diversity. Clinical observations have indicated notable improvements in eczema patients with the application of topical probiotics, which may contribute to rebalancing the skin microbiome, reinforcing the natural barrier function of the skin, and modulating immune responses (Herbert et al., 2023). By introducing beneficial bacteria to the skin microbiome, topical probiotics have the potential to outcompete harmful pathogens, thus mitigating inflammation and lowering the risk of flare-ups. Strains selected for clinical trials have frequently exhibited antimicrobial activity against S. aureus in laboratory settings. Several randomized clinical trials involving topical probiotics have demonstrated significant improvements in clinical severity, reduced abundance of S. aureus in treated lesional skin, and enhanced bacterial diversity. Notably, adverse effects reported in these studies have been minimal.
Pre-order our topical probiotic, CleanSKIN Restore, formulated to harness the benefits of topical probiotics!
Oral Probiotics
Oral probiotics offer a promising avenue for addressing eczema by influencing both the gut microbiome and immune system function. Research suggests that probiotics can enhance host defenses by stimulating mucus production, modulating tight junctions between intestinal epithelial cells (IECs) to reduce gut permeability, and outcompeting potentially pathogenic species (Park et al., 2017). In a study involving infants with AD, those who received formula fortified with probiotics showed faster reduction in disease severity compared to the control group, indicating a potential role of probiotics in AD management (Park et al., 2017). Furthermore, probiotic usage for at least 8 weeks has been shown to modulate the gut microbiome and immune status, which can help reduce allergic phenomena and the severity of AD symptoms (Rusu et al., 2019). By improving intestinal barrier function and immune regulation, oral probiotics may offer therapeutic and preventive benefits for individuals with AD across various age groups, including infants, children, adults, and during pregnancy and lactation.
Optimal Nutrition
Consuming a balanced diet rich in fiber, vitamins, and minerals is crucial for nurturing a diverse and thriving gut microbiome, which in turn can positively impact skin health. By incorporating a variety of nutrient-dense foods into your meals, such as fruits, vegetables, whole grains, and lean proteins, you provide essential nutrients that support the growth and diversity of beneficial gut bacteria.
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Fiber-rich foods, including fruits, vegetables, legumes, and whole grains, serve as fuel for the beneficial bacteria in the gut, promoting their growth and proliferation. Additionally, these foods help regulate bowel movements and maintain gut health.
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Optimal Lifestyle
Maintaining a healthy lifestyle is crucial for supporting optimal microbiome health, which positively impacts overall well-being, including skin health. Engage in regular physical activity, aim for 7-9 hours of quality sleep per night, and practice stress-reducing techniques like meditation or yoga. Stay hydrated throughout the day, limit antibiotic use to when necessary, and avoid smoking and excessive alcohol consumption. Minimize exposure to environmental toxins and pollutants, maintain a healthy weight through balanced nutrition, and cultivate social connections. Additionally, schedule regular health check-ups to monitor gut and skin health, discussing any concerns with your healthcare provider. By incorporating these lifestyle recommendations, you can support a diverse and thriving microbiome, essential for promoting optimal health and skin wellness.
Seek Professional Guidance
It's essential to emphasize the importance of seeking professional guidance for comprehensive evaluation and personalized treatment strategies. Collaborating with our team enables individuals to address specific nutritional, lifestyle, and treatment needs effectively. Evaluations may encompass various factors such as mold exposure, parasite infections, and gut dysbiosis, among others. Through thorough assessment and tailored interventions, individuals can receive targeted support to optimize their microbiome health and overall well-being. Don't hesitate to reach out to our team or trusted healthcare providers for guidance and support on your journey to improved gut and skin health.
While focusing on nutrient-rich foods, it's important to limit the intake of processed foods, sugary snacks, and excessive alcohol consumption. These dietary choices can disrupt the balance of gut bacteria, leading to dysbiosis and inflammation, which may exacerbate skin conditions like atopic dermatitis.
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In some cases, specialized nutrition plans may be necessary to target specific microbial imbalances and support optimal gut health. Working with a healthcare team or nutritionist can provide personalized guidance and recommendations tailored to your individual needs. By collaborating with experts, you can develop a customized nutrition plan that addresses your unique microbiome composition and promotes overall wellness. If you are interested in getting evaluated, book a consultation here.
More Eczema Resources
Take our Free Cleanbody Assessment or Check Out our Cleanbody Essentials
Membership and Dr. Fong's Library of Eczema Videos and Blog Posts to learn more!
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