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The Link Between Antibiotics and Eczema: What You Need to Know

By Dr. Diane Angela Fong, ND



Eczema, also known as atopic dermatitis, is a chronic inflammatory skin condition characterized by redness, itching, and dryness of the skin. It affects millions of people worldwide, with prevalence rates varying across regions and age groups. In industrialized countries, the prevalence of eczema has been steadily rising over recent decades, presenting a significant public health concern.


Simultaneously, there has been a marked increase in the use of antibiotics, both in medical settings and in agriculture. While antibiotics are invaluable in treating bacterial infections, their widespread use has raised concerns about their potential impact on human health, particularly their effects on the microbiome—the diverse community of microorganisms that inhabit our bodies—and the immune system.


Understanding the Microbiome and Immune System



The human microbiome is a complex ecosystem consisting of trillions of microorganisms, including bacteria, viruses, fungi, and other microbes. In fact, the human body is host to an estimated 38 trillion microbes, outnumbering human cells by a factor of approximately 1.3 to 1. These microbes inhabit various body sites, including the skin, gut, oral cavity, respiratory tract, and reproductive organs, forming a dynamic and interconnected community known as the microbiome.


The microbiome plays a crucial role in maintaining health and homeostasis throughout the body. These microorganisms contribute to essential physiological processes, such as digestion, nutrient absorption, metabolism, and immune system regulation. They also help protect against invading pathogens by competing for nutrients and space, producing antimicrobial substances, and modulating immune responses.


Of particular importance is the interaction between the microbiome and the immune system. The immune system serves as the body's defense mechanism against pathogens, toxins, and other harmful substances, while also maintaining tolerance to beneficial microbes and harmless antigens. The microbiome plays a central role in shaping the development and function of the immune system, influencing immune cell maturation, activation, and response to stimuli.


Through intricate signaling pathways and communication networks, the microbiome helps educate the immune system, teaching it to distinguish between harmful pathogens and beneficial microorganisms. This process, known as immune tolerance or immune education, is crucial for preventing inappropriate immune responses, such as the responses found in eczema, allergies, autoimmune diseases, and chronic inflammation.


Microbiome Disruption and Antibiotics



Disruptions in the microbiome can have far-reaching consequences for immune system function and overall health. Imbalances in microbial communities, known as dysbiosis, can lead to dysregulated immune responses, inflammation, and susceptibility to infections and chronic diseases. Factors such as diet, lifestyle, environmental exposures, and stress can all impact the composition and diversity of the microbiome, influencing immune system function and health outcomes.


Antibiotic usage, in particular, can have serious consequences on the microbiome. Antibiotics are designed to kill or inhibit the growth of bacteria, targeting both pathogenic and beneficial species. While effective in treating bacterial infections, antibiotics can have broad-spectrum effects on the microbiome, disrupting its composition and function. This disruption can lead to dysbiosis, favoring the overgrowth of harmful bacteria and compromising the diversity of beneficial species.


How Antibiotics Contribute to Eczema Development



The microbiome disruption caused by antibiotics can profoundly impact immune system function, potentially increasing the risk of inflammatory conditions like eczema. Dysbiosis, triggered by antibiotics, can disrupt immune system training and regulation, leading to abnormal immune responses and chronic inflammation characteristic of eczema.


Prenatal and Early-Life Exposure

Research has consistently shown a significant link between prenatal and early-life antibiotic exposure and the development of eczema. Chang et al. (2023) conducted a comprehensive population-based cohort study, revealing that maternal antibiotic use during pregnancy, particularly in the first and second trimesters, was associated with an elevated risk of childhood atopic dermatitis (AD), with the risk increasing with higher doses of antibiotics. Additionally, postnatal antibiotic or acetaminophen exposure in infants was found to contribute to an increased risk of AD after one year of age.


Similarly, Wan and Yang (2023) conducted a meta-analysis supporting these findings, indicating that maternal antibiotic exposure during the first and second trimesters modestly increases the risk of AD in offspring. Further research conducted by Hua et al. (2021) revealed a notable genetic predisposition, particularly in individuals with the MS4A2 rs569108 GG genotype. When coupled with early-life antibiotic exposure, this genetic variant was found to significantly increase the risk of eczema development in children.


Moreover, Tsakok et al. (2013) conducted a systematic review, highlighting a dose-response association between early-life antibiotic exposure and eczema risk, indicating a 7% increase in eczema risk for each additional antibiotic course received during the first year of life. This was supported by the findings of Huang et al. (2020), whose meta-analysis demonstrated that maternal antibiotic exposure was associated with eczema by one year of age, with potential lasting effects beyond the first year.


In a population-based cohort study in Sweden, Mubanga et al. (2021) further corroborated these findings, revealing that exposure to antibiotics during pregnancy and the first year of life was linked to a modestly increased risk of atopic dermatitis in children. These collective findings underscore the critical importance of minimizing prenatal and early-life antibiotic exposure to mitigate the risk of eczema development in children.


Addressing Dysbiosis with The Cleanbody Method



Given the association between antibiotic use and eczema risk, proactive measures are essential to restore microbiome balance and support overall health. At Cleanbody, we advocate for a comprehensive approach known as the Cleanbody Method, designed to promote microbiome health and reduce the risk of inflammatory conditions such as eczema.


Step 1: Evaluate - Comprehensive Stool Analysis

At the core of the Cleanbody Method lies the first crucial step: evaluation. We begin by meticulously assessing the status of your organ health, with particular emphasis on the intricate balance of your microbiome. Through a comprehensive stool analysis, we delve deep into understanding the composition and functionality of your microbiome, unearthing any imbalances or dysbiosis that could potentially underlie health concerns like eczema. By understanding the specific factors affecting microbiome health, personalized interventions can be developed to address underlying imbalances.


Step 2: Optimize the Pillars of Health



The next step in the Cleanbody Method is to optimize the Pillars of Health, encompassing CleanFOOD, CleanMIND, CleanROUTINE, CleanENVIRO, and CleanFIT. Each pillar focuses on promoting a healthy microbiome and supporting overall well-being.


  • CleanFOOD: Emphasizes the consumption of nutrient-dense, whole foods that nourish the microbiome and support immune function.

  • CleanMIND: Recognizes the connection between mental and emotional well-being and microbiome health.

  • CleanROUTINE: Advocates for healthy lifestyle habits, including regular exercise, adequate hydration, and optimal sleep hygiene.

  • CleanENVIRO: Highlights the importance of minimizing exposure to environmental toxins and pollutants that can disrupt the microbiome.

  • CleanFIT: Promotes physical activity and movement to support gut motility and circulation, crucial for maintaining a healthy microbiome.


Step 3: Support the Gut to Heal with CleanGUT: A 4R Protocol

Finally, the Cleanbody Method includes a targeted approach to support gut healing through CleanGUT: a 4R protocol: Rid, Replace, Repair, and Restore.


  • Rid: Involves removing potential triggers of gut inflammation, such as processed foods, allergens, and environmental toxins.

  • Replace: Focuses on replenishing beneficial nutrients and digestive enzymes that may be deficient.

  • Repair: Aims to heal and repair the intestinal lining, which may be damaged due to inflammation or dysbiosis.

  • Restore: Involves restoring balance to the microbiome through targeted interventions such as probiotics, fermented foods, and dietary fiber. Studies have shown that probiotics can help restore the microbiome after antibiotic use and support immune function (Foolad et al., 2018; Wickens et al., 2018).


Should You Avoid Antibiotics?



At Cleanbody, we advocate for a holistic approach to health that prioritizes supporting the body's natural defenses whenever possible. While antibiotics are essential for treating bacterial infections, their indiscriminate use can disrupt the delicate balance of the microbiome and compromise immune function. Therefore, we recommend exploring alternative strategies to support the immune system and address infections before resorting to antibiotics.


Supporting the Immune System with Nutrition and Herbs

Nutrition plays a vital role in supporting immune function and overall health. A diet rich in whole foods, including fruits, vegetables, lean proteins, and healthy fats, provides essential nutrients that bolster the immune system's ability to fight off infections. Additionally, certain herbs and botanicals have been used for centuries to support immune function and promote overall wellness. At Cleanbody, we offer guidance on incorporating immune-supportive foods and herbs into your daily routine to enhance your body's natural defenses.


The Immune System's Capacity to Overcome Infections

In many cases, the immune system is highly effective at combating infections when adequately supported. With proper nutrition, hydration, rest, stress management, and supportive immune-boosting supplements, the body can mount a robust immune response to eliminate pathogens and restore health. By adopting a proactive approach to wellness and prioritizing immune support, individuals can reduce their reliance on antibiotics and minimize the risk of microbiome disruption.


Using Antibiotics as a Last Resort

While antibiotics have saved countless lives and remain indispensable in treating severe bacterial infections, they should be used judiciously and reserved for situations where they are truly necessary. Antibiotics can have significant side effects and contribute to the development of antibiotic-resistant bacteria, posing long-term risks to public health. As a naturopathic doctor, I advocate for a holistic approach to healthcare that prioritizes natural interventions for acute illnesses whenever possible. I strongly encourage individuals to explore alternative remedies and work closely with qualified doctors like myself to address health concerns naturally before resorting to antibiotics. It's essential to preserve these invaluable medications for situations where their use is absolutely necessary or when the health threat posed by the infection is severe and immediate. By adopting a judicious approach to antibiotic usage, we can safeguard both individual health and the broader public health landscape for generations to come.


Avoiding Antibiotics in Food

In addition to medical use, antibiotics are widely used in agriculture to promote animal growth and prevent disease in livestock. However, the routine use of antibiotics in food production can contribute to the proliferation of antibiotic-resistant bacteria and pose risks to human health. To minimize exposure to antibiotics in food, choose organic and sustainably raised meat, poultry, and dairy products whenever possible. Additionally, prioritize locally sourced and ethically raised foods to support sustainable farming practices and reduce reliance on antibiotics in food production.

By adopting a cautious approach to antibiotic use and prioritizing immune support through nutrition and lifestyle interventions, individuals can promote optimal health while minimizing the risks associated with antibiotic exposure.


The antibiotics-eczema link underscores the intricate interplay between microbiome health, immune system development, and environmental exposures. While antibiotics are essential tools in combating bacterial infections, their widespread use has raised concerns about their potential impact on microbiome balance and immune function, contributing to conditions such as eczema. However, by adopting a comprehensive approach to health that prioritizes microbiome restoration, immune support, and judicious antibiotic use, individuals can take proactive steps towards promoting optimal well-being.


At Cleanbody, we specialize in addressing the root causes of conditions like eczema, including microbiome imbalances. If you're interested in exploring personalized strategies to restore your microbiome and support overall health, we're here to help. Learn more about working with us!



About the Author:



Dr. Diane Angela Fong, ND, is the CEO and founder of Cleanbody, a wellness company dedicated to treating and preventing chronic disease. She is the creator of the Cleanbody Method, which follows a three-step process: Evaluate (digging into the root causes of chronic disease using lab testing and other evaluation tools), Optimize (enhancing health foundations by addressing nutrition, lifestyle, and toxic exposures), and Support (optimizing organ functions through healing protocols).




References:

  • Tsakok T, McKeever TM, Yeo L, Flohr C. Does early life exposure to antibiotics increase the risk of eczema? A systematic review. Br J Dermatol. 2013 Nov;169(5):983-91. doi: 10.1111/bjd.12476. PMID: 23782060.

  • Wan M, Yang X. Maternal exposure to antibiotics and risk of atopic dermatitis in childhood: a systematic review and meta-analysis. Front Pediatr. 2023 May 15;11:1142069. doi: 10.3389/fped.2023.1142069. PMID: 37255572; PMCID: PMC10225666.

  • Chang Y-C, Wu M-C, Wu H-J, Liao P-L, Wei J-C. Prenatal and early-life antibiotic exposure and the risk of atopic dermatitis in children: A nationwide population-based cohort study. Pediatr Allergy Immunol. 2023; 34:e13959. doi:10.1111/pai.13959

  • Hua L, Chen Q, Liu QH, Guo YF, Cheng RH, Zhang J, Zhang JH, Wang LW, Ji RX. Interaction between antibiotic use and MS4A2 gene polymorphism on childhood eczema: a prospective birth cohort study. BMC Pediatr. 2021 Jul 14;21(1):314. doi: 10.1186/s12887-021-02786-x. PMID: 34261469; PMCID: PMC8278718.

  • Huang, FQ., Lu, CY., Wu, SP. et al. Maternal exposure to antibiotics increases the risk of infant eczema before one year of life: a meta-analysis of observational studies. World J Pediatr 16, 143–151 (2020). https://doi.org/10.1007/s12519-019-00301-y

  • Mubanga M, Lundholm C, D’Onofrio BM, Stratmann M, Hedman A, Almqvist C. Association of Early Life Exposure to Antibiotics With Risk of Atopic Dermatitis in Sweden. JAMA Netw Open. 2021;4(4):e215245. doi:10.1001/jamanetworkopen.2021.5245

  • Knoop KA, McDonald KG, Kulkarni DH, Newberry RD. Antibiotics promote inflammation through the translocation of native commensal colonic bacteria. Gut. 2016 Jul;65(7):1100-9. doi: 10.1136/gutjnl-2014-309059. Epub 2015 Jun 4. PMID: 26045138; PMCID: PMC4670297.

  • Schulfer A, Blaser MJ (2015) Risks of Antibiotic Exposures Early in Life on the Developing Microbiome. PLoS Pathog 11(7): e1004903. https://doi.org/10.1371/journal.ppat.1004903

  • Foolad N, Brezinski EA, Chase EP, Armstrong AW. Effect of nutrient supplementation on atopic dermatitis in children: a systematic review of probiotics, prebiotics, formula, and fatty acids. JAMA Dermatol. 2013 Mar;149(3):350-5. doi: 10.1001/jamadermatol.2013.1495. PMID: 23682371.



Medical Disclaimer: The information provided in this blog post is for educational and informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

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